Stubbs Chris, Mattingly Lisa, Crawford Steven A, Wickersham Elizabeth A, Brockhaus Jessica L, McCarthy Laine H
University of Oklahoma Health Sciences Center Family Medicine Residency Program, Oklahoma City, OK.
J Okla State Med Assoc. 2017 May;110(5):272-274.
In menopausal women who experience regular hot flashes, does treatment with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) reduce the frequency and/or severity of hot flashes?
Yes. Review of the literature suggests that treatment with SSRIs or SNRIs reduces the frequency and severity of hot flashes in menopausal and post-menopausal women. Studies demonstrated that paroxetine (Paxil), citalopram (Celexa) and escitolapram (Lexapro) were the most effective SSRIs, and venlafaxine (Effexor) was the most effective first line SNRI, with desvenlafaxine as a second option. The most common side effects reported for both SSRIs and SNRIs are nausea and constipation, with most resolving within the first week of treatment. SNRIs have been associated with increased blood pressure in some patients and should be used with caution in women with hypertension. Women with a history of breast cancer and taking tamoxifen should avoid SSRIs, which have been shown to interfere with tamoxifen metabolism. SNRIs are the safest drugs for this population. Treatment choice should be patient-specific and begin with the lowest dose available.
A.
SSRI, SNRI, hot flashes, vasomotor symptoms, menopause.
August 2014, February 2016 and August 2016.
menopausal, perimenopausal or postmenopausal women 18 years of age or older with frequent and/or severe vasomotor symptoms, meta-analyses, systematic reviews, randomized controlled trials, cohort studies.
pre-menopause, anxiety, depression, panic disorder, bipolar disorder, co-morbid conditions.
在经历规律性潮热的绝经后女性中，使用选择性5-羟色胺再摄取抑制剂（SSRI）或5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRI）进行治疗是否能降低潮热的频率和/或严重程度？
是。文献综述表明，使用SSRI或SNRI进行治疗可降低绝经和绝经后女性潮热的频率和严重程度。研究显示，帕罗西汀（帕罗西汀片）、西酞普兰（喜普妙）和依他普仑（来士普）是最有效的SSRI，而文拉法辛（怡诺思）是最有效的一线SNRI，度洛西汀作为第二选择。报告的SSRI和SNRI最常见的副作用是恶心和便秘，大多数在治疗的第一周内缓解。在一些患者中，SNRI与血压升高有关；高血压女性应谨慎使用。有乳腺癌病史且正在服用他莫昔芬的女性应避免使用SSRI，因为已证明其会干扰他莫昔芬的代谢。对于这一人群，SNRI是最安全的药物。治疗选择应因人而异，并从可用的最低剂量开始。
A。
SSRI、SNRI、潮热、血管舒缩症状、绝经。
2014年8月、2016年2月和2016年8月。
年龄在18岁及以上、有频繁和/或严重血管舒缩症状的绝经、围绝经期或绝经后女性、荟萃分析、系统评价、随机对照试验、队列研究。
绝经前、焦虑、抑郁、惊恐障碍、双相情感障碍、合并症。
