Treatment of choice for hot flushes after ADT

Medroxyprogesterone and cyproterone acetate are each superior to venlafaxine as treatment for hot flushes in men taking androgen deprivation therapy for prostate cancer (Lancet Oncol 2010;11:147–54).

This French trial randomised 311 men who requested treatment for hot flushes, or presented with 14 or more events per week, after six months’ treatment with leuprorelin. Symptoms were assessed by a daily hot flush score from patients’ diaries.

After one month, venlafaxine 75mg/day reduced the hot flush score by 47 per cent, significantly less than medroxyprogesterone acetate 20mg/day (84 per cent) and cyproterone acetate 100mg/day (95 per cent).