fluvoxamine and Hot-Flashes

To examine whether low-dose and short-term estrogen-replacement therapy (ERT) plus selective serotonin re-uptake inhibitor (SSRI) treatment is effective or not in the treatment of climacteric disorders, hot flashes and depressive symptoms, in oophorectomized women.. Forty-two oophorectomized women with hot flashes and depressive symptoms were assigned randomly to two groups. We examined the efficacy rates of climacteric disorders, particularly hot flashes and depressive symptoms in 21 women on low-dose ERT (conjugated equine estrogens [CEE] 0.3125 mg/day) and 21 women on low-dose ERT (CEE 0.3125 mg/day) plus SSRI (fluvoxamine 50 mg/day) treated for 8 weeks. We used questionnaires to evaluate the efficacy for depression, namely the Self-rating Depression Scale (SDS) and the Self-rating Questionnaire for Depression (SRQ-D), and for anxiety with the State-Trait Anxiety Inventory (STAI). In the statistical analysis, in the mixed-effect model, for the score against time and adjusted with age, treatment and treatment as the fixed effects.. The average scores on the SDS in both groups were decreased by the treatment (P < 0.001). But the efficacy of the ERT + SSRI group in the time x treatment SDS and SRQ-D scores was significantly higher compared with those of ERT (P = 0.0025, 0.0162) and there was a significant difference in the decrease in the frequency of hot flashes by 8 weeks between the two groups (P = 0.036).. A combination of low-dose and short-term ERT + SSRI is more effective than low-dose estrogen alone in relieving the depressive symptoms and hot flashes of oophorectomized women.

Topics: Adult; Depression; Drug Therapy, Combination; Estrogen Replacement Therapy; Female; Fluvoxamine; Hot Flashes; Humans; Middle Aged; Ovariectomy; Selective Serotonin Reuptake Inhibitors; Treatment Outcome

Hot flushes are one of the most frequent symptoms in menopausal women. Selective serotonin reuptake inhibitors (SSRIs) are considered to be first-line therapy for the treatment of hot flushes in women for whom hormone therapy is contraindicated. Recently, we have proposed forced exercise-induced flushing of tail skin in ovariectomized mice as a new experimental model of temperature dysregulation in menopausal hot flushes. In the present study, to validate this animal model as a tool for testing potential compounds for the treatment of menopausal hot flushes, we examined the effects of two SSRIs (fluvoxamine and paroxetine) on forced exercise-induced flushing of tail skin in ovariectomized mice, and compared it with that of estradiol replacement (1 mg/kg/week for 3 weeks, i.m.). Treatment with fluvoxamine (20 mg/kg, i.p.) or paroxetine (10 mg/kg, i.p.) completely inhibited forced exercise-induced flushing of tail skin in ovariectomized mice, and the effect of each was comparable to that of estradiol replacement. It is believed that the present findings provide the first experimental evidence to support the anti-flushing effects of SSRIs, such as fluvoxamine and paroxetine, in a clinical setting. An animal model with forced exercise probably serves as a useful experimental tool for evaluating the effects of different agents on hot flushes.

Topics: Animals; Dose-Response Relationship, Drug; Estradiol; Estrogens; Female; Fluvoxamine; Hot Flashes; Humans; Menopause; Mice; Mice, Inbred ICR; Models, Animal; Ovariectomy; Paroxetine; Physical Conditioning, Animal; Selective Serotonin Reuptake Inhibitors; Skin Temperature; Tail

We surveyed patients with prostate cancer treated with androgen deprivation therapy to examine the influence of hot flashes on quality of life (QOL).. Fifty-five outpatients with prostate cancer (M0, 39; M1, 16) treated with androgen deprivation therapy (castration, 15; castration and antiandrogen, 40) were enrolled in this study. Mean duration of androgen deprivation therapy was 21 months (2-91 months). The patients were still being treated with androgen deprivation therapy at the time of the survey. The functional assessment of cancer therapy (FACT) was used as a QOL questionnaire for outpatients with prostate cancer treated with androgen deprivation therapy. Hot flash assessments were used to document the number and severity (mild, moderate, and severe) of daily hot flashes. The patients prescribed fluvoxamine maleate were reassessed for hot flashes 2 weeks after the prescription.. Thirty-two of the 55 patients (58.2%) suffered from hot flashes. Hot flashes deteriorated the physical well-being subscale of QOL in patients with prostate cancer treated with androgen deprivation therapy (P = 0.043). There was a significant relationship between the desire to be treated for hot flashes and the hot flash assessments (P = 0.038). Fluvoxamine maleate was significantly effective in reducing hot flashes (P = 0.001).. Hot flashes had adverse effects on the patients' physical status and deteriorated the patients' QOL. New treatment options such as fluvoxamine maleate might help simplify the often difficult management of hot flashes in patients with prostate cancer treated with androgen deprivation therapy.

Topics: Aged; Androgen Antagonists; Fluvoxamine; Hot Flashes; Humans; Male; Middle Aged; Prostatic Neoplasms; Quality of Life; Surveys and Questionnaires