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Drugs for depression reduce hot flashes

Relatively small amounts of antidepressant drugs quickly eased the frequency and severity of hot flashes in some women with breast cancer, a researcher said Monday at the meeting of the American Society of Clinical Oncology.

Breast cancer patients often complain of debilitating hot flashes from early menopause induced by chemotherapy.

The apparent new use for antidepressants presumably will also benefit women suffering hot flashes during menopause and men who suffer hot flashes during hormonal therapy for prostate cancer, said the researcher, Dr. Charles L. Loprinzi of the Mayo Clinic in Rochester, Minn.

Although hormones known as estrogens and progesterones can relieve hot flashes, many doctors shy away from prescribing them for women with breast cancer because hormones may stimulate the growth of malignant tumors.

Hot flashes can come as night sweats, be part of mood swings and disrupt sleep and work.

There are now three studies that show the benefit of antidepressants on hot flashes.

Because the antidepressant drugs "so clearly work and are reasonably tolerated," they may offer an effective alternative for women who do not want to take hormones, Loprinzi said. However, Loprinzi added that the antidepressants do not completely relieve hot flashes in every woman.

The drugs were effective in smaller amounts than are used in treating depression, said Loprinzi, who has conducted two of the studies. They involved two common antidepressants, Prozac and Effexor, that are selective serotonin-reuptake inhibitors.

In March, researchers from Georgetown University reported a similar benefit in a third study among 27 women using Paxil. In the pilot study from Georgetown in Washington, the women kept diaries of the frequency and severity of hot flashes while they took increasing amounts of Paxil for six weeks. The women also completed questionnaires. All women knew they were taking Paxil.

The two studies with Prozac and Effexor were scientifically more rigorous because neither the women nor the doctors knew what drug the women were taking, Loprinzi said.

The idea for this new use of antidepressants came from anecdotal observations among women who reported unexpected improvement in their hot flashes while they were taking the drugs to fight depression.

The study reported Monday was the largest of the three, involving 229 women who were divided into four groups, Loprinzi said.

Precisely how the drugs ease hot flashes is not known, he said.

Loprinzi said researchers elsewhere are conducting a fourth study involving the antidepressant Zoloft.