Augmentation of venlafaxine and selective serotonin reuptake inhibitors with zolpidem improves sleep and quality of life in breast cancer patients with hot flashes

• DOI: 10.1097/gme.0b013e3181dbee1b
• Publication Date: 2010-06-25T14:20:44Z
• Authors: Hadine Joffe; Ann Partridge; Anita Giobbie-Hurder; Xiaochun Li; Karleen Habin; Paul Goss; Eric Winer; Judy Garber
• Keywords: Zolpidem; Hot flash; Venlafaxine Hydrochloride

In Brief Objective: Hot flashes are a major quality-of-life issue for breast cancer survivors, interrupting sleep, reducing quality of life, and diminishing treatment adherence to adjuvant endocrine therapies. Serotonin-norepinephrine reuptake inhibitors (SNRIs) selective serotonin (SSRIs) used widely but only partially effective hot flashes. Alternative strategies needed. We hypothesized that augmentation SSRI/SNRI therapy with hypnotic agents would optimize flash by improving sleep life. Methods: Women or at high risk developing the disease who had in association nocturnal awakenings were randomized double-blinded zolpidem 10 mg placebo 5 weeks. nonusers (81%) started venlafaxine XR 75 mg/day concurrently, whereas users continued therapy. compared proportion responders, defined as study completers improved subjective (Pittsburgh Sleep Quality Index) and/or objectively assessed wake time after onset on actigraphy, between groups. Results: Of 53 women (aged 51 ± 8 y) (n = 25) 28), 38 completed protocol (57% placebo, 88% zolpidem). More augmented than responders outcome (40% vs 14%; P 0.035). life more (P 0.01). Treatment effects mood did not differ Conclusions: Augmentation improves survivors associated disturbance. Adding agent an helps through nighttime Treatments targeting may be important supplemental strategy well-being. serotonin-norepinephrine selective-serotonin have disturbance inhibitors/selective-serotonin optimizes helping flashes, suggesting treatments