Affiliation:
1. School of Medicine, Tehran University of Medical Sciences, Tehran,
Iran
2. Department of Clinical Hematology Oncology and Bone Marrow
Transplantation, Imam Khomeini Hospital Complex, Tehran University of Medical
Sciences, Tehran, Iran
3. Department of Psychiatry, Psychosomatic Research Center, Imam Khomeini
Hospital Complex, Tehran University of Medical Sciences, Tehran,
Iran
Abstract
Abstract
Background Breast cancer is the most common cancer in women worldwide.
Premature menopause and hot flashes are the main complications of breast cancer
treatments. About 40 to 50 percent of breast cancer women who undergo
chemotherapy are experiencing premature menopause symptoms, including hot
flashes. Some endocrine therapies such as tamoxifen and aromatase inhibitors are
associated with induction or aggravating hot flashes. Hot flashes are often
debilitating and significantly impair daily functions. Therefore many
therapeutic options have been studied so far for the management of this adverse
effect. However, there are still some clinical challenges in managing hot
flashes in patients with breast cancer.
Objective We aimed to evaluate and compare the efficacy of venlafaxine and
citalopram on hot flashes in breast cancer women receiving tamoxifen.
Design We conducted a double-blind, placebo-controlled trial in forty-one,
35 to 65 years old female patients. The study lasted for four weeks, and the
follow-up was for two months. Venlafaxine and citalopram treatments started with
doses of 37.5 mg or 10 mg, respectively. Venlafaxine and
citalopram dosages were increased in the second week to 75 and 20 mg,
respectively. The study was conducted during the year 2017.
Key Results The results indicated that the total efficacy was
significantly different in groups receiving citalopram, venlafaxine, and
placebo. Total efficacy in the placebo group, venlafaxine, and citalopram was
14.3, 53.8, and 64.3%, respectively (p=0.02). During the second
week, the efficacy in groups receiving citalopram, venlafaxine, and placebo was
57.1, 53.8, and 14.3%, respectively (p=0.04). Generally, both
citalopram and venlafaxine were well tolerated. The associated adverse effects
were mild to moderate in both groups.
Conclusions Although citalopram was associated with more adverse effects,
including constipation, it was more effective in reducing the frequency of hot
flashes when compared to venlafaxine or placebo.
Subject
Drug Discovery,General Medicine
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