Pilot evaluation of citalopram for alleviation of hot flashes in women with inadequate hot flash control with venlafaxine

Abstract

8061 Background: While venlafaxine does alleviate hot flashes, it provides inadequate relief for some patients. To determine whether another antidepressant might alleviate hot flashes in such women, the current pilot trial was conducted. Methods: Women who had been on therapy with venlafaxine (75 mg/day), who were experiencing at least 14 hot flashes/week, and who wished to pursue other pharmacologic therapy because of inadequate benefit from venlafaxine were enrolled on this trial. Participants kept a daily hot flash diary during a baseline week (continuing venlafaxine for this week if they were still on it, 16 patients) and then also during four treatment weeks while receiving citalopram in the following manner: 10 mg/d for one week, then 20 mg/d for three weeks. A total of 30 patients were entered on this study between 8/29/03 and 2/27/04. Results: Complete hot flash information, currently available for 22 study patients, are provided in the table, illustrating hot flash score (daily frequency times average severity) data during the fourth treatment week compared to the baseline week (where patients had a mean of 8.8 hot flashes/day with a mean hot flash score of 16.8/day). Citalopram was well-tolerated, with most patients reporting an improvement in several measured symptoms over baseline. Following completion of the study, patients were given the choice of staying on citalopram. Nineteen patients (63% of pts entering the study, 86% of pts completing the 5 week study period) chose to continue it. Conclusions: These preliminary data support citalopram as a potentially effective alternative agent for managing hot flashes in women for whom venlafaxine provides inadequate relief. No significant financial relationships to disclose.