Paroxetine Controlled Release in the Treatment of Menopausal Hot Flashes

Abstract

OR MANY YEARS, HORMONE REplacement therapy (HRT) with combined estrogen/progestin has been the standard therapy for women experiencing menopausal symptoms. However, increased risks of long-term adverse clinical outcomes in a recent prospective study conducted by the Women's Health Initiative (WHI) on long-term HRT use, are likely to change clinical practice significantly. 1 The long-term benefits of HRT regimens have been called into question; thus, alternative treatments are needed. Hot flashes are the most common complaint among women entering menopause and, for many women, may continue to occur for up to 5 years (although about 20% of women may have them for up to 15 years). 2 Approximately 75% of perimenopausal women will experience some hot flashes, with 10% to 20% of those enduring severe symptoms. 3 Based on these figures, today more than 25 million women in the United States alone may have experienced symptoms, of which 4 million women reported severe symptoms. 4 Despite this prevalence, the physiology of hot flashes is not fully understood although a disturbance in normal thermoregulatory function is thought to be the main underlying cause. The pri

Risk for New Onset of Depression During the Menopausal Transition

“…The putative association of vasomotor symptoms and risk for depression in this subpopulation also underscores the importance of identifying safe and efficacious nonhormonal strategies for the treatment of symptomatic, perimenopausal women who are unable or unwilling to use estrogen preparations. [45][46][47][48] In the current study, we also noted a greater risk for developing depression among women who experienced major life events proximate to the inception of perimenopause, regardless of concurrent vasomotor symptoms. When we assessed the proportion of LES assessments that were antecedent, as opposed to subsequent, to the menopausal transition, we observed that a similar proportion reported negative (defined as Ն1 item) life events (72.6% and 77.5%, respectively).…”

Efficacy of Low-Dose Paroxetine for the Treatment of Hot Flushes in Surgical and Physiological Postmenopausal Women: Systematic Review and Meta-Analysis of Randomized Trials

“…Moreover, sporadic cases of dizziness and nausea were found. Concerning adverse effects, trials included in this quantitative analysis did not found any statistically significant differences between the two arms; women under paroxetine or under placebo experienced same adverse effects at similar frequencies [17,18,19,20,21]. Although nausea or dizziness or hypersomnia have been found clearly as main adverse events in reviews that involved paroxetine for major depressive syndromes, we did not find this evidence in our review.…”

Effect of escitalopram on insomnia symptoms and subjective sleep quality in healthy perimenopausal and postmenopausal women with hot flashes

“…We found no differences in the frequency of newly emergent adverse events of insomnia, fatigue, or drowsiness between escitalopram and placebo groups. In contrast, previous trials of paroxetine(31), citalopram(34), venlafaxine (a SNRI)(35) and desvenlafaxine (a SNRI)(36) in women with hot flashes reported that these adverse events were more common among women assigned to active treatment versus placebo, albeit not always at the level of significance. Differences in effects of specific SSRIs on self-reported sleep in women with hot flashes may be due to several reasons including differences in pharmacologic properties of specific drugs, study populations, choice of sleep outcome measures, and reporting of adverse events.…”