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Antidepressant Helps With Hot Flashes in Breast Cancer Survivors (dateline April 3, 2000)

Paxil (generic name, paroxetine), an antidepressant, helps reduce the frequency and severity of hot flashes in women who have had breast cancer according to a study presented at the American Cancer Society’s 42nd annual Science Writers Seminar. Over 55% of breast cancer survivors experience sudden rises in body temperature that cause them to break out into sweats. Post-menopausal women who suffer from hot flashes are often prescribed hormone replacement therapy , but many breast cancer survivors are advised not to take estrogen or progestin because their physicians believe the hormones may cause breast cancer to return ( recur).  

In the study, 30 breast cancer survivors who experienced a minimum of two hot flashes a day took 10 milligrams of Paxil daily for one week, no treatment for another week, and 20 milligrams of Paxil daily for four weeks. According to researchers, 67% of the patients experienced fewer side effects and 75% said their hot flashes were less severe while on Paxil. Vered Stearns, MD of the Lombardi Cancer Center in Georgetown says women will usually be able to tell if Paxil is working against their hot flashes within the first month of treatment. Women in the study also saw an improvement with depression, anxiety, and sleep.

A larger clinical trial is set to begin that will compare the effectiveness of Paxil to a placebo (an inactive pill). The trial will include breast cancer survivors and other women who experience hot flashes but have not had breast cancer. Preliminary results from other studies suggest that other antidepressants such as Prozac and Effexor may also help with hot flashes.

Breast cancer patients often experience hot flashes during treatment, especially if they use the drug tamoxifen. Often, hot flashes and other side effects lessen within six to 12 months after treatment is completed and disappear within two to six years. However, many women experience hot flashes for many years after treatment has ended. Certain breast cancer treatments, such as chemotherapy, have also been known to cause early menopause in younger women, contributing to an increase in hot flashes.

In the study, the most common side effect of Paxil was drowsiness. Other side effects reported were dry mouth and nausea. Two women in the study stopped taking Paxil due to the side effects while a third woman stopped because of increased anxiety. Researchers are unsure exactly how Paxil treats hot flashes, though they believe the drug raises serotonin levels in the brain. Low levels of the chemical messenger serotonin can affect the body’s ability to regulate its own temperature.

William Wood, MD, director of the oncology clinical research program at Emory University School of Medicine in Atlanta, Georgia says that researchers are unsure whether Paxil has a direct effect on hot flashes. Some researches believe hot flashes could be psychologically induced. Younger women who experience early menopause from breast cancer treatment often experience a higher frequency of hot flashes than menopausal women, suggesting that the stress of early menopause causes hot flashes. One theory about the results of the Paxil study is that Paxil decreased anxiety and depression in the patients, consequently lessening hot flashes.

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