Table 1. Hot flash treatment options .
| Drug | Dose | Expected reduction in hot flashes | Most common toxicities |
|---|---|---|---|
| Hormonal agents | |||
| Diethylstibestrol (DES)a,18, 19, 20 | 1 mg d−1 PO | 70%–90% | Gynecomastia, gynecodynia |
| Estradiolb,21 | 0.05 mg transdermal weekly | 70%–90% | Gynecomastia, gynecodynia |
| Megestrol acetatea,15, 23 | 20–40 mg d−1 PO | 70%–90% | Bloating, weight gain, thrombogenic |
| Medroxyprogesteronea,16, 17 | 400 mg IM single dose (repeat for relapse) | 70%–90% | Bloating, thrombogenic |
| Cyproterone acetatea,16 | 100 mg d−1 PO | 70%–90% | Fatigue, weakness |
| Non-hormonal agents | |||
| Anti-seizure agents | |||
| Gabapentina,12 | 300 mg d−1 PO thrice daily | 50%–60% | Dizziness, fatigue, somnolence |
| Pregabalinc,11, 13, 14, 31 | 75 mg PO twice daily | 50%–60% | Cognitive difficulty, sleepiness, weight gain |
| Antidepressants | |||
| Venlafaxinec,16, 17, 34 | 75 mg d−1 extended release PO daily | 50%–60% | Anorexia, dry mouth, insomnia, nausea |
| Desvenlafaxinec,40, 41 | 100 mg d−1 PO daily | 50%–60% | Dizziness, nausea, vomiting |
| Paroxetinec,37, 38 | 10 mg d−1 controlled release PO daily | 50%–60% | Insomnia, nausea, sexual dysfunction |
| Citalopramc,39, 67 | 10–20 mg d−1 PO daily | 50%–60% | Constipation, dry mouth, nausea |
| Fluoxetinec,36, 67 | 20 mg d−1 PO daily | 30%–50% | Dry mouth |
Abbreviations: IM, intramuscularly; PO, orally taken.
a
Randomized controlled data in men.
b
Pilot data in men.
c
Randomized controlled data, but only from trials conducted in women.