Venlafaxine versus clonidine for the treatment of hot flashes in breast cancer patients: a double-blind, randomized cross-over study

Buijs, Ciska; Mom, Constantijne H.; Willemse, Pax H.B.; Boezen, H. Marike; Maurer, J. M.; Wymenga, A.N.M.; Jong, R.S. de; Nieboer, Peter; Vries, Elisabeth G.E. de; Mourits, Marian J.E.

doi:10.1007/s10549-008-0138-7

Cited by 62 publications

(55 citation statements)

References 31 publications

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“…Venlafaxine and gabapentin do not interact with the CYP system, and are useful in the treatment of tamoxifen-induced flashes [38], but it is not known whether the use of these agents to prevent flushing improves adherence to the oral adjuvant therapy for breast cancer. It is known that about 30% of subjects with breast cancer given venlafaxine to counter hot flashes, discontinue venlafaxine treatment due to toxicity [39], and this may limit any improvement in adherence to the oral endocrine agents observed with venlafaxine.…”

Section: Interventions To Minimise Adverse Effectsmentioning

confidence: 99%

Adherence to oral endocrine treatments in women with breast cancer: can it be improved?

Doggrell

2011

Breast Cancer Res Treat

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There is a perception that women on oral endocrine treatments for oestrogen receptor-positive breast cancer will be adherent to these medicines, as they are facing a serious life-threatening disease, and the oral endocrine treatments are effective, easy to use and generally well tolerated. This is not in fact the case, and this is the basis of the first half of this review. The second half is of whether the changes/interventions to 'improve' adherence do actually increase adherence to the oral endocrine medicines. The review shows that better outcomes are achieved with good adherence to endocrine treatments in breast cancer. The rates of adherence to endocrine treatments range between 15 and 50%, and are influenced by a large number of factors (e.g. adverse effects, lack of belief in treatment, psychological problems and poor patient-health care provider relationship). Interventions to minimise the adverse effects have been used in an attempt to improve the adherence to the endocrine treatment therapies, but it is not known whether these do actually improve adherence. Similar, it has been assumed that interventions by health professionals (doctors, nurses and pharmacists) will improve the adherence, but this has not been tested. In conclusion, in women with breast cancer, we know there is a problem with adherence. There are also many approaches and suggestions about how to improve adherence to the oral endocrine treatments, but none of these approaches/suggestions have been scientifically tested, and they need to be.

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Section: Interventions To Minimise Adverse Effectsmentioning

confidence: 99%

Adherence to oral endocrine treatments in women with breast cancer: can it be improved?

Doggrell

2011

Breast Cancer Res Treat

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“…Data on hot flash score and frequency from Carpenter et al and Buijs et al were requested from the authors directly for analysis. Carpenter et al provided data that were incorporated into the primary analysis [23,24]. Data from Buijs et al were analyzed using data extracted from studies that used the same comparator in a sensitivity analysis (Supplementary Fig.…”

Section: Discussionmentioning

confidence: 99%

Venlafaxine in management of hot flashes in women with breast cancer: a systematic review and meta-analysis

Ramaswami

Villarreal

Pitta

et al. 2015

Breast Cancer Res Treat

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Toxicity due to treatment causes a negative impact on quality of life in breast cancer survivors. Hot flash symptoms, described as intense sensations of heat, sweating and flushing occur in more than 50 % of breast cancer patients taking tamoxifen. We hypothesized that venlafaxine, a selective-norepinephrine reuptake inhibitor drug, was effective for reducing patient-reported hot flash scores among women treated for breast cancer compared to other non-hormonal treatments. We searched Medline, Scopus, and Cochrane Central Register of Controlled Trials from inception till May 2015 for venlafaxine (75 mg once daily or greater) with non-hormonal comparators for the treatment of hot flashes in female breast cancer patients. The primary outcome was hot flash score (derived from patient-reported hot flash severity and frequency) in randomized controlled trials. Standardized mean differences (SMD) were calculated for each study due to variation in the outcome measures. Heterogeneity was determined using I (2) statistics, and publication bias was assessed using a contour funnel plot and Egger's tests. Pooled analyses demonstrated that venlafaxine significantly reduced hot flash scores compared to the trial comparators (overall SMD 2.06; 95% confidence interval (CI) [0.40, 3.72]). There was significant heterogeneity among these studies (I (2) = 98.7%, P < 0.001). Asymmetry in the contour funnel plot suggests the presence of publication bias and a trend towards small study effects (Egger's test, P = 0.096). Venlafaxine is efficacious in managing hot flashes among women with breast cancer. This review highlights methodological issues that arise from eligible trials and recommends a collaborative approach in survivorship studies.

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“…There have been three trials published comparing the antidepressant venlafaxine with clonidine (16,17,18). Buijs performed a crossover study of venlafaxine 75 mg vs clonidine 50 mg twice daily (one half of a 100 mg tablet).…”

Section: Comparative Trials Of Venlafaxine Vs Clonidinementioning

confidence: 99%

ENDOCRINE DILEMMA: Managing menopausal symptoms after breast cancer

Eden

2016

European Journal of Endocrinology

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Managing the symptoms of menopause after a diagnosis of breast cancer offers some unique clinical challenges. For some women, vasomotor symptoms can be severe and debilitating, and hormone therapy is at least relatively contraindicated. Non-oestrogen therapies for hot flushes include SSRIs, clonidine, gabapentin and perhaps black cohosh extracts. Vulvovaginal atrophy can usually be alleviated by simple moisturizers, although some may need specialized physiotherapy such as vaginal dilators. In a small number, topical oestrogens may be the only treatment that works. The CO 2 laser may be a novel, non-oestrogen therapy to alleviate this unpleasant symptom. Bone loss can be accelerated in some patients on AIs or those who had early menopause induced by chemotherapy.

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Venlafaxine versus clonidine for the treatment of hot flashes in breast cancer patients: a double-blind, randomized cross-over study

Abstract: Venlafaxine and clonidine are equally, but moderately effective in HF reduction. Side effects are the main reason for drug discontinuation, occurring more often with venlafaxine.

Cited by 62 publications

References 31 publications

Adherence to oral endocrine treatments in women with breast cancer: can it be improved?

Adherence to oral endocrine treatments in women with breast cancer: can it be improved?

Venlafaxine in management of hot flashes in women with breast cancer: a systematic review and meta-analysis

ENDOCRINE DILEMMA: Managing menopausal symptoms after breast cancer

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