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| |  DG DISPATCH - BREAST CANCER: Prozac Treats Hot Flashes By Robert Carlson Special to DG News SAN ANTONIO, TX -- December 15, 1999 -- The popular anti-depressant Prozac reduced the incidence of hot flashes, experienced by women following their therapy for breast cancer, by more than 50 percent, according to a study at the Mayo Clinic.
Hot flashes are a significant problem for some breast-cancer survivors who have gone through menopause due to their treatments, but the standard hormonal treatments for menopausal symptoms are not recommended. The study included 34 women, the majority over age 50, reported Charles L. Loprinzi, MD, Professor, Division of Medical Oncology, Mayo Clinic, Rochester, MN. Women were recruited for the trial if they had more than two bothersome hot flashes per day, for at least a month, and if they were severe enough that the women wanted to be treated. The women had no current evidence of breast cancer, had never used Prozac before, had not used another antidepressant in at least two years and were not taking any other therapy for hot flashes. About half were taking Tamoxifen. The average duration of hot flashes for the women had been nine months. Half of the 34 women had an average daily frequency of between four and nine episodes, while almost half were experiencing more than 10 per day. Two women reported having only two or three episodes per day before the trial began. The women began the trial by keeping a diary for one week, noting the frequency of hot flashes and scoring them from mild to very severe. The women were then randomly assigned to one of two groups, to take Prozac 20 mg per day, or to take a placebo (dummy) pill. After four weeks, the women were switched from one treatment to the other. The trial was "double blinded," meaning neither the women nor clinic personnel knew which pill was being taken at any point during the trial. The women rated their symptoms by frequency and intensity. Those taking Prozac reported that the frequency of hot flashes was decreased by 54 percent, and the severity decreased by 61 percent. While taking the placebo, the women reported reduction infrequency by 21 percent, and reduction in severity scores by 26 percent. Dr. Loprinzi noted that the placebo effect was significant in this study, at almost 20 percent, compared to the effect of Prozac at just above 50 percent. But the Prozac effect was verified when the group who took Prozac for the first four weeks were switched to placebo and saw their hot flashes return. Similarly, when women who first took placebo for four weeks were switched from placebo to Prozac, their hot flashes decreased. In a survey taken by 15 of the women after the trial was over, while they were still "blinded" to their treatment schedule, eight said they preferred the Prozac treatment, three preferred the placebo and four did not have a preference. Dr. Loprinzi mentioned other treatments that have been tested for hot flashes in breast-cancer survivors. Vitamin E and soy were rated as approximately the same as placebo, he said, while the hormonal treatment megesterol acetate produced at reduction of 75 to 80 percent. An ongoing trial of 220 women testing the anti-depressant venlafaxine found it reduced hot flashes by at least 50 percent, while a trial of the anti-depressant Paxil -- last year -- also found it to be effective.
Related Link: Prozac.
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