Biglia, N., Torta, R., Roagna, R., Maggiorotto, F., Cacciari, F., Ponzone, R., … Sismondi, P. (2005). Evaluation of low-dose venlafaxine hydrochloride for the therapy of hot flushes in breast cancer survivors. Maturitas, 52, 78–85.

• Evaluation of low-dose venlafaxine hydrochloride for the therapy of hot flashes in breast cancer survivors
• Evaluate the efficacy and tolerability of a longer treatment (eight weeks) at a lower dose of venlafaxine (37.5 mg/day)

• N = 40
• Patients attending the outpatient clinic for menopausal symptoms 
• All witha history of breast cancer without evidence of recurrence and no requirement of fulfilling menopausal status
• Anti-estrogen therapy was allowed provided that it had been started at least four months before study entry and continued the next three months

Outpatient

Open label study

Measures included:

• Hot flash diary and computation of daily hot flash scores
• Weekly documentation in diariesof side effects experienced  
• Beck Depression Inventory (BDI) as completed at baseline and at week 8 
• At weeks 4 and 8,a clinical visit to monitor blood pressure, assess side effects, and hot flash frequency
  • Patient was excluded from study if blood pressure found diastolic above 95 or systolic above 160, or if important side effect occurred

Thirty patients completed the first 4 weeks of treatment with reduction of hot flash frequency of 39% compared to baseline. After eight weeks of treatment, a further significant reduction in hot flashes by 53% and a hot flash score by 59% was observed. Very few side effects were reported, mainly nausea during first the two weeks and mouth dryness. Only 23 women completed the BDI at week 8 with a reduction of 23% reported. No patient was withdrawn for blood pressure increase or major toxicity.

Low-dose venlafaxine hydrochloride can be effective in reducing frequency and severity of hot flashes in patients with breast cancer.

• Not blinded or placebo-controlled