Two studies suggest that a low dose of Paxil (chemical name: paroxetine; another brand name is Pexeva), an antidepressant medicine, can lower the number and severity of hot flashes in some women.
The research was presented at a meeting of the North American Menopause Society on Oct. 4, 2012.
It’s not clear whether any of the 568 women in the first study had been diagnosed with breast cancer. The women were age 40 or older and were having about seven to eight hot flashes per day (about 50 to 60 per week).
The study lasted for 24 weeks. Half the women got a low dose (7.5 mg.) of Paxil and the other half got a placebo (sugar pill). Paxil is a pill taken by mouth.
The women kept track of the number and severity of each hot flash they had during the study. At 12 weeks and again at 24 weeks, the researchers compared the number and severity of hot flashes in each group (women who got Paxil versus women who got placebo).
At 12 weeks, hot flashes were less frequent in both groups, but were reduced more in the women who got Paxil. Compared to the number at the study’s start, the average number of hot flashes per week dropped about 49% in women who got Paxil. The average number dropped about 38% in women who got the placebo.
The severity of the hot flashes also eased somewhat in both groups of women, but eased more in women who got Paxil.
At 24 weeks, 48% of the women who got Paxil had a 50% or higher reduction in hot flashes compared to 36% of the women who got the placebo.
The second study was very similar to the first (the women were having the same number of hot flashes and were randomly selected to receive the same dose of Paxil or placebo), but lasted only 12 weeks.
At 4 weeks, hot flashes again were less frequent in both groups, but were more reduced in women who got Paxil. Compared to the number at the study’s start, the average number of hot flashes per week dropped about 43% in women who got Paxil. The average number dropped about 31% in women who got the placebo. At 12 weeks, hot flashes were reduced by about 58% in women who got Paxil and 49% in women who got the placebo.
The researchers in both studies used the 7.5 mg dose of Paxil (considered low-dose) because side effects are more likely with higher doses of Paxil. None of the women in the study had serious side effects, though some women in the first study did have:
- nausea (5%)
- bronchitis (3%)
In the second study, the most common side effects were dizziness and fatigue.
Some experts believe these results suggest that Paxil could ease hot flashes from menopause in some women. Still, other experts say that the benefits of Paxil are small and that even the women who got the placebo had less frequent and less severe hot flashes during the study.
Hot flashes are a known side effect of hormonal therapy medicines used to treat breast cancer. For some women, hot flashes can affect quality of life so much that they’re considering medicine to ease them.
Hormone replacement therapy (HRT) is one option. Still, there is strong evidence that HRT can substantially increase a woman’s breast cancer risk and can increase the risk of breast cancer recurrence (the cancer coming back) or growing in women already diagnosed with breast cancer. This is why women who’ve been diagnosed shouldn’t take HRT.
Research has suggested that other antidepressants can help ease hot flashes, including:
- SSRIs (serotonin-specific reuptake inhibitors)
- Prozac (chemical name: fluoxetine)
- Lexapro (chemical name: escitalopram)
- Celexa (chemical name: citalopram)
- SNRIs (serotonin-norepinephrine reuptake inhibitors)
- Effexor (chemical name: venlafaxine)
Some of these antidepressants may cause problems for women taking tamoxifen. An enzyme called CYP2D6 helps tamoxifen work in the body. Some research has shown that women with an abnormal gene that blocks their bodies’ ability to produce CYP2D6 don’t get the same benefits from tamoxifen as women who produce CYP2D6. Other research has shown that some medicines – including the antidepressants Paxil and Prozac – can interfere with how CYP2D6 works and might reduce tamoxifen’s effectiveness against breast cancer. Still, the subject is controversial and not all experts agree that a lack of CYP2D6 or taking an antidepressant reduces tamoxifen’s effectiveness.
If you’re a postmenopausal woman having troublesome hot flashes because of breast cancer treatment, you might want to ask your doctor about hot flash treatment options and if a medicine such as Paxil makes sense for you. There are other nonprescription techniques you can try to help avoid and ease hot flashes. Visit the Breastcancer.org All About Hot Flashes page to learn more about hot flashes and how to manage them.
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