Levetiracetam for the treatment of hot flashes: a phase II study.
OBJECTIVE
The objectives of this pilot trial were to assess the potential efficacy and safety of levetiracetam for the treatment of hot flashes, a major cause of morbidity among breast cancer survivors.


METHODS
Women, aged 18 years or more, with a history of breast cancer or those who wished to avoid estrogen because of a perceived increased risk of breast cancer, who were experiencing bothersome hot flashes (more than or equal to 14 times per week, for more than or equal to 1 month before study entry), were included. During the baseline week, general demographic characteristics, hot flash information, and quality of life data were obtained. At the beginning of week 2, patients were started on levetiracetam for a total of 4 weeks. Information about hot flashes, quality of life, and toxicity were collected during these 4 weeks and compared with the baseline week.


RESULTS
After treatment with levetiracetam for 4 weeks (N = 19), mean hot flash scores (frequency times mean severity) were reduced by 57%, and mean hot flash frequencies were reduced by 53%, compared to the baseline week; both these reductions were greater than what would be expected with a placebo (20-25% reduction). There were significant improvements in abnormal sweating (p = 0.004), hot flash distress (p = 0.0002), and satisfaction of hot flash control (p = 0.0001), when comparing data from the fourth week of treatment to the baseline week. Twenty-nine percent of the subjects did not complete the study because of treatment-related adverse events, with the most frequently reported side effects being somnolence, fatigue, and dizziness, usually with mild to moderate intensity.


CONCLUSIONS
The results of this pilot trial suggest that levetiracetam might be an effective therapy for the treatment of hot flashes. Further data are needed to test this hypothesis, evaluating the efficacy and toxicity of this agent.
Thompson
Susan
S
Division of Medical Oncology, Mayo Clinic College of Medicine, 200 First Street S.W., Rochester, MN 55905, USA.
Bardia
Aditya
A
Tan
Angelina
A
Barton
Debra L
DL
Kottschade
Lisa
L
Sloan
Jeff A
JA
Christensen
Brad
B
Smith
DeAnne
D
Loprinzi
Charles L
CL
D001943:Breast Neoplasms / Q000150:complications*; D004244:Dizziness / Q000139:chemically induced; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D000077287:Levetiracetam; D008875:Middle Aged; D018697:Nootropic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017060:Patient Satisfaction; D010865:Pilot Projects; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011788:Quality of Life; D012720:Severity of Illness Index; D012894:Sleep Stages / Q000187:drug effects
D018697:Nootropic Agents; D000077287:Levetiracetam; D010889:Piracetam