Clinical experience with venlafaxine in the treatment of hot flushes in women with a history of breast cancer.
OBJECTIVE
To obtain practical experience with venlafaxine for hot flushes in breast cancer patients and incorporate this in a treatment protocol.


METHODS
Twenty-two women with a history of breast cancer (mean age 49.2 years, range 35-65) were referred for consideration of treatment with venlafaxine for hot flushes. Patients received extensive information on treatment with venlafaxine and were advised to self-monitor the frequency of their hot flushes.


RESULTS
Eight women did not start venlafaxine because they had no postmenopausal complaints, were lost to follow-up, had too low a frequency of hot flushes, or refused treatment. Eventually 14 women started venlafaxine. Two of them did not tolerate venlafaxine, four reported some effect but stopped because of side effects, two women had no effect whatsoever. Six women observed a clear ( > 50%) reduction in their hot flush frequency that was maintained at a median follow-up of 13 months.


CONCLUSIONS
The group of patients referred for treatment was more heterogeneous and more patients dropped out because of side effects than expected. Extensive patient education, patient selection and evaluation of the treatment effect (by self-monitoring of hot flush frequency) are mandatory to avoid useless (continuation of) treatment and to prepare patients for side effects. Under these conditions, a substantial minority of patients benefit from venlafaxine.
van Gool
A R
AR
Department of Psychiatry, Erasmus Medical Centre-Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands. a.vangool@erasmusmc.nl
Bannink
M
M
Bontenbal
M
M
Seynaeve
C
C
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications*; D003511:Cyclohexanols / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D019584:Hot Flashes / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride
D003511:Cyclohexanols; D000069470:Venlafaxine Hydrochloride