FRIDAY, March 15, 2002 (HealthDayNews) -- There's new hope for women who suffer from hot flashes and are concerned about taking estrogen.
A Mayo Clinic study has found that the antidepressant Prozac relieves hot flashes in women who've been treated for breast cancer or are considered at risk for the disease.
But the researchers also suspect that the drug could benefit all women struggling with hot flashes, not just those who've had breast cancer or may develop the disease.
The findings appear in today's issue of the Journal of Clinical Oncology.
Physicians have long had anecdotal evidence that antidepressants could help alleviate the abrupt changes in temperature experienced by women in menopause, and some doctors even prescribe the drugs for that purpose. The clinical data, though, is just starting to trickle in.
"This study adds some weight to the anecdotal experiences that people have had with using antidepressants for the treatment of hot flashes," says Dr. Allan Klapper, director of gynecology and urogynecology at Beth Israel Medical Center in New York City.
"The only concern that I have is, how good is it compared to estrogen and how good are the different types of antidepressants compared to each other? I don't think we really know that yet," he adds.
Hot flashes, which are sudden fluctuations in the area of the brain that controls temperature, are the most common symptom of menopause. The main treatment is some kind of hormone-replacement therapy, including estrogen, doctors say.
"Estrogen is the best treatment for hot flashes across the board," Klapper says. "You don't have great options beyond estrogen."
But many women are reluctant to use estrogen because of concern that it might lead to the growth of breast cancer cells.
The problem is particularly acute for women who've been treated for breast cancer, because chemotherapy can trigger the onset of menopause and, therefore, hot flashes. And tamoxifen, a drug that acts by blocking estrogen in estrogen receptor-positive cancer cells, can also cause hot flashes, health experts say.
"We would like a non-hormonal way of alleviating the hot flashes," says Dr. Charles Loprinzi, lead author of the study and chairman of medical oncology at the Mayo Clinic in Rochester, Minn.
Other trials have started looking at other antidepressants, including venlafaxine, which has been reported to reduce hot flashes by 50 percent. Effexor also appears to reduce symptoms.
The Mayo Clinic study looked at 81 women who'd been treated for breast cancer or who were at greater risk for the disease. None of the women had cancer at the time of the study, and all had to have experienced at least 14 hot flashes a week for at least a month before entering the study. On average, the participants experienced seven hot flashes a day, though one woman reported 20 a day.
The women were randomly placed into two groups, one receiving fluoxetine (the generic name for Prozac), and the other a placebo. They were all instructed to record the frequency and severity of their hot flashes in a daily diary.
The women who took Prozac reported a 50 percent decrease in the frequency and severity of their hot flashes. Women in the placebo group had only a 36 percent decrease in symptoms.
While this study looked specifically at women who had had or were worried they might develop breast cancer, the results could apply to many more women.
"The effect of this thing is on hot flashes and has nothing to do with breast cancer," Loprinzi says. "Most of the women were cured of breast cancer."
The exact mechanism by which Prozac alleviates symptoms remains unknown.
New studies are getting under way that will look at dosing and the relative efficacies of different antidepressants.
What To Do
The North American Menopause Society has information on all aspects of menopause, including hot flashes and treatment options, in its Menopause Guidebook.
Menopause Online has a fact sheet on estrogen.
Prozac is already being used to treat premenstrual syndrome under the brand name Sarafem. For more information on these two drugs, click on Sarafem or Prozac.
