Hot Flashes - Anyone on Celexa?
My Oncologist is taking me off of Lyrica because it is no longer helping with the Hot Flashes. Anyone have experience with Celexa? My hot flashes are worse, they come wave after wave, I know we go through this, but really do we want to? NOOO! Sorry, I am just looking for input!
Mary
Comments
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Treatment of Hot Flashes
It is interesting that your oncologist prescribed Lyrica and then Celexa for the treatment of hot flashes as neither were approved by the FDA for that purpose. Perhaps this is an "off-label" use? The North American Menopause Society (who knew there was such an organization?) has published the following information on prescription drug treatment of hot flashes. I hope you find it useful.
Prescription therapies
The following prescription medications reduce hot flashes more than placebos in scientific studies. They
may be a good option if you have frequent, bothersome hot flashes. Every medication has risks and side
effects. Review your medical history with your healthcare provider when considering a prescription
medication.
Hormonal options:
• Prescription hormone therapy with estrogen is the most effective treatment for hot flashes and the
only government-approved treatment. Although using hormones can increase your risk of breast
cancer and cardiovascular disease, studies show that benefits may outweigh risks for healthy
women under age 60 with moderate to severe hot flashes. The goal is to use the lowest dose of
hormone therapy that treats your symptoms for the shortest time necessary. Women with a uterus
need to combine estrogen with a progestogen.
• If it has not been a full year since your last period and you are a healthy nonsmoker, you may
consider a combination estrogen-progestin birth control pill. This will provide contraception, hot flash
relief, and regular periods.
Nonhormonal options:
You also may consider the following nonhormonal medications. They are more effective than placebos in
scientific studies, though not as effective as hormone therapy. They are not government-approved for
treating hot flashes.
• Certain drugs approved to treat depression reduce hot flashes in women without depression.
Effective drugs include paroxetine (Paxil), venlafaxine (Effexor), and escitalopram (Lexapro). **You
should not take paroxetine if you take tamoxifen for breast cancer. **
• Gabapentin (Neurontin) is a drug approved to treat epilepsy, migraine, and nerve pain, but it also
reduces hot flashes. It can cause excessive sleepiness, so it is an especially good option if you have
bothersome night sweats and take your gabapentin at bedtime.
• Sleeping medications will not reduce your hot flashes but may help you sleep through them.
Available both by prescription and nonprescription (such as Ambien, Lunesta, and Benadryl).
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Cymbalta is ok if it helps
Cymbalta is ok if it helps and you are not on tamoxifen. Here is some info about antidepressants used for hot flashes (which are often very helpful in breast cancer patients with an estrogen receptor positive tumor):
"Relieving hot flashes with medications
If you have tried these lifestyle, nutritional, and alternative medicine recommendations, and they have not helped, you may feel compelled to go on to stronger remedies, available only through your physician.
Blood pressure-lowering medication
Blood pressure-lowering medications such as clonidine (Catapres-TTS, 0.1–mg patch applied once weekly) and Aldomet (250 mg twice daily) can lessen the severity and frequency of hot flashes. They modify how the blood vessels respond to the brain's command to give off heat quickly. These drugs must be prescribed and adjusted carefully by your doctor.
Antidepressants
Low-dose antidepressant medication may help forestall a hot flash by rebalancing or intercepting the chemicals in the brain that transmit the hot flash alarm, epinephrine and serotonin.
Effexor (venlafaxine) can reduce hot flashes by about 50% in nearly 60% of women with breast cancer according to a study done by Dr. Charles Loprinzi at the Mayo Clinic. Improvement happened relatively quickly: 80% of the eventual decrease in hot flashes occurred within the first week of taking the medication. Side effects, when they were noted, were mild. The dose used was 12.5 milligrams taken twice daily.
A more recent study showed that some women may need a higher total dose of 75 milligrams daily to get significant relief. Extended-release preparations are available. Paxil (paroxetine) works in a similar way to Effexor and is a good alternative. Some women tolerate Paxil better. Its recommended dose is 10 mg once a day for the first week, then 20 mg once a day thereafter.
If you are taking tamoxifen, talk to your doctor about which antidepressants are safe for you to take to manage hot flashes. Some antidepressants — including Paxil, Wellbutrin (chemical name: bupropion), Prozac (chemical name: fluoxetine), Cymbalta (chemical name: duloxetine), and Zoloft (chemical name: sertraline) — interfere with the body's ability to convert tamoxifen into its active form, preventing you from getting the full benefit of tamoxifen. For more information, please visit the Tamoxifen page." http://www.breastcancer.org/tips/menopausal/facing/hot_flashes
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Hot flashes
Unfortunately, I am on tamoxifen for another year, or longer. I was on lyrica, which stopped working. He is having me try celesta, I am almost 54, and pre menopausal. The flashes have intensified so much, that I don't sleep much at all.
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There is a supplement called
There is a supplement called Evening Primrose Oil. It helps some with hot flashes and is safe with Tamoxifen. Like anything, it helps some, but not others.
There is a supplement called Black Cohosh, but it is not recommended for people with estrogen positive bc. I was estrogen, but my onocologist said I could take it because I had DCIS and since I had a double mastectomy, the ducts and cancer were "gone."
Like anything we suggest, make sure you discuss it with your doctors/oncologist.
Oh...and Walmart sells a little personal fan you can wear around your neck. Brian bought me one last year the year before. If they still sell them, it was in the camping section. I wear it a lot, especially since the prednisone make my hot flashes worse.
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