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. 2009 Jun 10;27(17):2831-7.
doi: 10.1200/JCO.2008.19.6253. Epub 2009 Mar 30.

Newer antidepressants and gabapentin for hot flashes: an individual patient pooled analysis

Charles L Loprinzi  1 , Jeff Sloan, Vered Stearns, Rebecca Slack, Malini Iyengar, Brent Diekmann, Gretchen Kimmick, James Lovato, Paul Gordon, Kishan Pandya, Thomas Guttuso Jr, Debra Barton, Paul Novotny
Affiliations

Newer antidepressants and gabapentin for hot flashes: an individual patient pooled analysis

Charles L Loprinzi et al. J Clin Oncol. .

Abstract

Purpose: Nonhormonal treatment options have been investigated as treatments for hot flashes, a major clinical problem in many women. Starting in 2000, a series of 10 individual double-blind placebo-controlled studies has evaluated newer antidepressants and gabapentin for treating hot flashes. This current project was developed to conduct an individual patient pooled analysis of the data from these published clinical trials.

Patients and methods: Individual patient data were collected from the various study investigators who published their study results between 2000 and 2007. Between-study heterogeneity for study characteristics and patient populations was tested via chi2 tests before a pooled analysis. The primary end point, the change in hot flash activity from baseline to week 4, for each agent was calculated via both weighted and unweighted approaches, using the size of the study as the weight. Basic summary statistics were produced for hot flash score and frequency using the following three statistics: raw change, percent reduction, and whether or not a 50% reduction was achieved.

Results: This study included seven trials of newer antidepressants and three trials of gabapentin. The optimal doses (defined by individual study results) of the newer antidepressants paroxetine, venlafaxine, fluoxetine, and sertraline decreased hot flash scores by 41%, 33%, 13%, and 3% to 18% compared with the corresponding placebo arms, respectively. The three gabapentin trials decreased hot flashes by 35% to 38% compared with the corresponding placebo arms.

Conclusion: Some newer antidepressants and gabapentin, within 4 weeks of therapy initiation, decrease hot flashes more than placebo.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
Individual study results. (A) Venlafaxine study results.(B) Fluoxetine study results. (C) Paroxetine individual study results., (D) Sertraline individual study results.,, (E) Gabapentin individual study results.–
Fig 2.
Fig 2.
Forest plots of hot flash reduction in newer antidepressant studies.
Fig 3.
Fig 3.
Forest plots of hot flash reduction in gabapentin studies.
Fig 4.
Fig 4.
Hot flash score data for paroxetine patients who were not receiving tamoxifen.
See this image and copyright information in PMC

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