Objective: To obtain practical experience with venlafaxine for hot flushes in breast cancer patients and incorporate this in a treatment protocol.
Method: Twenty-two women with a history of breast cancer (mean age 49.2 years, range 35-65) were referred for consideration of treatment with venlafaxine for hot flushes. Patients received extensive information on treatment with venlafaxine and were advised to self-monitor the frequency of their hot flushes.
Results: Eight women did not start venlafaxine because they had no postmenopausal complaints, were lost to followup, had too low a frequency of hot flushes, or refused treatment. Eventually 14 women started venlafaxine. Two of them did not tolerate venlafaxine, four reported some effect but stopped because of side effects, two women had no effect whatsoever. Six women observed a clear (>50%) reduction in their hot flush frequency that was maintained at a median follow-up of 13 months.
Conclusion: The group of patients referred for treatment
was more heterogeneous and more patients dropped out
because of side effects than expected. Extensive patient
education, patient selection and evaluation of the treatment effect (by self-monitoring of hot flush frequency) are mandatory to avoid useless (continuation of) treatment and to prepare patients for side effects. Under these conditions, a substantial minority of patients benefit from venlafaxine.