Pharmacological Treatment
Clonidine
Clonidine is an alpha-2 adrenergic receptors which is an antihypertensive medicine that can help reduce hot flushes and night sweats caused by menopause. It can interact with some other hypertensive medication and not suitable for women with low blood pressure. The side effects are dose related, which are fatigue, sleep disturbance and dry mouth.
Serotonin and noradrenaline reuptake receptor inhibitors (SNRIs)
SNRIs is a class of antidepressants which helps to treat menopausal symptoms and significantly improve women’s quality of life. It is available in the market as venlafaxine and desvenlafaxine. It does not interact with cytochrome P450 so may be safest choice for women on Tamoxifen. Side effects of SNRIs are feeling sick, dizzy and reduced sex dr ive.
Serotonin selective reuptake inhibitors (SSRIs)
SSRIs is also a class of antidepressants which helps to treat menopausal symptoms and significantly improve women’s quality of life. They are available as paroxetine, fluoxetine, citalopram and sertraline. SSRIs like fluoxetine and
paroxetine should be avoided in breast cancer patients taking tamoxifen as it diminishes its efficacy.
Antiepileptics
Gabapentin and Pregabalin are medications used to treat epilepsy, neuropathic pain and migraine. There are found to significantly improve vasomotor symptoms, improve sleep and mood. The side effects are dry mouth, drowsiness and weight gain but it is very much dose dependent.