[Non-hormonal treatment for vasomotor symptoms during menopause: role of desvenlafaxine]

Abstract

Objective: To review the published data that include Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), especially desvenlafaxine, on vasomotor symptoms (VMS).

Methods: This review is based on published data in Medline (1990-2009) for studies on SSRI and SNRIs, especially desvenlafaxine, and VMS.

Results: There is increasing evidence that both norepinephrine and serotonin are associated with the communication and modulation of the temperature homeostasis maintained by the hypothalamus. Different studies demonstrated the modest efficacy of SSRIs and SNRIs on VMS. Recently, a program of clinical trials with desvenlafaxine (a salt from the major metabolite of venlafaxine) has been developed for VMS. Currently, there are three randomized, double-blind clinical trials published, showing a significantly higher efficacy of desvenlafaxine versus placebo on VMS. There were also increased minor side effects with desvenlafaxine, especially nausea, at the beginning of the treatment.

Conclusions: A non-hormonal alternative--desvenlafaxine--has proven efficacy for VMS. There was also an increase in minor side effects, especially nausea, at the beginning of the treatment. There are clear subgroups of patients with VMS eligible, such as women with hormone-dependent cancers, women who do not want to be treated with hormone therapy or just want to get relief of their vasomotor symptoms.