Considering Venlafaxine as Distress Treatment in Breast Cancer

During or after breast cancer therapy, adverse effects like anxiety, depression, or vasomotor symptoms may arise. Vasomotor symptoms, like hot flashes, can particularly disrupt a patient’s quality of life.

During the 2026 American Psychosocial Oncology Society Annual Meeting, CancerNetwork® spoke with Jonathan Kaplan, MD, and Amber Altidor, NP, regarding the use of venlafaxine (Effexor) for patients experiencing distress during their breast cancer treatment. Of the 67 patients who were prescribed venlafaxine, the response rate was 77.6% (OR, 2.46; 95% CI, 1.23-5.09) compared with 58.5% (OR, 1.00) in 94 patients who were not prescribed.

Kaplan, an assistant professor in the Department of Psychiatry and Behavioral Sciences, and Altidor, a psychiatric nurse practitioner from Rush University, highlighted the impact that vasomotor symptoms can have on patients, and why using venlafaxine can help to mitigate some of these responses.

Transcript:

Kaplan: Any person experiencing cancer is going to be at a greater risk than the general population for mood disorders, anxiety disorders, and severe distress just by nature of what it is to receive a diagnosis and go through intense cancer treatments, which often involve surgery, radiation, and chemotherapy. For women with breast cancer, or sometimes men with breast cancer, you’re talking about additional hormonal therapies for years beyond that initial, intense treatment period. Each of those phases represents an opportunity for distress, and [I] give these patients a lot of credit; they go through a lot.

What was unique in this population, too, is there’s some relationship and association between the use of various hormonal therapies and the potential for various [adverse] effects, with vasomotor symptoms being one, which are those hot flashes and sweats that come on suddenly. For some [patients], it’s very mild, but for some [patients], it’s intense. We’re talking 20, 30, or 40 times a day. It can be debilitating. It can disrupt their sleep, their quality of life. Additionally, and this is not necessarily clear in the literature, some studies would suggest that rates of anxiety and depression are similar to placebo for patients taking hormonal therapy. Then, some other studies would suggest, particularly those reported by patients, that those symptoms were more prominent after the start of that treatment. These patients are particularly vulnerable to distress from [adverse] effects, treatments themselves, and the distress of what it is to live with cancer as a chronic disease or perhaps trying to prevent the recurrence. Those hormonal shifts also represent a risk factor for mood changes and anxiety symptoms that can arise.

Altidor: I think he covered it very well. It continues to be a medication that we consider just because venlafaxine can improve the vasomotor symptoms, [like the] hot flashes that he was just describing and those night sweats that can be disruptive to our patients’ quality of life. Then, having the benefits of treating anxiety and depression, it continues to be a medication that we often think of.

Reference

Kaplan J, Smith A, Venkataramanan A, et al. Pharmacotherapy for treatment of distress in breast cancer patients: harnessing venlafaxine for depression, anxiety, and vasomotor symptoms. Presented at the 2026 American Psychosocial Oncology Society Annual Meeting; New Orleans, LA; March 18-20, 2026. Poster 83.