Cooling hot flushes from leuprolide in prostate Ca
"A patient has been on leuprolide acetate for prostate carcinoma. His main complaint is hot flushes and sweating," writes ROBERT LUND, MD, of Charlottetown, PEI, and asks, "Is there any suggested treatment?"
In women on anti-estrogen drugs for breast cancer, the most effective treatment for hot flushes and sweats is sustained-release venlafaxine 75 mg daily. At this dosage, side effects are minimal and over 50% of patients achieve a significant reduction in hot flushes and night sweats. I don't have much experience in using this treatment in men on hormonal suppression therapy, but it's likely to be just as helpful in them. I usually advise my patients to use the drug for six months, then try withdrawing for a few weeks to see whether they still need it -- in many cases, flushing levels off over time. JJ