Anti-depressants can ease hot flashes in cancer patients

From Rhonda Rowland
CNN Correspondent

May 23, 2000
Web posted at: 12:07 p.m. EDT (1607 GMT)

(CNN) -- Breast cancer patients who suffer from hot flashes may get relief from several types of anti-depressants, researchers at the American Society of Clinical Oncology conference in New Orleans said.

The drugs, known as SSRIs, include such well-known brands as Zoloft, Paxil and Prozac.

Hot flashes are a frequent side effect of breast cancer treatment. Chemotherapy can trigger premature menopause in women with the disease, and the anti-estrogen drug tamoxifen, commonly used to combat breast cancer, can also cause hot flashes.

That side effect can be disruptive and frustrating, said breast cancer patient Michelle Tennyson, who took part in a pilot study of Paxil. "You lose your concentration. Things that you try to accomplish, it's very difficult until the hot flash has subsided."

Although estrogen replacement therapy is a proven remedy for hot flashes, it can increase the risk of breast cancer.

"Patients don't want to take it and physicians don't want to give it, primarily because of concern of what estrogen will do to breast cancer," said Dr. Charles Loprinzi of the Mayo Clinic.

But the anti-depressants seemed to help.

"I started feeling the effects almost immediately," said Tennyson. "I would say (within) three, four days tops my hot flashes started lessening."

The drug showed other benefits, as well. "The women also reported improvement in depression scores -- and sleep. The sleep scores improved significantly, as well as quality of life," said Dr. Vered Stearns of Georgetown University's Lombardi Cancer Center.

In the largest study to date, researchers found that a similar drug, venlafaxine (marketed as Effexor), reduced hot flashes by 60 percent when taken in low dosages.

There were few negative side effects -- and an unanticipated positive one.

"Lo and behold, the libido was improved in all the women in the study whether they were on placebo or venlafaxine, and there was a tendency for an improvement more with women on the drug," Loprinzi said.

There's even evidence the anti-depressants can relieve hot flashes in men who have prostate cancer.

Although studies have been done primarily in women who have survived breast cancer, doctors believe healthy women concerned about getting the disease can also treat their hot flashes with anti-depressants.

A study last week reported some success combatting hot flashes in breast cancer patients with the blood pressure drug clonidine.

Antidepressants linked to sexual side effects
February 9, 2000
Breast cancer risk greater with estrogen/progestin combination, study reports
January 25, 2000
FDA approves Taxol to treat early-stage breast cancer
October 27, 1999
Alternatives to hormone replacement therapy for menopause
June 4, 1999
Hormone-replacement therapy and breast cancer
May 26, 1999

National Alliance of Breast Cancer Organizations
American Cancer Society
New York - Presbyterian Hospital Fact Sheet: Antidepressant Medicines

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