Venlafaxine alters microvascular perfusion, [¹²³I]-beta-CIT binding and BDI scores in flushing postmenopausal women.

Abstract

BACKGROUND:

Although 70% of postmenopausal women suffer from hot flashes the pathophysiology is poorly understood. The serotonin and noradrenaline reuptake inhibitor (SNRI) venlafaxine provides relief of flushing although the mechanism is unknown and could involve a central effect and/or a peripheral effect. Using single photon emission computed tomography (SPECT) we studied the central serotonin transporter (SERT) in vivo using [(123)I]-beta-carbomethoxy-3-β-(4-iodophenyl)tropane (beta-CIT) and, as previous studies have shown that reactivity of the skin blood vessels is enhanced in those who flush, we examined cutaneous microvascular perfusion.

METHODS:

Cutaneous microvascular perfusion was assessed in 31 postmenopausal women, with flushing, using laser Doppler imaging with iontophoresis (LDI+ION), before and after 8 weeks of treatment with venlafaxine. A sub-group of 14 of these women also had SPECT imaging at both time points to evaluate the availability of SERT in the brain. Flush frequency and score was recorded, and Beck Depression Inventory (BDI) II scores were assessed before and after treatment.

RESULTS:

Following treatment with venlafaxine, there was a significant reduction in the [(123)I]-beta-CIT binding ratio, BDI scores, flushing and endothelial dependent perfusion response. [(123)I]-Beta-CIT reduction was associated with BDI reduction (r(2)=0.54; F=8.8; p=0.004), but not flushing reduction or perfusion reduction.

CONCLUSIONS:

Venlafaxine resulted in a decrease in BDI II scores with an associated reduction in [(123)I]-beta-CIT binding in a group of non-depressed women. It also improved flush frequency and severity which may be as a result of decreases seen in enhanced cutaneous microvascular perfusion.

• Authors: Jenifer Sassarini, Rajeev Krishnadas, Jonathan Cavanagh, Alice Nicol, Sally L Pimlott, William Ferrell, Mary Ann Lumsden
• Journal: Maturitas (Maturitas) Vol. 77 Issue 3 Pg. 267-73 (Mar 2014) ISSN: 1873-4111 [Electronic] Ireland
• PMID: 24411555 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Cyclohexanols
• Serotonin Plasma Membrane Transport Proteins
• Serotonin Uptake Inhibitors
• Serotonin
• Venlafaxine Hydrochloride

Topics

• Aged
• Brain (drug effects, metabolism)
• Cyclohexanols (pharmacology, therapeutic use)
• Endothelium, Vascular
• Female
• Hot Flashes (drug therapy, metabolism)
• Humans
• Microvessels (drug effects)
• Middle Aged
• Postmenopause
• Serotonin (metabolism)
• Serotonin Plasma Membrane Transport Proteins (metabolism)
• Selective Serotonin Reuptake Inhibitors (pharmacology, therapeutic use)
• Skin (blood supply, drug effects)
• Tomography, Emission-Computed, Single-Photon
• Venlafaxine Hydrochloride