TAMPA, FlaAnecdotal reports suggest that the selective
serotonin-reuptake inhibitors (SSRIs) commonly prescribed for
depression might be efficacious in alleviating hot flashes in breast
cancer survivors without the risks associated with hormonal
therapies. Vered Stearns, MD, of the Lombardi Cancer Center,
Georgetown University Medical Center, discussed her research at the
American Cancer Societys 42nd Annual Science Writers Seminar.
Dr. Stearns was the lead investigator of a study that tested the
effectiveness of the SSRI paroxetine (Paxil) in the treatment of hot
flashes. We enrolled 30 women with prior breast cancer who were
suffering at least two hot flashes a day in a single-institution
pilot trial. Our endpoint was to determine paroxetines efficacy
in reducing the frequency and severity of the episodes, Dr.
After completing daily diaries for 1 week on no therapy, the women
received open-label paroxetine 10 mg for 1 week, followed by 4 weeks
of paroxetine 20 mg daily. The women completed hot-flash daily
diaries throughout the study, and a health-related symptom-assessment
questionnaire and quality-of-life rating scale in the first and sixth
weeks, she said.
Of the original 30 women, 27 completed the 6-week study. The mean
reduction in hot flash frequency was 67%, and the mean reduction in
severity was 75%. There was also a statistically significant
improvement in depression, sleep, anxiety, and quality-of-life scores.
The most common adverse effect was somnolence, which resulted in
discontinuation in two women and dose reduction in two women, Dr.
Our studies indicate that the relative benefits achieved with
paroxetine clearly, in most instances, outweigh the negative side
effects, including varying degrees of drowsiness. Its clear
that paroxetine has an important role to play in assuaging the
debilitating effects of hot flashes, she said. The study was
recently published in the Annals of Oncology (11:1-6: 2000).
Dr. Stearns is currently conducting a prospective, randomized,
placebo-controlled clinical trial to further determine the
effectiveness of paroxetine in reducing hot flashes. She pointed out
that pilot studies of other SSRIs in breast cancer survivors and in
men on androgen blockade have shown promising results. Further
studies investigating the mechanism of action of SSRIs in controlling
hot flashes are necessary, she concluded.