Venlafaxine for the Control of Hot Flashes: Results of a Longitudinal Continuation Study

Debra L. Barton

Beth La Vasseur

Charles Loprinzi

Paul Novotny

Mary Beth Wilwerding

Jeff A. Sloan

ONF 2002, 29(1), 33-40. DOI: 10.1188/02.ONF.33-40

Purpose/Objectives: To evaluate the intermediate term efficacy and toxicity of the use of venlafaxine for the control of hot flashes.

Design: An open-label continuation phase study following a double-blind, randomized, placebo-controlled clinical trial that tested three doses of venlafaxine for the control of hot flashes.

Setting: North Central Cancer Treatment Group institutions.

Sample: 102 postmenopausal women.

Methods: Women could titrate venlafaxine to optimum efficacy while recording daily hot flash counts and weekly toxicity information.

Main Research Variables: Hot flash frequency, hot flash score.

Findings: The reduction in hot flashes previously reported in the randomized study phase was maintained during the open-label study. Toxicity did not appear to increase over time.

Conclusions: The data from this study provides evidence that venlafaxine has intermediate term efficacy and good tolerability as a treatment for hot flashes.

Implications for Nursing Practice: Nurses can inform symptomatic women that an effective nonhormonal alternative exists to control their hot flashes.

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    Barton, D.L., Loprinzi, C.L., Quella, S.K., Sloan, J.A., Veeder, M.H., Egner, J.R., Stella, P.J., Swan, D.K., Vaught, N.L., & Novotny, P. (1998). Prospective evaluation of vitamin E for hot flashes in breast cancer survivors. Journal of Clinical Oncology, 16, 155-158.

    Beck, A.T., Steer, R.A., & Garbin, M.G. (1998). Psychometric properties of the Beck depression inventory: Twenty-five years of evaluation. Clinical Psychological Review, 8, 77-100.

    Bergmans, M., Merkus, J., Corbey, R., Schelleken, L., & Ubachs, J. (1987). Effect of Bellergal Retard on climacteric complaints: A double-blind, placebo-controlled study. Maturitas, 9, 227-234.

    Carpenter, J., & Andrykowski, M. (1999). Menopausal symptoms in breast cancer survivors. Oncology Nursing Forum, 26, 1311-1317.

    Dew, J., Eden, J., Beller, E., Magarey, C., Schwartz, P., Crea, P., & Wren, B. (1998). A cohort study of hormone replacement therapy given to women previously treated for breast cancer. Climacteric, 1(1), 137-142.

    Fenlon, D. (1995). Menopause: A problem for breast cancer patients. European Journal of Cancer Care, 4, 166-172.

    Finck, G., Barton, D.L., Loprinzi, C.L., Quella, S.K., & Sloan, J.A. (1998). Definitions of hot flashes in breast cancer survivors. Journal of Pain and Symptom Management, 16, 327-333.

    Goldberg, R.M., Loprinzi, C.L., O'Fallon, J.R., Veeder, M.H., Miser, A.W., Mailliard, J.A., Michalak, J.C., Dose, A.M., Rowland, K.M., Jr., & Burnham, N.L. (1994). Transdermal clonidine for ameliorating tamoxifeninduced hot flashes. Journal of Clinical Oncology, 12, 155-158.

    Greendale, G., Lee, N., & Arriola, E. (1999). The menopause. Lancet, 353, 571-580.

    Kent, J. (2000). SnaRIs, NaSSAs, and NaRIs: New agents for the treatment of depression. Lancet, 355, 911-918.

    Kronenberg, F. (1990). Hot flashes: Epidemiology and physiology. In M. Flint, F. Kronenberg, and W. Utian (Eds.), Multidisciplinary perspectives on menopause (pp. 52-86). New York: New York Academy of Sciences.

    Loprinzi, C.L., Kugler, J.W., Sloan, J.A., Mailliard, J.A., La Vasseur, B.I., Barton, D.L., Novotny, P.J., Dakhil, S.R., Rodger, K., Rummans, T.A., & Christensen, B.J. (2000). Venlafaxine in management of hot flashes in survivors of breast cancer: A randomized controlled trial. Lancet, 356, 2059-2063.

    Loprinzi, C.L., Michalak, J.C., Quella, S.K., O'Fallon, J.R., Hatfield, A.K., Nelimark, R.A., Dose, A.M., Fischer, T., Johnson, C., Klatt, N.E., Bate, W.W., Rospond, R.M., & Oesterling, J.E. (1994). Megesterol acetate for the prevention of hot flashes. New England Journal of Medicine, 331, 347-352.

    Loprinzi, C.L., Pisansky, T.M., Fonseca, R., Sloan, J.A., Zahasky, K.M., Quella, S.K., Novotny, P.J., Rummans, T.A., Dumesic, D.A., & Perez, E.A. (1998). Pilot evaluation of venlafaxine hydrochloride for the therapy of hot flashes in cancer survivors. Journal of Clinical Oncology, 16, 2377-2381.

    Maunsell, E., Allard, P., Dorval, M., & Labbe, J. (2000). A brief pain diary for ambulatory patients with advanced cancer: Acceptability and validity. Cancer, 88, 2387-2397.

    Pandya, K., Raubertas, R., Flynn, P., Hynes, H., Rosenbluth, R., Kirshner, J., Pierce, I., Dragalin, V., & Morrow, G. (2000). Oral clonidine in postmenopausal patients with breast cancer experiencing tamoxifen-induced hot flashes: A University of Rochester Cancer Center community clinical oncology program study. Annals of Internal Medicine, 132, 788-793.

    Sherliker, L., & Steptoe, A. (2000). Coping with new treatments for cancer: A feasibility study of daily diary measures. Patient Education and Counseling, 40(1), 11-19.

    Sloan, J.A., Loprinzi, C.L., Kuross, S.A., Miser, A.W., O'Fallon, J.R., Mahoney, M.R., Heid, I.M., Bretscher, M.E., & Vaught, N.L. (1998). Randomized comparison of four tools measuring overall quality of life in patients with advanced cancer. Journal of Clinical Oncology, 16, 3662-3673.

    Swain, S., Santen, R., Burger, H., & Pritchard, K. (1999). Treatment of estrogen deficiency symptoms in women surviving breast cancer. Part 6: Executive summary and consensus statement. Oncology, 56, 859-875.

    Treatment of estrogen deficiency symptoms in woman surviving breast cancer. (1998). Journal of Clinical Endocrinology and Metabolism, 83, 1993-2000.

    University of California, San Francisco School of Nursing Symptom Management Faculty Group. (1994). A model for symptom management. Image, 26, 272-276.

    Weitzner, M.A., Mazzocca, J., Jacobsen, P.B., & Minton, S. (2000). Treatment of hot flashes and fatigue in women with breast cancer: Preliminary findings. Supportive Care in Cancer, 8, 243.