Antidepressants Found to Ease Hot Flashes

      Relatively small amounts of antidepressant drugs quickly eased the frequency and severity of hot flashes in some women with breast cancer, a researcher said Monday at the meeting of the American Society of Clinical Oncology.

      Breast cancer patients often complain of debilitating hot flashes from early menopause induced by chemotherapy.

      The apparent new use for antidepressants presumably will also benefit women suffering hot flashes during menopause and men who suffer hot flashes during hormonal therapy for prostate cancer, said the researcher, Dr. Charles L. Loprinzi of the Mayo Clinic in Rochester, Minn.

      Although hormones known as estrogens and progesterones can relieve hot flashes, many doctors shy away from prescribing them for women with breast cancer because of concerns that hormones may stimulate the growth of malignant tumors.

      Hot flashes can come as night sweats, be part of mood swings, and disrupt sleep and work.

      There are now three studies that show the benefit of antidepressants on hot flashes.

      Because the antidepressant drugs "so clearly work and are reasonably tolerated," they may offer an effective alternative for women who do not want to take hormones, Loprinzi said at the meeting. However, Loprinzi said, the antidepressants do not completely relieve hot flashes in every woman.

      The drugs were effective in smaller amounts than are used in treating depression, said Loprinzi, who has conducted two of the studies. They involved two common antidepressants, Prozac and Effexor, that are SSRIs, or selective serotonin-reuptake inhibitors.

      In March, researchers from Georgetown University reported a similar benefit in a third study among 27 women using Paxil, also an SSRI, said Loprinzi. In the pilot study from Georgetown in Washington, the women kept diaries of the frequency and severity of hot flashes while they took increasing amounts of Paxil for six weeks. The women also completed questionnaires. All women knew they were taking Paxil.

      The two studies with Prozac and Effexor were scientifically more rigorous because neither the women nor the doctors knew what drug the women were taking, Loprinzi said.

      The idea for this new use of antidepressants came from anecdotal observations among women who reported unexpected improvement in their hot flashes while they were taking the drugs to fight depression.

      Loprinzi reported on his study using Effexor on Monday. The study was the largest of the three, involving 229 women who were divided into four groups. The federally funded study began when all women kept a diary of their hot flashes for one week.

      Then the women took pills for four weeks. Three groups took different doses of Effexor - either the full dose, 150 milligrams, used in treating depression, the half dose, 75 milligrams, or the quarter dose, 37.5 milligrams. A fourth group received a placebo, or dummy pill.

      The half dose seemed to be the most effective and best tolerated in easing hot flashes, Loprinzi said. In this group, Effexor reduced hot flashes by 61 percent, compared with the number of hot flashes the women had before the study began.

      A small number of participants experienced nausea, dry mouth and a decreased appetite. None reported common side effects associated with use of the antidepressants, such as diminished libido, dizziness or nervousness, Loprinzi said.

      Precisely how the drugs ease hot flashes is not known, he said.