Hot Flushes in a 76-Year-Old Man-Reply

Abstract

In Reply.— Drs Harris and Schwartz are to be congratulated for finding so satisfying a solution to the problem of Dr Harris' patient. They are wise to emphasize that the resolution of the patient's symptoms after the administration of doxepin cannot be adduced as proof that the hot flushes were due to depression or a panic disorder. Objectively verifiable hot flushes, particularly those that awaken a patient at night, must be a quite unusual manifestation of a purely emotional disorder. Confessing openly my inbred and too often misguided reluctance to abandon a diagnosis as well as my vast ignorance of psychopharmacology, I suggest still that this patient's symptoms may result from a cerebral discharge that was controlled by an unpredicted action of a psychotropic drug. Nevertheless, the patient is doing well and I agree heartily that if it ain't broke, don't fix it. In response to Dr Kreider, hot flushes