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Phase III, placebo-controlled trial of three doses of citalopram for the treatment of hot flashes: NCCTG trial N05C9.

AbstractPURPOSE:
Up to 75% of women experience hot flashes, which can negatively impact quality of life. As hot flash physiology is not definitively understood, it cannot be assumed that effective agents represent class effects. Therefore, there is a continued need for rigorous evaluation to identify effective nonhormonal options for hot flash relief.
METHODS:
A randomized, double-blind trial evaluated citalopram at target doses of 10, 20, or 30 mg/d versus placebo for 6 weeks. Postmenopausal women with at least 14 bothersome hot flashes per week recorded hot flashes for 7 days before starting treatment and were then titrated to their target doses. The primary end point was the change from baseline to 6 weeks in hot flash score.
RESULTS:
Two hundred fifty-four women were randomly assigned onto this study. Data for hot flash scores and frequencies showed significant improvement in hot flashes with citalopram over placebo, with no significant differences among doses. Reductions in mean hot flash scores were 2.0 (23%), 7.0 (49%), 7.7 (50%), and 10.7 (55%) for placebo and 10, 20, and 30 mg of citalopram, respectively (P <or= .002). Improvement in secondary outcomes, such as the Hot Flash Related Daily Interference Scale, was statistically superior in the 20-mg arm. Citalopram was well-tolerated, with no significant negative adverse effects.
CONCLUSION:
Citalopram is an effective, well-tolerated agent in managing hot flashes. There does not appear to be a significant dose response above 10 mg/d, but broader helpful effects of the agent appear to be more evident at 20 mg/d.
AuthorsDebra L Barton, Beth I LaVasseur, Jeff A Sloan, Allen N Stawis, Kathleen A Flynn, Missy Dyar, David B Johnson, Pamela J Atherton, Brent Diekmann, Charles L Loprinzi
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 28 Issue 20 Pg. 3278-83 (Jul 10 2010) ISSN: 1527-7755 [Electronic] United States
PMID20498389 (Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
Chemical References
  • Antineoplastic Agents, Hormonal
  • Placebos
  • Serotonin Uptake Inhibitors
  • Citalopram
Topics
  • Antineoplastic Agents, Hormonal (adverse effects)
  • Citalopram (administration & dosage)
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Hot Flashes (drug therapy, epidemiology)
  • Humans
  • Middle Aged
  • Placebos
  • Selective Serotonin Reuptake Inhibitors (administration & dosage)

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