A patient after treatment of breast carcinoma with conservative surgery and radiotherapy has big problems with feeling chilly and sweating. She should still be on hormonal treatment, but now isn’t because of big side effects. Before she got breast carcinoma she was on hormonal replaceable therapy for 20 years. Her oncologist takes care on illness and finds no repeated tumour growth nor metastases. We treat her with acupuncture against menopausal troubles. Now she sleeps better, is more undisturbed but still has terrible sweating and annoying feeling of cold. I would be very thankful for some suggestions what to do.
Some SSRI 's are helpful. But since these symptoms are most likely due to stopping hormone replacement therapy, they will be gone within a year.
Still, SSRI s are considered to be effective alternatives to HRT, with quick clinical response. Venlafaxine (may have disturbing side effects) and citalopram have beneficial effects for hot flashes.
I suggest a psychiatrists consultation before starting these medications.
one drug may be better than another depending on the patient,and also gabapentine has been recommended by some if the SSRI dont function.
Dear Branka,
for instance, ASRM's alternative (non-hormonal) treatment of vasomotor symptoms may be found here: http://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Practice_Guidelines/Committee_Opinions/The_menopausal_transition.pdf. And it seems that the most effective drugs are Paroxetine and Desvenlafaxine (Pristiq). At least, according to few recent published works.
Regards.
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