title: Duloxetine and escitalopram for hot flushes: efficacy and compliance in breast cancer survivors.
abstract: Selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRI) might be an effective treatment for hot flushes (HFs) in breast cancer survivors (BCSs). This study aims to compare the efficacy and tolerability of duloxetine (SNRI) versus escitalopram (SSRI) in reducing frequency and severity of HFs in BCSs and to assess the effect on depression. Thirty-four symptomatic BCSs with emotional impairment received randomly duloxetine 60 mg daily or escitalopram 20 mg daily for 12 weeks. Patients were asked to record in a diary HF frequency and severity at baseline and after 4 and 12 weeks of treatment. Depression was evaluated through validated questionnaires (Beck Depression Inventory and Montgomery Asberg Depression Rating Scale) at baseline and after 4 and 12 weeks of treatment. Both drugs showed a significant reduction of HF frequency and severity after 12 weeks of treatment with no significant difference between the two groups. A significant improvement in depression symptoms was observed at the end of the study period within both the groups, without difference between the two drugs. In conclusion, escitalopram and duloxetine are both effective treatment for the relief of HFs in BCSs, with similar beneficial effect. A significant improvement of depression was obtained with no major side effects.
authors.affiliation: Gynaecology and Obstetrics Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, Turin.
authors.forename: N
authors.initials: N
authors.lastname: Biglia
authors.affiliation: Gynaecology and Obstetrics Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, Turin.
authors.forename: V E
authors.initials: VE
authors.lastname: Bounous
authors.affiliation: Breast Unit Department of Health Science, OB & GYN Section, AOU Careggi, School of Medicine, University of Florence, Florence.
authors.forename: T
authors.initials: T
authors.lastname: Susini
authors.affiliation: Gynaecology and Obstetrics Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, Turin.
authors.forename: S
authors.initials: S
authors.lastname: Pecchio
authors.affiliation: Gynaecology and Obstetrics Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, Turin.
authors.forename: L G
authors.initials: LG
authors.lastname: Sgro
authors.affiliation: Gynaecology and Obstetrics Unit, Umberto I Hospital, Department of Surgical Sciences, University of Turin, Turin.
authors.forename: V
authors.initials: V
authors.lastname: Tuninetti
authors.affiliation: Psycho-Oncology Unit, Department of Neurosciences, University of Turin, Turin, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Torta
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000008:administration & dosage; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000150:complications*; D000073116:Cancer Survivors; D015283:Citalopram / Q000008:administration & dosage*; D003865:Major Depressive Disorder / Q000517:prevention & control; D004334:Drug Administration Schedule; D000068736:Duloxetine Hydrochloride / Q000008:administration & dosage*; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D055118:Medication Adherence; D008875:Middle Aged; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage*; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000008:administration & dosage*; D013607:Tablets; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram; D000068736:Duloxetine Hydrochloride; D017367:Selective Serotonin Reuptake Inhibitors; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors; D013607:Tablets
keywords: breast cancer; duloxetine; escitalopram; hot flushes; selective serotonin reuptake inhibitors; serotonin-norepinephrine reuptake inhibitors