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Prozac (Fluoxetine) Effective for Hot Flashes Post-Breast Cancer Treatment

ROCHESTER, MN -- March 15, 2002 -- A Mayo Clinic study indicates that ProzacŪ (fluoxetine) can safely and significantly relieve hot flashes in women who have been treated for breast cancer.

In this eight-week study, women experienced a 50 percent decrease in the frequency and severity of hot flashes while taking Prozac for the first four weeks of the study. Women randomized to receive a placebo during the first four weeks noted a 36 percent decrease in their hot flashes. Both groups of women were switched to the alternative substance (placebo or Prozac) during the second four-week study period.

The findings of this study are published in the March 15 issue of the Journal of Clinical Oncology.

"Our findings provide proof of principle that some of the newer antidepressants can relieve hot flashes," says Charles Loprinzi, MD, a Mayo Clinic medical oncologist and lead researcher on the study. Previous Mayo Clinic research found that Effexor, also one of the newer antidepressants, alleviated hot flashes.

"The encouraging news for women, particularly those who have had breast cancer and for whom estrogen may not be recommended, is that they have another effective alternative treatment for controlling their hot flashes," says Dr. Loprinzi.

Hot flashes affect most postmenopausal women. In women without breast cancer, hormone replacement therapy involving estrogen is the typical treatment for relief.

That is not the case for women who have had breast cancer. Frequently, the chemotherapy used to treat the breast cancer causes the women to go into early menopause and experience severe hot flashes. Because of the concern that estrogen may lead to the growth of breast cancer cells, these women are often denied estrogen for hot flashes.

The newer antidepressants, which include Prozac and Effexor (venlafaxine HCl), offer more hope for non-hormonal management of hot flashes. These antidepressants work to control various neurotransmitters in the brain. Some of those neurotransmitters are thought to be associated with hot flashes.

This latest study included 81 women who had been treated for breast cancer or were at higher risk for the cancer. These women had, on average, seven hot flashes per day (with the most affected women reporting 20 hot flashes per day) when they started the study.

The study used a double-blinded, randomized, cross-over methodology to measure the effectiveness of Prozac compared to placebo. The women kept a daily diary to record the frequency and severity of their hot flashes.

While the findings indicate that Prozac, as well as Effexor, provide a viable treatment option for hot flashes, Dr. Loprinzi notes that one of the next steps in the research process is to compare and contrast the newer antidepressants for their effectiveness in relieving hot flashes and to measure their side effects. It is likely that some of them will be better than others.

SOURCE: Mayo Clinic

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