ROCHESTER, MinnPreliminary results from an ongoing Mayo Clinic
study show that fluoxetine (Prozac) reduced the incidence of hot
flashes in breast cancer survivors by more than 50%, Charles L.
Loprinzi, MD, said at the San Antonio Breast Cancer Symposium.
Eligible patients had more than two hot flashes a day on average, for
more than 1 month. The flashes were significant enough that the women
desired intervention but had concerns about use of hormone therapy.
Dr. Loprinzi reported on 33 patients.
After a 1-week baseline evaluation, patients received 20 mg/d of
fluoxetine or placebo in a double-blind manner for 4 weeks. Then,
while still double-blinded, patients were crossed over to the
alternative treatment. Hot flashes were scored as 1 (mild), 2
(moderate), 3 (severe), or 4 (very severe). Total daily points were
added to get the daily hot flash score.
During the initial 4 weeks of therapy, the fluoxetine group
experienced about a 50% reduction in hot flashes, Dr. Loprinzi
said, while the placebo arm had approximately a 20% reduction
in hot flashes. When crossed over from fluoxetine to placebo, the hot
flashes came back. When crossed over from placebo to fluoxetine, the
hot flashes decreased.
In the 4th treatment week, about 19% of the placebo patients had a
major reduction of hot flashes to half or less of their baseline
score. About 53% of the fluoxetine patients had a similar dramatic
reduction. This is an interesting placebo effect that we need
to think about when giving other agents, he said. He noted that
the P values associated with these results are hovering around