Role of Serotonin in Hot Flashes after Breast Cancer

摘要

Hot flashes are a frequent, severe and bothersome symptom for women with breast cancer. Unfortunately, this symptom; is difficult to treat due to limitations in understanding hot flash physiology. Although serotonin may be involved in hot flashes, it has not been directly manipulated to study effect on hot flashes. Our study purpose was to improve our understanding of the role of serotonin in hot flashes by altering central serotonin concentrations using a well-established acute tryptophan depletion paradigm. The main hypothesis was that alterations in central serotonin levels are involved in the induction of hot flashes in women with breast cancer and that variability in response to serotonin manipulation could be partly explained by genetic variations in the serotonin receptors and transporters. The study opened to enrollment in September, 2005 as planned with 75 women completing being our target goal. As reported in previous reports, a revised power analysis in year 2 indicated 26 participants would provide sufficient power. Overall, 28 women completed week 1 and 27 completed weeks 1 and 2. Our hypothesis was not supported. Despite achieving adequate tryptophan depletion with the active drink, we did not see any difference in objective or subjective hot flashes between the study arms. In addition, individual variation in response to depletion did not appear to be explained by genetic polymorphisms.