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A Clinical Review on Paroxetine and Emerging Therapies for the Treatment of Vasomotor Symptoms

Most women experience vasomotor symptoms (VMS) during their menopausal transition. Menopausal hormone therapy (HT) is the most effective treatment for VMS, but some women choose not to use HT or have contraindications to using HT. Non-hormonal treatment options should be offered to these symptomatic...

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Autores principales: David, Paru S, Smith, Taryn L, Nordhues, Hannah C, Kling, Juliana M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8921794/
https://www.ncbi.nlm.nih.gov/pubmed/35300283
http://dx.doi.org/10.2147/IJWH.S282396
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author David, Paru S
Smith, Taryn L
Nordhues, Hannah C
Kling, Juliana M
author_facet David, Paru S
Smith, Taryn L
Nordhues, Hannah C
Kling, Juliana M
author_sort David, Paru S
collection PubMed
description Most women experience vasomotor symptoms (VMS) during their menopausal transition. Menopausal hormone therapy (HT) is the most effective treatment for VMS, but some women choose not to use HT or have contraindications to using HT. Non-hormonal treatment options should be offered to these symptomatic menopausal women. Multiple large randomized controlled trials have demonstrated statistically significant reductions in hot flash severity and/or frequency with the use of selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs). To date, paroxetine mesylate remains the only non-hormonal treatment that has been approved by the United States Food and Drug Administration (FDA) for the management of moderate to severe postmenopausal vasomotor symptoms. Lower doses are needed to reduce VMS than those used to treat anxiety or depression, which is beneficial since side effects are typically dose dependent. The recommended dosage is 7.5 mg once daily at bedtime. Dose dependent side effects include nausea, fatigue, and dizziness. Knowing potential medication interactions is critical such as with medications that can lead to serotonin syndrome, concomitant use with monoamine oxidase inhibitors and being aware of p450 drug metabolism is essential for patients taking drugs that utilize the CYP2D6 enzyme for metabolism including tamoxifen. This review discusses in detail the available data supporting the use of paroxetine for the treatment of VMS, including side effects and considerations regarding prescribing. A discussion of other emerging treatments is included as well, including estetrol, oxybutynin and neurokinin 3 (NK3) receptor antagonists.
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spelling pubmed-89217942022-03-16 A Clinical Review on Paroxetine and Emerging Therapies for the Treatment of Vasomotor Symptoms David, Paru S Smith, Taryn L Nordhues, Hannah C Kling, Juliana M Int J Womens Health Review Most women experience vasomotor symptoms (VMS) during their menopausal transition. Menopausal hormone therapy (HT) is the most effective treatment for VMS, but some women choose not to use HT or have contraindications to using HT. Non-hormonal treatment options should be offered to these symptomatic menopausal women. Multiple large randomized controlled trials have demonstrated statistically significant reductions in hot flash severity and/or frequency with the use of selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs). To date, paroxetine mesylate remains the only non-hormonal treatment that has been approved by the United States Food and Drug Administration (FDA) for the management of moderate to severe postmenopausal vasomotor symptoms. Lower doses are needed to reduce VMS than those used to treat anxiety or depression, which is beneficial since side effects are typically dose dependent. The recommended dosage is 7.5 mg once daily at bedtime. Dose dependent side effects include nausea, fatigue, and dizziness. Knowing potential medication interactions is critical such as with medications that can lead to serotonin syndrome, concomitant use with monoamine oxidase inhibitors and being aware of p450 drug metabolism is essential for patients taking drugs that utilize the CYP2D6 enzyme for metabolism including tamoxifen. This review discusses in detail the available data supporting the use of paroxetine for the treatment of VMS, including side effects and considerations regarding prescribing. A discussion of other emerging treatments is included as well, including estetrol, oxybutynin and neurokinin 3 (NK3) receptor antagonists. Dove 2022-03-10 /pmc/articles/PMC8921794/ /pubmed/35300283 http://dx.doi.org/10.2147/IJWH.S282396 Text en © 2022 David et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
David, Paru S
Smith, Taryn L
Nordhues, Hannah C
Kling, Juliana M
A Clinical Review on Paroxetine and Emerging Therapies for the Treatment of Vasomotor Symptoms
title A Clinical Review on Paroxetine and Emerging Therapies for the Treatment of Vasomotor Symptoms
title_full A Clinical Review on Paroxetine and Emerging Therapies for the Treatment of Vasomotor Symptoms
title_fullStr A Clinical Review on Paroxetine and Emerging Therapies for the Treatment of Vasomotor Symptoms
title_full_unstemmed A Clinical Review on Paroxetine and Emerging Therapies for the Treatment of Vasomotor Symptoms
title_short A Clinical Review on Paroxetine and Emerging Therapies for the Treatment of Vasomotor Symptoms
title_sort clinical review on paroxetine and emerging therapies for the treatment of vasomotor symptoms
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8921794/
https://www.ncbi.nlm.nih.gov/pubmed/35300283
http://dx.doi.org/10.2147/IJWH.S282396
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