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


CONCLUSIONS
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.
Buijs
Ciska
C
Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Mom
Constantijne H
CH
Willemse
Pax H B
PH
Marike Boezen
H
H
Maurer
J Marina
JM
Wymenga
A N Machteld
AN
de Jong
Robert S
RS
Nieboer
Peter
P
de Vries
Elisabeth G E
EG
Mourits
Marian J E
MJ
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use*; D000328:Adult; D001943:Breast Neoplasms / Q000150:complications*; D003000:Clonidine / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003511:Cyclohexanols / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012725:Sexual Behavior; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride
D000316:Adrenergic alpha-Agonists; D003000:Clonidine; D003511:Cyclohexanols; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride