Disease relevance of Hot Flashes

• CONCLUSION: Oral clonidine, 0.1 mg/d, is effective against tamoxifen-induced hot flashes in postmenopausal women with breast cancer [1].
• Toremifene is well tolerated in patients, and common adverse effects of this drug include vasomotor symptoms such as hot flashes and vaginal discharge [2].
• Pilot evaluation of venlafaxine for the treatment of hot flashes in men undergoing androgen ablation therapy for prostate cancer [3].
• Toxicities were similar in the two treatment arms, except for hot flashes which only occurred in patients on cisplatin plus decapeptyl [4].
• The highest incidences of adverse events were the pharmacological side effects of hot flashes in the castration group, and breast pain and gynecomastia in the bicalutamide group [5].

Psychiatry related information on Hot Flashes

• CONCLUSIONS: Hot flashes in peri- and postmenopausal women were associated with anxious and depressive symptoms in East Asian population with low prevalence of vasomotor symptoms [6].
• Paroxetine treatment of mood disorders in women: premenstrual dysphoric disorder and hot flashes [7].
• More recently, transdermal clonidine has found alternative uses in the areas of smoking cessation, posttraumatic stress disorder, menopausal hot flashes, and alcohol and opiate withdrawal syndromes [8].

High impact information on Hot Flashes

• The proportion of women receiving raloxifene who reported hot flashes or vaginal bleeding was not different from that of the women receiving placebo [9].
• Megestrol acetate for the prevention of hot flashes [10].
• Paroxetine controlled release in the treatment of menopausal hot flashes: a randomized controlled trial [11].
• CONTEXT: Standard therapy for hot flashes has been hormone replacement with estradiol or progestational agents, but recent data suggest that antidepressants inhibiting serotonin reuptake may also be effective [11].
• Preliminary data have suggested that newer antidepressants, such as venlafaxine, can diminish hot flashes [12].

Chemical compound and disease context of Hot Flashes

• Pilot trials have suggested that the progestational agent megestrol acetate can ameliorate hot flashes in both groups of patients [13].
• RESULTS: Patients in the placebo and treatment groups were similar in age, duration of tamoxifen use, reported frequency and duration of hot flashes at baseline, and dropout rates [1].
• CONCLUSION: Better means are needed to alleviate hot flashes among patients in whom estrogen therapy is contraindicated [14].
• PURPOSE: Hot flashes can be a prominent clinical problem for breast cancer survivors and men who undergo androgen-deprivation therapy [15].
• Hot flashes (75% v 46%) and tumor flare (16% v 3%) were more common with goserelin [16].

Biological context of Hot Flashes

• CONCLUSION: In tamoxifen-treated patients, women with the CYP2D6 *4/*4 genotype tend to have a higher risk of disease relapse and a lower incidence of hot flashes, which is consistent with our previous observation that CYP2D6 is responsible for the metabolic activation of tamoxifen to endoxifen [17].
• Results showed that women taking ERT were more likely to know that decreased estrogen levels lead to osteoporosis, to perceive that menopause is a medical condition, to believe that natural approaches to menopause are less preferable, to be seeing a gynecologist for care, and to believe that women should take ERT for hot flashes [18].
• CONCLUSION(S): E(2) ameliorates hot flashes by raising the core body temperature sweating threshold, but does not affect core temperature fluctuations or plasma 3-methoxy-4-hydroxyphenylglycol [19].
• The mechanism underlying the hot flashes observed in menopausal women may also involve, in part, the up-regulation of CGRP receptors following ovarian hormone deficiency [20].
• This withdrawal of estrogen causes physiological changes, some changes which are short-term and obvious (i.e., hot flashes, night sweats) and other changes that are more subtle and lead to long-term problems (i.e., loss of bone density, increased risk of fracture) [21].

Anatomical context of Hot Flashes

• CONCLUSIONS: Ospemifene at daily doses of 30 to 90 mg did not stimulate endometrium or aggravate hot flashes but clearly had a rather strong estrogenic effect on the vaginal epithelium during a 3-month treatment period [22].
• To evaluate other potential pathways by which black cohosh might reduce menopausal hot flashes, serotonin activity was first assessed by the inhibition of radioligand binding to cell membrane preparations containing recombinant human serotonin receptor (5-HT) subtypes [23].
• OBJECTIVE: To investigate whether standard C6 stellate ganglion blockade (SGB) might provide relief from hot flashes associated with menopause [24].

Gene context of Hot Flashes

• These results suggest that CGRP is involved in the mechanism underlying hot flashes in men [25].
• Future drug development efforts should focus on developing superior SERMs that have a greater efficacy against ER-positive tumors and do not cause hot flashes or thromboembolism, and explore combination strategies to simultaneously target hormone-dependent as well as hormone-independent breast cancer [26].
• To determine whether the extent of estrogen deficiency influences the occurrence of the disturbance, the authors measured the levels of estradiol (E2), estrone (E1), and sex-hormone binding globulin (SHBG), and the percent and total non-SHBG-bound E2 in 24 women with frequent hot flashes and 24 women who had never experienced the symptom [27].
• Changes in neurotensin-like immunoreactivity during menopausal hot flashes [28].
• Treatment with bromocriptine was associated with normalization of plasma PRL levels, elevation of plasma gonadotropin levels, and the onset of menopausal hot flashes in both patients [29].

Analytical, diagnostic and therapeutic context of Hot Flashes

• A randomized prospective double blind study was performed to assess the ability of a transdermal therapeutic system (TTS) delivering estradiol (E2) to suppress hot flashes (HFs) in symptomatic postmenopausal women [30].
• PURPOSE: Hot flashes may be a significant clinical problem in men undergoing androgen deprivation therapy with gonadotropin releasing hormone analogues, oral antiandrogens and/or surgical bilateral orchiectomy [3].
• The hot flashes were quantified and the severity was graded (3-point analogue scale) before and after treatment with MPA [31].
• A short study in the treatment of hot flashes with buccal administration of 17-beta estradiol [32].
• Isoflavone's effect on hot flashes is variable and inconsistent, and only modest and delayed improvement of symptoms could be expected by BC and vitamin E. There are insufficient data on the other herbal alternative therapies at this time [33].

References