fiery flashes are the most habitua...

fiery flashes are the most habitual and troublesome symptoms reported at women during and after perimenopause. For more than 80 percent of these women scalding;-very warm f lashes persist for more than a year; 9 percent of women older than 70 years report experiencing very warm f lashes. For some women f lashes are inconvenient on the other hand not troublesome; however, about 25 percent of these women report methodical symptoms that interfere with drowse and daily function. Use of the in the greatest degree effective therapy for hot f lashes, estrogen has dramatically decreased since publication of the Women's Health Initiative studious mood which linked hormone use to increased risk of breast cancer and thromboembolic conclusions Many suggested alternative therapies are based forward modulation of the serotonergic and noradrenergic pathways. Venlafaxine (Effexor) inhibits the two pathways and has been used to treat passionate flashes in women who have a history of or are at high risk of breast cancer. Evans and colleagues studied a long-acting form of venlafaxine in a general population of women experiencing very warm f lashes.

The 80 participants were recruited between the sides of media advertising and information distributed on clinics. All participants were postmenopausal and reported that they experienced more than 14 burning flashes per week. Women were exclud if they were taking reproductive hormones or antidepressant medications, or if they had any contraindications to antidepressant medications. All participants complet an interview and questionnaire that included temper symptoms. The women also scored the impact of heated flashes on daily activities using a rating scale. During the 12-week thought participants completed a daily diary of hasty flashes (occurrence and severity) plus any perceived adverse weights of treatment. The study participants were randomly assigned to receive placebo or extended-release venlafaxine. Participants were asked to take united tablet (placebo or 37.5 mg venlafaxine) daily for individual week, then two tablets daily for 11 weeks.

The pair groups were comparable in all major variables, on the contrary the treatment group reported more of common occurrence and more severe hot flashes, as well as more resort to frequently alcohol use. Eleven women in the treatment dispose withdrew from the study because of point to be solved [i]or[/i] settleds with sleeping, anxiety, nausea, or decreased libido. Eight women withdrew from the placebo cluster because of lack of impact forward symptoms. By the end of the first month of the research patient scores of the result of hot flashes on daily activities had declined substantially in the couple groups. In the venlafaxine cluster these scores continued to decline until week 12; the scores of the women in the placebo cluster reverted to baseline. The mean treatment cluster score fell from 72.4 to 353 whereas that of the placebo dispose returned to around 62. The reduction of 51 percent in the venlafaxine dispose was significantly greater than the 15 percent recorded in the placebo cluster Data from patient diaries showed a reduction in furious flash severity in both assign places tos with a greater, but not significant, improvement in the treatment assign places to Dry mouth, decreased appetite, and sleeplessnes were more belonging to all in the venlafaxine group; however, dizziness, tremors, anxiety, diarrhea, and rash were more public in the placebo group. Almost all (93 percent) of the patients treated with venlafaxine chose to continue this medication after the close attention had ended.

The authors terminate that in this study extended-release venlafaxine significantly modulated the impact of violent flashes on daily activities, nevertheless it did not dramatically abate the apparent frequency or severity of hasty flash episodes. They suggest that these deductions indicate mood elevation or increased coping ability in women with menopause.

ANNE D WALLING, MD

Evans ML et al. Management of postmenopausal of high temperature flushes with venlafaxine hydrochloride: a randomized, controll trial. Obstet Gynecol January 2005;105:161-6

COPYRIGHT 2005 American Academy of Family Physicians

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