Bupropion for Control of Hot Flashes in Breast Cancer Survivors: A Prospective, Double-Blind, Randomized, Crossover, Pilot Phase II Trial

Nuñez, Geila Ribeiro; Pinczowski, Hélio; Zanellato, Rebecca Melo; Tateyama, Lívia; Schindler, Fernanda; Fonseca, Fernando L. A.; Giglio, Auro del

doi:10.1016/j.jpainsymman.2012.06.011

Cited by 19 publications

(11 citation statements)

References 44 publications

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“…No increases in estradiol were noted while on testosterone cream, consistent with prior studies in women without history of breast cancer [ 35 – 40 ]. Two additional trials involving 115 participants intervened on hot flashes as the primary outcome with venlafaxine, clonidine or bupropion and examined if sexual function differed by these medications [ 41 , 42 ]. There were no differences in sexual function between women treated with venlafaxine compared to clonidine nor with women treated with bupropion versus placebo [ 41 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…Clonidine (C) then Venlafaxine (V) • One medication daily x 8 weeks • History of breast cancer 2. Venlafaxine, then Clonidine or vice versa • 2-week washout • ≥ 14 hot flashes/week • Second medication daily x 8 weeks • V: 75 mg once daily • C: 0.05 mg twice daily Nunez (2013) [ 41 ] To test bupropion on hot flashes • Sample size = 55 Two groups: 10-week intervention: 1. Sexual function (Arizona Sexual Experience Scale) • Median age 49, range 33-71 1.…”

Section: Resultsmentioning

confidence: 99%

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Management of sexual dysfunction in breast cancer survivors: a systematic review

Seav

Dominick

Stepanyuk

et al. 2015

womens midlife health

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Female sexual dysfunction occurs frequently in midlife breast cancer survivors (BCS) and encompasses problems with sexual desire, interest, arousal, orgasm and genitopelvic pain. Although common, sexual problems are under-diagnosed and under-treated in BCS. The objective of this review was to assess primary studies that intervene on sexual dysfunction in BCS. In February 2015, PubMed, SCOPUS, CINAHL, COCHRANE and Web of Science databases were systematically searched for randomized controlled clinical trials (RCTs) of vaginal (lubricants, moisturizers, estrogens, dehydroepiandrosterone [DHEA], testosterone, vibrators, dilators), systemic (androgens, anti-depressants, flibanserin, ospemifene), physical therapy (physical activity, pelvic floor training), counseling and educational interventions on sexual function in BCS. Observational studies of vaginal interventions were also included due to the paucity of RCTs. The search yielded 1414 studies, 34 of which met inclusion criteria. Both interventions and outcomes, measured by 31 different sexual function scales, were heterogeneous, and therefore data were not pooled. The review found that regular and prolonged use of vaginal moisturizers was effective in improving vaginal dryness, dyspareunia, and sexual satisfaction. Educational and counseling interventions targeting sexual dysfunction showed consistent improvement in various aspects of sexual health. No consistent improvements in sexual health were observed with physical activity, transdermal testosterone or hot flash interventions. There was a lack of BCS-specific data on vaginal lubricants, vibrators, dilators, pelvic floor therapy, flibanserin or ospemifene. Overall, the quality of evidence for these studies was moderate to very low. Because each of the interventions with BCS data had limited efficacy, clinical trials to test novel interventions are needed to provide evidence-based clinical recommendations and improve sexual function in BCS.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Management of sexual dysfunction in breast cancer survivors: a systematic review

Seav

Dominick

Stepanyuk

et al. 2015

womens midlife health

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“…Clinically, a few other antidepressants and antipsychotics have been reported to elicit a lower SD frequency in non-depressive patients than depressive patients, such as a 22.6% and 3% for patients being treated with fluoxetine and desipramine for lumbago ( Atkinson et al, 2007 ), and 29.8% with paroxetine for tinnitus ( Baldo, Doree, Molin, McFerran, & Cecco, 2012 ). Sexual function did not change under treatment with bupropion or venlafaxine ( Nuñez et al, 2013 ; Reed et al, 2014 ) and even improved with escitalopram compared with a placebo treatment for menopausal hot flashes in non-depressive women ( Reed et al, 2012 ). Therefore, the sexual adversity of antidepressants, like amitriptyline, is drug and disease codependent, and amitriptyline is safer for non-depressive patients than for those with depression.…”

Section: Discussionmentioning

confidence: 96%

Amitriptyline and Sexual Function: A Systematic Review Updated for Sexual Health Practice

Chen

Lian

et al. 2017

Am J Mens Health

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Amitriptyline is an old drug but is still prevalently used as the first-line treatment for a variety of common diseases. Surprisingly, knowledge of sexual risks with amitriptyline comes from only one clinical trial and several case reports from three decades ago. In the current study, a systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) related to amitriptyline and sexual dysfunction (SD) was performed. The frequency, gender-difference, types, disease-specificity and time course of SD, and the relationship between SD and nonsexual adversity were studied. A total of 14 publications, including 8 qualified randomized clinical trials, were eligible. The frequency of SD in overall, male and female patients was 5.7, 11.9 and 1.7%, respectively. SD was six-fold higher in men than women. The frequency of SD was 6.9% in depressive patients compared with 0.8% in non-depressive patients (p = .008), and gradually decreased at 8 weeks after treatment (p = .02). Amitriptyline impacted arousal and libido more than orgasm and ejaculation in male patients but mainly libido in female patients. SD was significantly correlated with insomnia linearly whereas somnolence and nausea dually. Therefore, amitriptyline-associated SD mainly occurs in depressive and male patients, disturbs each phase of the sexual response cycle in men but mainly libido in women, gradually decreases under long-term treatment, and can be predicted by the co-existence of insomnia, somnolence or nausea during treatment. Clinicians should caution and tailor the gender and disease vulnerability of amitriptyline in their practice.

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“…Buproprion: In a randomized, double-blind, crossover, placebocontrolled pilot study of bupropion 150 mg in breast cancer survivors (N = 55), participants reported a larger reduction in hot flashes with placebo and a preference for placebo (Nuñez et al, 2013).…”

Section: Other Interventionsmentioning

confidence: 99%

“…A review of data from 375 participants in seven randomized, placebo-controlled clinical trials found that those receiving the placebo intervention reported an average decrease of 25% in hot flash frequency and scores at four weeks (Sloan et al, 2001). A small, double-blind, crossover study that compared bupropion to placebo reported a larger reduction in hot flashes in the placebo group and a preference for the placebo intervention (Nuñez et al, 2013). A small, double-blind, crossover study that compared bupropion to placebo reported a larger reduction in hot flashes in the placebo group and a preference for the placebo intervention (Nuñez et al, 2013).…”

Section: The Placebo Effect On Hot Flash Interventionsmentioning

confidence: 99%

Hot Flash Management: Update of the Evidence for Patients With Cancer

Kaplan¹,

Mahon

2014

Clinical Journal of Oncology Nursing

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Hot flashes are a distressing symptom frequently experienced by survivors of breast cancer or prostate cancer who are receiving estrogen or androgen-deprivation therapies. The frequency and intensity of hot flashes can lead to diminished quality of life and decreased adherence with prescribed antineoplastic therapies. This evidence-based review synthesizes and updates the findings of the highest quality evidence-based studies of interventions to manage hot flashes resulting from cancer therapies in patients with breast or prostate cancer since the initial Putting Evidence Into Practice review of hot flashes in 2011. Recent studies involving a variety of pharmacologic and nonpharmacologic interventions were evaluated and, as reported in 2011, the drugs gabapentin and venlafaxine were the only therapies rated as likely to be effective. In addition, a strong placebo effect was noted in several studies that included a placebo intervention and should be considered when reviewing interventions for hot flashes.

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Bupropion for Control of Hot Flashes in Breast Cancer Survivors: A Prospective, Double-Blind, Randomized, Crossover, Pilot Phase II Trial

Abstract: Compared with placebo, bupropion did not control HFs in this group of BC survivors.

Cited by 19 publications

References 44 publications

Management of sexual dysfunction in breast cancer survivors: a systematic review

Management of sexual dysfunction in breast cancer survivors: a systematic review

Amitriptyline and Sexual Function: A Systematic Review Updated for Sexual Health Practice

Hot Flash Management: Update of the Evidence for Patients With Cancer

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