Venlafaxine for hot flushes?

The Pharmaceutical Journal
Vol 265 No 7128p907
December 23/30, 2000 Clinical

Venlafaxine (Efexor) is effective at treating hot flushes in menopausal women who cannot or do not wish to take hormonal treatment, say American researchers.
Professor Charles Loprinzi and colleagues (Mayo Clinic and Mayo Foundation, Rochester, Minnesota) assessed the efficacy of venlafaxine in reducing the number and severity of hot flushes in women who had a history of breast cancer or who did not want to take estrogen for fear of developing breast cancer.
They found that the median decrease in hot flush scores was significantly greater in patients taking venlafaxine than those in a placebo group.
A total of 191 women were randomly assigned to receive one of four treatments for 28 days: 37.5mg extended-release (ER) venlafaxine daily; 75mg venlafaxine ER daily (after initial titration); 150mg venlafaxine ER daily (after initial titration); or placebo. They were asked to complete a daily diary of hot flushes for a baseline week and throughout the four-week study period.
A greater than 50 per cent reduction in hot flush activity was experienced by 20 per cent of patients taking placebo and 45, 63 and 55 per cent of those receiving venlafaxine 37.5, 75 and 150mg, respectively.
The main adverse events experienced by women taking venlafaxine included mouth dryness, decreased appetite, nausea and constipation. All occurred more commonly with the 150mg dose.
The authors recommend that treatment should start with a daily dose of 37.5mg and be increased, if necessary, to not more than 75mg daily (Lancet 2000;356:2059).
Venlafaxine, a serotonin and noradrenaline reuptake inhibitor, is only licensed in the UK for treatment of depressive illness.