Effexor for this???

Hardknox · Aug 29, 2003

In a recent Mayo Clinic Health letter they had an article on Effexor being used for hot fllashes. I wil try and find the article link and post it for you,

My friend Judy, who stopped the Pre-pro HRT, has been plagued by wicked hot flashes. She called her GYN and told her about the Mayo article. The MD had never heard of using Effexor for this purpose but got on line and was impressed with the study enough to prescribe Effexor for Judy. It's been a month now and the hot flashes have disappeared! Judy is now well rested and I don't know if it's the anti-depressive mode of effexor that is working or the fact that she is no longer sleep deprived from the hot flashes, but she is a hellova lot more upbeat.

Hardknox · Aug 29, 2003

Here is a re-print of the article. *Please note they suggest 75mg/day.*

Hot flashes: Treatments are available

As you approach menopause, you may sometimes experience a feeling of warmth moving upward from your chest to your shoulders, neck and head. You may sweat, and as the sweat evaporates from your skin, you may feel chilled, weak or even slightly faint. Your face might look flushed, and red blotches may appear on your chest, neck and arms.

These episodes, called hot flashes, can last from 30 seconds to as long as 30 minutes, but most subside in 2 to 3 minutes. The frequency of hot flashes varies. You may have one an hour or have them only occasionally. They can occur any time during the day or night. They may be a part of your life for a year or more, or you may never have them.

As many as 75 percent of women in the United States experience hot flashes during menopause, some for as long as 5 years or more. Although hot flashes are an occasional annoyance for some, others have them more frequently and severely. Fortunately, medications and other remedies are available to allow you to progress through menopause more comfortably.

The most effective treatment for hot flashes is estrogen, also known as estrogen replacement therapy (ERT) or hormone replacement therapy (HRT), says Lynne Shuster, M.D., a specialist in internal medicine at Mayo Clinic, Rochester, Minn. But not all effects of HRT are positive. Taking HRT as a combination therapy-estrogen plus progestin-can result in serious side effects and health risks. Work with your doctor to discuss your options and decide what's best for you.

Medications to consider

As an alternative to estrogen, some doctors prescribe megestrol acetate for controlling hot flashes. Available as a pill, this medication is a form of progesterone that appears to decrease hot flashes as well as estrogen does. Because the medication can cause cancer cells to grow, megestrol acetate may not be an option for breast cancer patients.

Another progesterone treatment available for managing hot flashes is medroxyprogesterone (Depo-Provera), a medication related to megestrol acetate that is delivered by injection at 3-month intervals.

However, many of the concerns raised about estrogen therapy can also be raised about progesterone treatment. Therefore, researchers have been trying to find nonhormonal medications over the past decade.

These medications include some antidepressants, which have been shown to be helpful for diminishing hot flashes. Mayo Clinic researchers have found that the antidepressant venlafaxine (Effexor) can suppress hot flashes. The study involved 222 women who tracked the number of hot flashes they had while taking Effexor. Women who took 75 milligrams (mg) a day had a 61-percent reduction in the number of hot flashes they experienced.

Some women who take Effexor may experience side effects, such as nausea, nervousness or anxiety, and difficulty sleeping. If you have uncontrolled hypertension, you should not take Effexor since it can increase your blood pressure.

Mayo researchers also have found that another antidepressant, fluoxetine (Prozac), may help reduce hot flashes. Eighty-one breast cancer survivors were given either Prozac or a placebo (inactive substitute). After 4 weeks, women taking Prozac had 50 percent fewer hot flashes, while women taking the placebo had 36 percent fewer hot flashes. The results showed that Prozac was moderately effective.

Other researchers have found that Paroxetine (Paxil), a drug in the same category as fluoxetine, will reduce hot flashes in some menopausal women.

Clonidine, a pill or patch typically used to treat high blood pressure, has been used in the past for hot flashes. It may reduce hot flashes by 20 percent to 65 percent. Frequent side effects include dizziness, drowsiness, dry mouth and constipation. Doctors don't prescribe it as often as other remedies for hot flashes because of these side effects.

Gabapentin (Neurontin), a medication typically used to treat seizures or chronic pain, is being studied for its effectiveness against hot flashes. Studies have shown the drug to be moderately effective in reducing hot flashes. The low doses used in the trials were relatively well tolerated. The side effects reported were some lightheadedness and leg swelling. Researchers need to do further studies of Neurontin to confirm its effectiveness for menopausal symptoms.

Supplements can ease symptoms

If prescription medications don't work for you, or you prefer nonprescription alternatives, you may want to consider herbal supplements or vitamins.

Black cohosh is an herbal treatment approved in Germany for treating hot flashes. Some studies have found black cohosh to be 25 percent to 30 percent more effective than a placebo in treating hot flashes. In Germany, experts recommend that black cohosh be used for no more than 6 months at a time, at doses of 20 mg to 40 mg a day.

In studies among women with a history of breast cancer, black cohosh generally hasn't been found to be helpful, possibly because many of these women were taking tamoxifen. Taken to combat the effects of estrogen to reduce the risk of cancer recurrence, tamoxifen may counteract the effects of black cohosh. Further studies of black cohosh are ongoing.

Another supplement you might try is vitamin E, which provides some relief from mild hot flashes for some women. Because of its overall safety and potential for other health benefits, it's considered an option worth trying.

Other herbal supplements that women have tried include dong quai, licorice, chaste tree berry, evening primrose oil and wild yam cream-which is also known as a natural progesterone cream. However, scientific evidence of their effectiveness is lacking.

Just because these supplements seem natural doesn't mean they're safe, Dr. Shuster says. All supplements have potentially harmful side effects. Use them with caution, and review what you're taking with your doctor.

Soy-worth a try?

One popular alternative for hot flashes is soy. Soybeans contain phytoestrogens, which are estrogens found in plants and which behave like weak forms of your body's own estrogen. Isoflavones are one kind of phytoestrogen and are plentiful in whole-soy foods.

Scientists have observed that women who eat an abundance of soy products-such as women in Asian countries-are less likely to have hot flashes and other bothersome menopausal symptoms. This has led to studies through the years to evaluate more specifically what effect soy products might have on menopausal symptoms.

Unfortunately, although some individual women find adding soy to their daily diet seems to help hot flashes, clinical trials have generally yielded unimpressive results. Particularly among women who have had breast cancer and are taking tamoxifen, soy is not helpful for relieving hot flashes. But other studies have found that different forms of soy and isoflavone-containing products slightly help some women with their menopausal symptoms.

Because phytoestrogens found in soy and other plants have been found to behave like estrogen in some ways, there's concern that eating too much soy or taking isoflavone supplements could cause cancer. If you have had breast or ovarian cancer, talk to your doctor before supplementing your diet with soy products.

Continuing research will reveal the best and safest way to incorporate soy into a healthy lifestyle. Dr Shuster recommends against taking isoflavone supplements but instead including whole-soy foods as part of a healthy diet.

Including tofu, soy milk, and other soy products into your diet will, at the very least, promote healthy cholesterol levels and a healthy heart, and might help protect you from certain types of cancer, researchers propose.

Make lifestyle changes

Keeping hot flashes at bay isn't just about medications and supplements. Your first step should be to make changes in your diet and lifestyle.

Hot and spicy foods as well as alcohol trigger hot flashes. Avoid them if you have bothersome hot flashes. Caffeine also can be a trigger. Limit your intake of coffee, caffeinated tea and other caffeinated beverages.

Daily exercise is very important during the menopausal years and beyond. If you aren't already exercising regularly, adding daily aerobic exercise can help reduce hot flashes. "It really does make a difference," Dr. Shuster says. "This is an opportunity to begin a very healthy habit." She suggests brisk walking, or a similarly vigorous exercise, for 20 to 30 minutes or more every day.

Some women find that meditation, relaxation exercises, stress reduction techniques or yoga can help reduce hot flashes. Even if these approaches don't quell severe hot flashes, they can help against some sleep disturbances that become more common during the menopausal transition.

There are other things you can add to your daily routine that may help decrease hot flashes. One of the most important is to dress in layers in loosely woven cotton clothing and to use loosely woven bedding. This allows air to flow around your skin better than some tighter fabrics. Also, it's a good idea to keep air circulating either with an open window or a fan.

Menopause can be a trying time. Use it to make positive changes in your life. By focusing on improving your diet and incorporating exercise into your daily routine, you'll reduce your hot flashes. Most important, you'll feel good about your body in the decades to come.

HQ01409

June 26, 2003

© 1998-2003 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research.

Berta · Aug 29, 2003

I been given clotromitzol (SP)for rash under bust. Yes, airing them out is suggested, but I'd scare the heck out of the kids. lol

KaroSnowQueen, RN · Aug 29, 2003

Oh yes Effexor XR is GREAT for hot flashes!!!! I have been on it for over a year. I REALLY didn't want to take synthetic hormones, large family hx of breast Ca, but this has done wonders!!!!!!!!

**canoehead, BSN, RN** · Aug 29, 2003

I know nothing about menopause, but perhaps he meant the Effexor to be for the neighbors, to treat PTSD after she did the topless thing?

Tell mom to use a good sunblock...and use the money she saves on Effexor to get some trashy beach reading!

kids · Aug 29, 2003

Effexor can NOT be just stopped after 30 days...it has to be weaned.

ceecel.dee, MSN, RN · Aug 29, 2003

Originally posted by canoehead
I know nothing about menopause, but perhaps he meant the Effexor to be for the neighbors, to treat PTSD after she did the topless thing?

Tell mom to use a good sunblock...and use the money she saves on Effexor to get some trashy beach reading!

:chuckle

Todd SPN · Aug 29, 2003

Originally posted by kids-r-fun
Effexor can NOT be just stopped after 30 days...it has to be weaned.

I know you are right, but I did it. No adverse affects were noted.

fourbirds4me · Aug 29, 2003

I would be concerned that the rash under the breast is fungal and not due at all to the hot flashes. My mother gets these and has to take diflucan to get rid of it. She is also a typeII diabetic and you can sure tell when her sugars are up.... the rash reoccurs like magic!

Nurse2bSandy · Aug 30, 2003

The effexor could have been introduced at 37.5mg to start to reduce side effects. Effexor is supposed to have an energizing effect, but it does make me sleepy. Other than that, I notice none of the other side effects, but was given small doses and worked up to the therapeutic level.

Good luck to mom!

Long Term Care Columnist / Guide · Aug 30, 2003

I've been taking Paxil for several years, but if it's doing anything for the hot flashes, I'm unaware of it.....I started having the beastly things just before I turned 43, and they've gotten progressively worse with time. I've learned to bear the indignity of looking like a tomato with sweat pouring off me by the quart, and I'm doing my best to stay ahead of the under-breast rashes and interrupted sleep and crazy dreams. Thank God for the Paxil, which allows me to have some quality of life while I go through this process; it's just not helping the hot flashes any.