Table 1. Effectiveness of different interventions for hot flashes.

Agent	Dose	% of Patients in Active Arm with ≥50% Decrease in Baseline Hot Flash Score136,137	% of Patients in Placebo Arm with ≥50% Decrease in Baseline Hot Flash Score136,137	Other Outcomes More Common in Active Arm vs Placebo
MPA138	400 mg  intramuscularly	72	Comparison with  venlafaxine	No placebo data
Megestrol  acetate12	20 mg BID	63	30	Withdrawal  menstrual  bleeding
Venlafaxine139 Venlafaxine139 Venlafaxine139	37.5 mg/d 75 mg/d 150 mg/d	54 70 62	30	Nausea, appetite  loss, dizziness,  constipation,  dry mouth,  sleepiness,  improved  quality of life
Fluoxetine140	20 mg/d	70	52	None
Paroxetine CR141	12.5 mg/d	50	49	None
Paroxetine CR141	25 mg/d	68		None
Paroxetine142	10 mg/d	70	33; 57a	No side effects.  Improved sleep
Paroxetine142	20 mg/d	76		Nausea
Sertraline143-144	50 mg/d	40–50	21–38	Nausea, fatigue,  diarrhea,  anxiety
Sertraline145	100 mg/d	56	41	Nausea
Gabapentin14 Gabapentin14,146	300 mg/d 900 mg/d	46 56–63	27 27–38	Decrease in  appetite,  decrease in pain
Gabapentin147	2400 mg/d	84	47	Trend toward  more headache,  dizziness,  disorientation,  sleep  disturbance
Clonidine16	0.1 mg/d oral or patch	37	30	Difficulty  sleeping,  dry mouth,  constipation,  skin rash from  patch,  improved  quality of life
Vitamin E148	800 IU/d	32	30	None
Soy149	70–150 mg isoflavones/d	30	?	None
Black cohosh150	20 mg/d	20	30	None

All agents were compared with placebo unless otherwise noted.

^aThis study had two placebo arms.

Data from Loprinzi CL, Barton DL, Sloan JA, et al. Mayo Clinic and North Central Cancer Treatment Group hot flash studies: a 20-year experience. Menopause 2008;15(4 Pt 1):655–60; and Loprinzi CL, Sloan J, Stearns V, et al. Newer antidepressants and gabapentin for hot flashes: an individual patient pooled analysis. J Clin Oncol 2009;27(17):2831–7.