Paroxetine Is an Effective Treatment for Hot Flashes: Results From a Prospective Randomized Clinical Trial

Abstract

Paroxetine is an effective treatment for hot flashes in women with or without a prior breast cancer.

Altering Metabolic Profiles of Drugs by Precision Deuteration: Reducing Mechanism-Based Inhibition of CYP2D6 by Paroxetine

“…Paroxetine (Paxil; GlaxoSmithKline, Research Triangle Park, NC) is a selective serotonin reuptake inhibitor currently indicated for major depressive, obsessive compulsive, panic, social anxiety, general anxiety, and posttraumatic stress disorders (Paxil, 2012). Paroxetine and other serotonin reuptake inhibitors also have proven effective in the treatment of vasomotor symptoms (e.g., hot flashes, night sweats) in women undergoing menopausal transition (Stearns et al, 2005;Deecher and Dorries, 2007) and in patients receiving antiestrogenic cancer therapy (Fisher et al, 1998;Bordeleau et al, 2007). Paroxetine undergoes significant first-pass metabolism (Kaye et al, 1989), catalyzed largely but not exclusively by CYP2D6 (Bloomer et al, 1992;Brosen et al, 1993).…”

Centrally active nonhormonal hot flash therapies

“…The placebo effect in this study was a 14% reduction in the 10-mg arm and a 28.5% reduction in the 20-mg arm for average hot flash scores. 9 The only statistically significant side effect between paroxetine and placebo was nausea associated with the 20-mg dose. The authors recommended that paroxetine 10 mg/day be used in practice, given the efficacy and toxicity information from this trial.…”

“…6,10 In addition, some of the clinical trials 8,13 largely included women who specifically did not have a history of breast cancer, demonstrating similar efficacy to that seen in patients with a history of breast cancer in other trials. 6,9,10,14 …”

“…A second double-blind placebocontrolled trial with a crossover design of immediate-release paroxetine 10 mg/day or 20 mg/day was reported. 9 This study enrolled 151 women, primarily breast cancer survivors, with 60% taking antiestrogen therapy (i.e., tamoxifen). Paroxetine was reported to reduce average hot flash frequency by 41% and average hot flash score by 46% at the 10-mg dose and by 52% (frequency) and 56% (score) at the 20-mg dose in the crossover analysis.…”

“…There are several centrally acting compounds that have been investigated as a means of alleviating hot flashes in women ( Table 1). [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Potential mechanisms for their efficacy have been described in detail. 15 The present article delineates the histories of several of these classes of agents in the order in which they were first investigated.…”