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Effexor effective for hot flashes in patients with breast cancer

CypressCynthia's picture
Posts: 4014
Joined: Oct 2009

Just FYI. The study below was published in OcologyStat, Nov 8, 2010. Not a huge study, but effexor might be an option for those with the hot flashes issue.

Also, FYI, Venlafaxine=Effexor and Gabapentin=Neurontin

"Based on patient preference data, venlafaxine is a preferred and efficacious drug in the treatment of hot flashes in survivors of breast cancer and can be considered a first-line agent over gabapentin.

Hot flashes are a common problem in breast cancer survivors. Although hormones are effective in the treatment of hot flashes, their safety has not been established in patients with breast cancer. Previous randomized trials have shown that gabapentin and combination selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs) agents such as venlafaxine are effective in reducing hot flashes. Although the effectiveness of gabapentin and antidepressants appears to be similar, to date, there is limited data that directly compare these nonhormonal treatments.

This study is an open-label, cross-over, randomized clinical trial, which allowed patients to be their own controls to collect patient preference data, the primary endpoint of the study. A total of 66 women with a history of invasive breast cancer, ductal or lobular carcinoma in situ, without evidence of metastasis, entered the study. Patients had a history of at least 1 month of bothersome hot flashes (≥ 14/week) severe enough that they desired pharmacologic intervention. Menopausal status was not an exclusion criterion. However, patients were excluded if they had received chemotherapy within 8 weeks or planned to have chemotherapy during the 14-week study. Concomitant treatment with tamoxifen, luteinizing hormone–releasing hormone (LHRH) analogs, and aromatase inhibitors was allowed, provided that the patients had been on therapy for at least 4 weeks and would remain on therapy for the duration of the study. Patients were also excluded if they had used venlafaxine or any other antidepressant, including St. John’s wort, within the previous year, used gabapentin or calcium channel antagonists within 2 weeks, or had used any other treatment for hot flashes.

Patients were randomized to venlafaxine 37.5 mg for 7 days then 75 mg daily for 21 days or gabapentin 300 mg at bedtime for 3 days, twice daily for 3 days, then three times daily for 22 days. After 4 weeks, patients were tapered off the medication and were then on a washout period of 2 to 4 weeks before crossover to the other study period for 4 weeks.

A total of 58 patients reported preference data, 2 with no preference between drugs. Of the 56 patients, 68% preferred venlafaxine over gabapentin (P = 0.01). Reasons for preference of one drug over another were similar, with reduction in hot flash severity and frequency and fewer adverse events the same between both groups. The overall efficacy of the two treatments was also similar. However, patients who preferred a particular agent experienced greater hot flash reduction on that agent compared to the alternative (venlafaxine-preferring patients had a 41% lower score for hot flashes; gabapentin-preferring patients had a 47% lower score for hot flashes). Venlafaxine was associated with greater nausea, appetite loss, and constipation but with fewer mood changes and reduced nervousness compared with gabapentin. Gabapentin was associated with more dizziness and increased appetite compared with venlafaxine.

Based on these results, both treatment options are found to be efficacious in treatment of hot flashes in survivors of breast cancer; however, a significant proportion of women preferred venlafaxine over gabapentin. Gabapentin remains an effective and appropriate second-line agent in this patient population."

Venlafaxine vs Gabapentin for the Management of Hot Flashes

cindycflynn's picture
Posts: 1133
Joined: Oct 2009

My doctor put me on Effexor after the vitamin E she first recommended became insufficient. The Effexor seems to be helping. Although I do still get hot flashes, they are less frequent and less severe than before I started taking the Effexor.

Also, I'm not sure if it's from the Effexor or one of the many other changes to my life post-BC, but I am now able to sleep at night extremely well. Even if I get up to use the restroom (which I still do almost every night) I fall right back to sleep. The only problem with that now is that I DO still have to get up and go to work, and I just feel like I could keep sleeping forever. I've had some mornings on the weekends where I've slept in past 8:00, which I hadn't been able to do for several years before BC.

Thanks for sharing!

Sher43009's picture
Posts: 602
Joined: Nov 2009

Venlafaxine is the generic for Effexor. I've been on it since April. I still get the hot flashes-night sweats, but not as bad as before. I'm on Tamoxefin so this works with it--one pill causes the problem--another pill fixes the problem. I'm just glad the pills are available.

Thanks for the info

Angie2U's picture
Posts: 2992
Joined: Sep 2009

Great information Cynthia. I know many on here that have written that they take Effexor and are happy with it.


phoenixrising's picture
Posts: 1511
Joined: Feb 2007

Good article! Thank you! I've used both and found gabapentin did help with hot flashes and if taken at night will also help you sleep. My dosages were low so going on and off didn't cause any problems. However when I tried going off venlafaxine...even slowly, the effects were horrible. It probably took me about 6wks to 2 mos to finally get rid of it. Just a heads up.

carkris's picture
Posts: 4554
Joined: Aug 2009

I was on neurontin for PN it played havoc with my chemistry (even at the smallest of doses) and Ihad to go off it. I felt like a big cloud had descended on me. I know people who take much larger doses and are ok. It seemed to negate the lexapro for me.
thank you for the article, I love to read new research.

VickiSam's picture
Posts: 9085
Joined: Aug 2009

have been for over 1 year .. I long for the day - when any depressant is needed for many of us 'Warriors'.

Vicki Sam

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