Making sense of the evidence regarding nonhormonal treatments for hot flashes.
The demand for nonhormonal interventions for hot flashes is increasing because of the number of patients diagnosed with hormone-sensitive cancers and the results of the Women's Health Initiative indicating that hormone replacement therapy is not as beneficial as originally believed. Since 2002, numerous studies testing nonhormonal treatments for hot flashes have been conducted. Clinicians need to be able to use these research findings to help patients make treatment decisions. Because hot flashes can interfere with activities of daily living such as sleep and work, clinicians first should assess the extent to which hot flashes are disruptive to a woman's life. The evidence for nonhormonal interventions is summarized, and a decision treatment algorithm is offered for use in clinical practice. This algorithm includes nonhormonal options of the antidepressants available in addition to gabapentin, an antiseizure medication. A short review of the evidence for possible complementary therapies also is included.
Barton
Debra
D
barton.debra@mayo.edu
Loprinzi
Charles L
CL
D000085:Acetates / Q000627:therapeutic use; D000203:Activities of Daily Living; D000465:Algorithms; D000588:Amines; D003509:Cyclohexanecarboxylic Acids; D003511:Cyclohexanols / Q000627:therapeutic use; D003663:Decision Trees; D016903:Drug Monitoring; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D005260:Female; D000077206:Gabapentin; D019584:Hot Flashes / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D009730:Nursing Assessment / Q000379:methods; D018579:Patient Selection; D011788:Quality of Life; D012648:Self Care / Q000379:methods; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D003509:Cyclohexanecarboxylic Acids; D003511:Cyclohexanols; D018691:Excitatory Amino Acid Antagonists; D000077206:Gabapentin; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride; D005680:gamma-Aminobutyric Acid