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

• Published in: Breast cancer research and treatment Vol. 115; no. 3; pp. 573 - 580
• Main Authors: Buijs, Ciska, Mom, Constantijne H, Willemse, Pax H. B, Marike Boezen, H, Maurer, J. Marina, Wymenga, A. N. Machteld, de Jong, Robert S, Nieboer, Peter, de Vries, Elisabeth G. E, Mourits, Marian J. E
• Format: Journal Article
• Language: English
• Published: Boston Boston : Springer US 01.06.2009; Springer US; Springer; Springer Nature B.V; Springer Verlag
• Subjects: Adrenergic alpha-Agonists - therapeutic use; Adult; Biological and medical sciences; Breast cancer; Breast Neoplasms - complications; Cancer research; Cancer therapies; Clinical Trial; Clinical trials; Clonidine - therapeutic use; Cross-Over Studies; Cyclohexanols - therapeutic use; Dermatology; Double-Blind Method; Drug therapy; Female; Gynecology. Andrology. Obstetrics; Hot Flashes - drug therapy; Humans; Mammary gland diseases; Medical sciences; Medicine; Medicine & Public Health; Menopause; Middle Aged; Oncology; Quality of Life; Serotonin Uptake Inhibitors - therapeutic use; Sexual Behavior; Side effects; Skin involvement in other diseases. Miscellaneous. General aspects; Treatment Outcome; Tumors; Vascular disorders of the skin; Venlafaxine Hydrochloride; Venlafaxine; Breast cancer; Clonidine; Menopause; Hot flashes; Imidazole derivatives; Agonist; Skin disease; Breast disease; Cardiovascular disease; Phénéthylamine derivatives; Reuptake inhibitor; Hot flush; Vascular disease; Imidazoline receptor; Randomization; α2-Adrenergic receptor; Human; Serotonin; Patient; Malignant tumor; Catecholamine; Crossover study; Mammary gland diseases; Treatment; Neurotransmitter; Double blind study; Norepinephrine; α-Adrenergic receptor agonist; Erythema; Comparative study; Cancer
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-008-0138-7

Purpose Breast cancer patients with treatment-induced menopause experience frequent and severe hot flashes (HF). We compared venlafaxine and clonidine for the treatment of HF with regard to side effects, efficacy, quality of life and sexual functioning. Methods In a double-blind, cross-over study, 60 breast cancer patients experiencing HF were randomized to 8 weeks venlafaxine followed by 2 weeks wash-out, and 8 weeks clonidine or vice versa. HF frequency and severity, side effects, quality of life and sexuality were assessed. Results Thirty patients started with venlafaxine and 30 with clonidine. Premature discontinuation for toxicity occurred in 14/59 during venlafaxine and 5/53 during clonidine (P = .038). Venlafaxine induced more side effects. Median reduction in HF score was 49% for venlafaxine and 55% for clonidine (ns). Conclusion 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.