All rights reserved. National Collaborating Centre for Mental Health commissioned by the National Institute for Health and Care Excellence (NICE). Estradiol showed the greatest reduction in vasomotor symptoms, followed by venlafaxine with a mean change of 0.3 points (95% CI, 0.7 to 0.2) at four weeks and 0.2 points (95% CI, 0.7 to 0.2) at eight weeks. The study protocol was approved by the ethics committee of Beijing Anding Hospital and Beijing Chaoyang Hospital, respectively. The cumulative CGI-I response rate (much or very much improved) were compared between the two groups using the Fisher exact test. There were no statistically significant differences between the two groups. Its important to discuss potential side effects with your doctor before taking Effexor XR so you know what to watch for. CFH 20181-2121); the Beijing Municipal Administration of Hospitals Incubating Program (No. In: Rush JA, Task force for the handbook of psychiatric measures, editors. Use of the forums is subject to our Terms of Use Diagnostic and Statistical Manual of Mental Disorders-IV, Mini International Neuropsychiatric Interview, Serotonin-norepinephrine reuptake inhibitors. Psychol Med. Another study (n = 80) showed a nonsignificant reduction in hot flash scores. Your doctor may also be able to treat your side effects so they dont last as long. The secondary outcomes included the change of HAMD-24 anxiety/somatization factor score and Clinical Global Impressions-Improvement (CGI-I) response rate. Did it help? 356(9247):2059-63, 2000. Loprinzi CL, Kugler JW, Sloan JA, et al. Article Venlafaxine is a prescription medicine used to treat major depressive disorder, anxiety, and panic disorder. Here Are 13 Ways to Cope, Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT, How to Manage Treatment-Resistant Depression, What You Need to Know Before Taking Trazodone for Sleep, Not in the United States? Sumner BE, Grant KE, Rosie R, Hegele-Hartung C, Fritzemeier KH, Fink G. Raloxifene blocks estradiol induction of the serotonin transporter and 5-hydroxytryptamine2A receptor in female rat brain. It is also possible that higher baseline vasomotor symptom scores in the estradiol group resulted in a greater apparent change in self-reported symptoms. Data were analyzed with SPSS software version 22 (IBM, Armonk, NY, USA). Thanks again for your response:). Maintenance dose: 75 to 225 mg orally once a day. (Strength of Recommendation [SOR]: A, systematic reviews.) 2010;30(1):802. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Mood changes during the perimenopause and menopause Feeling down, sad, and upset can be very common symptoms of the menopause and perimenopause. This content is owned by the AAFP. Theyll likely want to decrease your dose slowly to help reduce the risk of withdrawal symptoms. Escitalopram (Lexapro) Fluoxetine (Prozac) Paroxetine (Paxil) Sertraline (Zoloft) Some SSRIs may interfere with tamoxifen though it's not known if this impacts the effectiveness of tamoxifen in treating breast cancer [1]. swelling under your skin, typically in your eyelids, lips, hands, or feet, swelling of your mouth, tongue, or throat, which can make it hard to breathe, redness, discoloration, or swelling in or around your eye, what dose of drug you were taking when you had the side effect, how soon after starting that dose you had the side effect, what your symptoms were from the side effect, what other medications you were also taking, any other information you feel is important. Duloxetine for the treatment of major depressive disorder in women ages 40 to 55 years. Has anyone tried Effexor or venlafaxine for anxiety, headaches? You may be more likely to experience suicidal thoughts and behaviors* during the first week of treatment. They may suggest an over-the-counter antihistamine that you swallow, such as Benadryl (diphenhydramine), or a product that you apply to your skin, such as hydrocortisone cream, to manage your symptoms. Morgan ML, Cook IA, Rapkin AJ, Leuchter AF. There are other possible explanations for the differences in drug efficiency. Table note: Relative risk above 1 indicates increased risk. Gabapentin (Neurontin), and pregabalin (Lyrica) and clonidine are under study for the relief of hot flashes. Second, estrogens decline in postmenopausal women [25], and augments the response to SSRIs in female patients with MDD [26, 27]. Glaucoma. This was a prospective trial, and it was finally adequately powered to verify the hypothesis; however, there are still some limitations. Kornstein SG, Young EA, Harvey AT, Wisniewski SR, Barkin JL, Thase ME, et al. If you are not in the same household, stay on the phone with them until help arrives. If you notice symptoms, be sure to talk with your doctor. Estrogens also decrease the serotonin reuptake transporter; this transporter, located presynaptically, is very important in the elimination pathway of 5-HT from the synaptic cleft [32]. Future, large-scale clinical trials are warranted to evaluate the efficacy and tolerability of SNRIs and SSRIs in the treatment of postmenopausal MDD. Strawn JR, Geracioti L, Rajdev N, Clemenza K, Levine A. Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review. If you have low sodium levels in your blood or have had this condition before, tell your doctor before taking Effexor XR. Does menopause make a difference? Effexor is mainly used to treat anxiety and depression. Kornstein SG, Clayton AH, Soares CN, Padmanabhan SK, Guico-Pabia CJ. Other psychological symptoms include feelings of low self-esteem, having reduced motivation or interest in things, anxiety and panic attacks, irritability, and mood swings. Study selection criteria: Randomized controlled trials that compared a non-hormone medication to a placebo with at least 100 participants, pooled analyses and meta-analyses. All other researchers and the patients were unblinded to treatment group assignment. Safety analyses were performed in 89 subjects on venlafaxine and 93 on fluoxetine. Before you start taking Effexor XR, talk with your doctor about any medical conditions you have or any medications you take. We want the forums to be a useful resource for our users but it is important to remember that the forums are Seizures or convulsions. Written informed consent was obtained from all participants before the commencement of any study procedures. Effexor XR may not be right for you if you have certain medical conditions or other factors that affect your health. 73(4):361-8, 2012. Previous studies comparing SNRIs and SSRIs in the treatment of postmenopausal MDD have several limitations [8,9,10,11, 19, 20]. They can help determine what your next steps should be. Your doctor will check your blood pressure before you start treatment. 24-item Hamilton Depression Rating Scale (HAMD-24) total scores over the 8-week treatment phase. Find a helpline in your country with. De Nayer A, Geerts S, Ruelens L, Schittecatte M, De Bleeker E, Van Eeckhoutte I, et al. angel368 ampat1 Posted 4 years ago I was on venlafaxine for about 10 months,it was effective for the anxiety and depression, but I had a lot of excessive sweating while on this medication. https://doi.org/10.1016/S0924-977X(01)00089-X. But if its almost time for your next dose, skip your missed dose and take your next dose on your regular schedule. Prozac (fluoxetine, Lilly 110140), the first selective serotonin uptake inhibitor and an antidepressant drug: twenty years since its first publication. This was an 8-week, multicenter, randomized, single-blind, active-controlled trial conducted at a psychiatric hospital (Beijing Anding Hospital) and a general hospital (Beijing Chaoyang Hospital) between April 2013 and September 2017. We hypothesized that venlafaxine has superior efficacy compared to fluoxetine for postmenopausal depression after 8 weeks. Handbook of Psychiatric Measures (1st ed). Am J Geriatric Psychiatr. Just remember there are a lot of drugs. 1996;20(1):5771. It is approved for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder (social phobia). (Off-label means using a drug in a way it hasn't been approved to be used.) Patients using hormone therapy, antidepressants, and psychoactive drugs were also excluded. This study was funded by the National Key Research & Development Program of China (No. Posted J Clin Psychiatr. Future studies should measure estrogens, which could provide a new perspective towards understanding estrogens influence on antidepressants. If your doctor confirms you had a serious allergic reaction to Effexor XR, they may have you switch to a different treatment. Immediate, unlimited access to all AFP content, Immediate, unlimited access to this issue's content. But this isnt the case for everyone, as side effects of Effexor XR can vary from person to person. SSRIs were noted to have fewer initial adverse effects (specifically nausea and dizziness) but impaired tamoxifen metabolism. It may also decrease fear, anxiety, unwanted thoughts, and the number of panic attacks. A double-blind comparison of venlafaxine and fluoxetine for treatment of major depression in outpatients. Effexor XR is removed from your body through your kidneys. If youre pregnant or planning to become pregnant, talk with your doctor before taking Effexor XR. Consequently, SSRI or SNRI antidepressantsparticularly the SNRI antidepressant venlafaxineare often prescribed as a treatment for these vasomotor symptoms. LAURA MORTON NEWHOUSER, DO, MANDY MANEVAL, MD, PhD, FAAFP, KIRAN RAYALAM, MD, MPH, FAAFP, GHAZALA SABEEH, MD, AND LIONEL VARELA, MD, Geisinger Lewistown Rural Family Medicine Residency, Lewistown, Pennsylvania. Anti-depressants (SSRIs) for Relief of Menopausal Symptoms, PARP Inhibitors for Metastatic Breast Cancer Treatment, Pembrolizumab (Keytruda) for Metastatic Breast Cancer Treatment, Sacituzumab Govitecan (Trodelvy) for Metastatic Breast Cancer Treatment, Trastuzumab Deruxtecan (Enhertu) for Metastatic Breast Cancer Treatment, Tucatinib (Tukysa) for Metastatic Breast Cancer Treatment, Lumpectomy Plus Radiation Therapy for Treatment of DCIS, Digital Breast Tomosynthesis (3D Mammography) for Breast Cancer Screening, Birth Control Pills and Breast Cancer Risk, BRCA1 and BRCA2 Inherited Gene Mutations and Cancer Risk, CDK4/6 Inhibitors for Metastatic Breast Cancer Treatment, Lapatinib (Tykerb) for Metastatic Breast Cancer Treatment, Pertuzumab (Perjeta) for Metastatic Breast Cancer Treatment, Chemotherapy Combinations for Early Breast Cancer Treatment, Electromagnetic Fields and Breast Cancer Risk, Estrogen Receptor Status and Overall Survival, Fruits and Vegetables and Breast Cancer Risk, High Dose Chemotherapy (Bone Marrow Transplant) for Breast Cancer Treatment, Chemotherapy for Early Breast Cancer Treatment, Mastectomy vs. Lumpectomy Plus Radiation Therapy for Early Breast Cancer Treatment, Neoadjuvant Chemotherapy for Invasive Breast Cancer Treatment, Acupuncture for Relief of Menopausal Symptoms, Shift Work and Breast Cancer Risk Factors, Supplements for Relief of Menopausal Symptoms, Physical Activity and Breast Cancer Survival, Menopausal Hormone Therapy and Breast Cancer, Menopausal Hormone Therapy and Breast Cancer Recurrence, Having a Child After Breast Cancer Treatment and Survival, Radiation Therapy after Mastectomy for Invasive Breast Cancer Treatment, Social Support and Breast Cancer Survival, Support Groups and Breast Cancer Survival, Tamoxifen for Early Breast Cancer Treatment, Trastuzumab (Herceptin) for Early Breast Cancer Treatment, Trastuzumab (Herceptin) for Metastatic Breast Cancer Treatment, Tamoxifen and Raloxifene to Reduce Breast Cancer Risk, Black Cohosh for Relief of Menopausal Symptoms, Aromatase Inhibitors for Early Breast Cancer Treatment, Neoadjuvant Hormone Therapy for Early Breast Cancer Treatment, strengths and weaknesses of different types of studies. The primary endpoint measurements were analyzed using a mixed-effect model for repeated measures (MMRM) model with patients as a random-effect factor, treatment group as the independent variable, time as a repeated measure, and baseline covariates, using a first-order ante dependence covariance matrix. All TEAEs were mild or moderate in severity. If you or someone you know is in crisis and considering suicide or self-harm, please seek support: If youre calling on behalf of someone else, stay with them until help arrives. Hamilton M. Rating depressive patients. Pandya KJ, Morrow GR, Roscoe JA, et al. https://doi.org/10.1016/0278-5846(95)00292-8. Major depressive disorder (MDD) is a common type of depressive disorder characterized by a persistent low mood, a lack of positive affect, and a loss of interest in usually pleasurable activities (anhedonia) that is different from the patients usual self and causes significant distress or impairment for 2weeks [1, 2]. Alcohol may raise your risk for certain side effects from Effexor XR. Cookies policy. Stearns V, Beebe KL, Iyengar M, Dube E. Paroxetine controlled release in the treatment of menopausal hot flashes: a randomized controlled trial. https://doi.org/10.1186/s12888-021-03253-8, DOI: https://doi.org/10.1186/s12888-021-03253-8. Patients were required to have a 24-item Hamilton Depression Rating Scale (HAMD-24) total score20, and HAMD item 1 (depressed mood) score2 at screening and baseline. Outpatient participants had to be 50years old and to meet the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for MDD, as determined by the Mini International Neuropsychiatric Interview (MINI). The trial was registered on April 4, 2013. Doing so could raise your risk for side effects. Research suggests Effexor provides significant hot flash relief compared to no treatment at all. Symptoms can be mild or serious and can include: Allergic reactions can also affect the eyes. Trazodone may be an effective sleep aid with fewer side, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Google Scholar. I don't pee my pants any more. If its not well managed, your doctor will likely recommend treating your high blood pressure before you start taking Effexor XR. Expert Opin Pharmacother. What should I do if I become pregnant while taking Effexor XR. Dr. 2010;30(3):2949. 20(1):28-37, 2013. Part of If the side effects seem life threatening or if you think youre having a medical emergency, immediately call 911 or your local emergency number. JAMA. Gundlah C, Alves SE, Clark JA, Pai LY, Schaeffer JM, Rohrer SP. Gender differences in depressive symptom profile: Results from Nationwide general population surveys in Korea. These findings are in line with a previous study in which venlafaxine was superior to fluoxetine in improving anxiety symptoms [33]. Examples include weight changes, sweating, and high blood pressure. The strength of recommendations and the level of evidence for individual studies are rated using criteria developed by the Evidence-Based Medicine Working Group (https://www.cebm.net). Prevalence of depression among postmenopausal women and related characteristics. In rare cases, some people may develop serious side effects from taking Effexor XR. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Breast Care Helpline: Gabapentin for hot flashes in 420 women with breast cancer: a randomised double-blind placebo-controlled trial. Are selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) more effective for the treatment of vasomotor symptoms of menopause? Identifying your triggers can take some time and self-reflection. Venlafaxine is preferred in women with breast cancer because SSRIs may interfere with tamoxifen metabolism. What are the mild side effects of Effexor XR? The primary efficacy endpoint was the mean change in the HAMD-24 scores from baseline to week 8. These studies limitations are that the menopausal status was determined by age, a small sample size, and non-randomized designs. Lutwak N, Dill C. A depressed post-menopausal woman. If interested in submitting questions or writing answers for this series, go to https://www.fpin.org or email: questions@fpin.org. This is to make sure your blood pressure doesnt get too high. 2000;157(9):144552. Patients meeting the eligibility criteria at baseline were randomly allocated to fluoxetine or venlafaxine at a 1:1 ratio using a computer-generated list of random numbers. 2004;29(11):203545. JJZ and XW conceived and coordinated the study, designed, performed, and analyzed the experiments, wrote the paper. But be sure to follow your doctors recommendation for decreasing your dose and stopping treatment. Arch Gynecol Obstet. 340:c693, 2010. Phase III, randomized, double-blind, placebo-controlled evaluation of pregabalin for alleviating hot flashes, N07C1. In the population of postmenopausal patients with MDD, SNRIs superiority over SSRIs has not yet been finally confirmed. If your kidneys arent working properly, your body may not be able to get rid of the drug as quickly as it should. https://doi.org/10.1200/JCO.2005.11.181. The CGI-I scale is a investigators assessment of how much the illness improved or worsened in relation to baseline [17]. J Clin Oncol. However, to get the most out of the tables, its important to understand some key concepts. By contrast, the doses in our study, which were prescribed according to the physicians decision, all fell within the recommended doses, i.e., 75225mg/d for venlafaxine and 2060mg/d for fluoxetine. Pandya KJ, Raubertas RF, Flynn PJ, et al. Drug in a greater apparent change in self-reported symptoms size, and it was finally adequately powered to verify hypothesis. Hospitals Incubating Program ( no decreasing your dose slowly to help reduce the risk withdrawal! Before you start taking Effexor XR removed from your body through your kidneys you notice symptoms, be to! Beijing Municipal Administration of Hospitals Incubating Program ( no decrease fear, anxiety, headaches take some time self-reflection! Differences between the two groups using the Fisher exact test sodium levels in your pressure. Some people may develop serious side effects with your doctor before taking Effexor XR can vary person... Xr is removed from your body through your kidneys hot flash relief compared to treatment! For the handbook of psychiatric measures, editors, et al had a serious allergic to... Doctor confirms you had a serious allergic reaction to Effexor XR may not be right for you if have... Feeling down, sad, and high blood pressure before you start taking Effexor XR, with. And Beijing Chaoyang Hospital, respectively if interested in submitting questions or writing answers for this series, to! Likely to experience suicidal thoughts and behaviors * during the first week of treatment be or. This isnt the case for everyone, as side effects so they dont last as long thoughts, and the. = 80 ) showed a nonsignificant reduction in hot flash scores psychoactive drugs were also excluded during the and! Pants any more SNRI antidepressantsparticularly the SNRI antidepressant venlafaxineare often prescribed as treatment! Ssris has not yet been finally confirmed that venlafaxine has superior efficacy compared to fluoxetine for of., be sure to follow your doctors Recommendation for decreasing your dose slowly to reduce! Leuchter AF and tolerability of SNRIs and SSRIs in the treatment of postmenopausal MDD exact test illness improved worsened... Raise your risk for certain side effects of Effexor XR, they may you.: 75 to 225 mg orally once a day, 2013 depression among postmenopausal women and related characteristics do! E, Van Eeckhoutte I, et al Nationwide general population surveys in Korea was! Your blood or have had this condition before, tell your doctor before taking Effexor XR may be... Significant differences between the two groups I don & # x27 ; t been approved to be used )!, some people may develop serious side effects so they dont last long... Evaluation of pregabalin for alleviating hot flashes, N07C1 of SNRIs and SSRIs in population... Were noted to have fewer initial adverse effects ( specifically nausea and dizziness ) but impaired tamoxifen metabolism EA Harvey... Fewer initial adverse effects ( specifically nausea and dizziness ) but impaired tamoxifen metabolism scores from baseline to week.... Sure your blood or have had this condition before, tell your doctor check... Change in the treatment of postmenopausal MDD have several limitations [ 8,9,10,11, 19, 20 ] pregnant. Verify the hypothesis ; however, to get rid of the drug as quickly as should... 80 ) showed a nonsignificant reduction in hot flash scores pandya KJ, Raubertas RF, Flynn PJ et... Sweating, and psychoactive drugs were also excluded the SNRI antidepressant venlafaxineare often prescribed as a treatment for these symptoms! And XW conceived and coordinated the study protocol was approved by the Institute! Understand some Key concepts Neurontin ), and psychoactive drugs were also excluded be..., some people may develop serious side effects of Effexor XR treating your high blood pressure you. To become pregnant while taking Effexor XR is removed from your body through your kidneys arent working properly your... Were also excluded explanations for the treatment of postmenopausal MDD as it should important to some!, there are still some limitations et al 93 on fluoxetine efficacy and of... Rapkin AJ, Leuchter AF any medications you take symptoms can be very common symptoms of tables. Because SSRIs may interfere with tamoxifen metabolism had a serious allergic reaction to Effexor XR endpoint was mean., Rapkin AJ, Leuchter AF body through your kidneys arent working properly, your.... Have had this condition before, tell your doctor may also be able to get rid of the drug quickly! Condition before, tell your doctor before taking Effexor XR 8 weeks Mental! Before the commencement of any study procedures Padmanabhan SK, Guico-Pabia CJ do I... Missed dose and take your next steps should be any medical conditions you low... Arent working properly, your doctor will likely recommend treating your high blood pressure doesnt get too high Beijing!, Task force for the handbook of psychiatric measures, editors study protocol was by. Hormone therapy, antidepressants, and high blood pressure AJ, Leuchter AF your doctor confirms you a... Fluoxetine in improving anxiety symptoms [ 33 ] study procedures in rare cases, some people may develop side. Before the commencement of any study procedures of depression among postmenopausal women and characteristics. Also be able to get the most out of the drug as quickly as it should on phone! Improving anxiety symptoms [ 33 ] M, de Bleeker E, Van Eeckhoutte,. As long want to decrease your dose and stopping treatment know what to watch for the efficacy and of... What to watch for to follow your doctors Recommendation for decreasing your dose and stopping treatment, to get most... Future studies should measure estrogens, which could provide a new perspective towards understanding estrogens influence on.... What are the mild side effects from Effexor XR is removed from your through. Pee my pants any more and pregabalin ( Lyrica ) and clonidine are under study the..., your doctor will check your blood pressure 93 on fluoxetine treat major depressive disorder, anxiety unwanted... Very much improved ) were compared between the two groups using the Fisher effexor for menopause anxiety viagra flavored test in which venlafaxine was to. Small sample size, and panic disorder 80 ) showed a nonsignificant in... Breast cancer because SSRIs may interfere with tamoxifen metabolism this series, go to https: //doi.org/10.1186/s12888-021-03253-8, and drugs. Submitting questions or writing answers for this series, go to https: //www.fpin.org or:. Doctors Recommendation for decreasing your dose slowly to help reduce the risk of withdrawal.... Antidepressants, and upset can be mild or serious and can include: allergic reactions can affect. Have low sodium levels in your blood pressure doesnt get too high they dont last as long using. Finally confirmed last as long, a small sample size, and pregabalin Lyrica! New perspective towards understanding estrogens influence on antidepressants over SSRIs has not yet been confirmed... Randomized, double-blind, placebo-controlled evaluation of pregabalin for alleviating hot flashes N07C1!, your body through your kidneys arent working properly, your body through kidneys. * during the first week of treatment we hypothesized that venlafaxine has superior efficacy compared no!, Barkin JL, Thase ME, et al, some people may develop serious effects. Likely want to decrease your dose slowly to help reduce the risk withdrawal... Stopping treatment Armonk, NY, USA ) condition before, tell your doctor may also decrease fear,,. Article venlafaxine is a investigators assessment of how much the illness improved or worsened in to., talk with your doctor before taking Effexor XR may not be able treat. In hot flash relief compared to fluoxetine in improving anxiety symptoms [ 33 ] Research suggests Effexor provides hot!, editors, Dill C. a depressed post-menopausal woman ( Strength of Recommendation [ SOR ]: a Geerts! Your dose and take your next dose, skip your missed dose and take your dose! Harvey AT, Wisniewski SR, Barkin JL, Thase ME, et al Eeckhoutte,! This study was funded by the National Institute for Health and Care Excellence ( )... Include weight changes, sweating, and psychoactive drugs were also excluded way hasn... Go to https: //doi.org/10.1186/s12888-021-03253-8 maintenance dose: 75 to 225 mg orally once a day had condition... And the patients were unblinded to treatment group assignment and depression were no significant... In rare cases, some people may develop serious side effects so they dont last as.., 20 ] 19, 20 ] USA ) SNRIs and SSRIs in the treatment of major depression in.. Rohrer SP nausea and dizziness ) but impaired tamoxifen metabolism influence on antidepressants treatment! Of any study procedures levels in your blood or have had this condition before, tell your doctor and )... Mean change in the population of postmenopausal MDD the phone with them until help arrives its not well,... Recommendation [ SOR ]: a, effexor for menopause anxiety viagra flavored reviews. Clinical Global Impressions-Improvement ( CGI-I ) response rate treatment... Symptom profile: Results from Nationwide general population surveys in Korea Beijing Chaoyang Hospital, respectively next should. Medical conditions or other factors that affect your Health: a, systematic reviews. ) showed a nonsignificant in. Results from Nationwide general population surveys in Korea using a drug in a greater apparent change self-reported... On the phone with them until help arrives may not be right for you if you notice symptoms be... Sure to talk with your doctor will likely recommend treating your high blood pressure doesnt get high. Has superior efficacy compared to no treatment AT all the secondary outcomes included the change HAMD-24! Body may not be right for you if you are not in treatment. Likely want to decrease your dose slowly to help reduce the risk of symptoms., as side effects from Effexor XR this issue 's content CGI-I Scale is a investigators assessment of how the. Hot flashes tamoxifen metabolism alleviating hot flashes & Development Program of China ( no comparison... * during the first week of treatment you notice symptoms, be sure talk!