Citalopram in Treating Postmenopausal Women With Hot Flashes

This study has been completed.
Information provided by:
National Cancer Institute (NCI) Identifier:
First received: August 10, 2006
Last updated: December 4, 2010
Last verified: April 2007

RATIONALE: Citalopram may help relieve hot flashes in women who had or have not had breast cancer. It is not yet known which dose of citalopram is more effective in treating hot flashes in postmenopausal women.

PURPOSE: This randomized phase III trial is studying three different doses of citalopram to compare how well they work in treating postmenopausal women with hot flashes.

Condition Intervention Phase
Breast Cancer
Hot Flashes
Psychosocial Effects of Cancer and Its Treatment
Drug: citalopram hydrobromide
Procedure: psychosocial assessment and care
Procedure: quality-of-life assessment
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Masking: Double-Blind
Primary Purpose: Supportive Care
Official Title: Phase III Randomized, Double-Blind, Placebo-Controlled Evaluation of Citalopram for the Treatment of Hot Flashes

Resource links provided by NLM:

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Difference in average hot flash score from baseline until week 7 of treatment

Secondary Outcome Measures:
  • Toxicity
  • Mood- and hot flash-related daily interference with activities

Estimated Enrollment: 220
Study Start Date: November 2006
Primary Completion Date: December 2010 (Final data collection date for primary outcome measure)
Detailed Description:



  • Evaluate the efficacy of three different doses of citalopram hydrobromide on hot flash scores in postmenopausal women with a history of breast cancer or in postmenopausal women who do not wish to take estrogen replacement therapy for fear of increased risk of breast cancer.


  • Compare the side effect profile of these regimens in these patients.
  • Compare the effects of these regimens on the secondary outcome of mood and interference with activities from hot flashes.
  • Determine if CYP2C19 and CYP2D6 polymorphisms predict efficacy of various doses of citalopram hydrobromide.

OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients are stratified according to age (18-49 years vs ≥ 50 years), tamoxifen (yes vs no), selective estrogen-receptor modulators (SERMs) (yes vs no), aromatase inhibitors (yes vs no), duration of hot flashes (< 9 months vs ≥ 9 months), and frequency of hot flashes per day (< 4 vs 4-9 vs ≥ 10). Patients are randomized to 1 of 4 treatment arms.

  • Arm I (low-dose citalopram hydrobromide): Patients receive 1 tablet of oral citalopram once daily in weeks 2-7.
  • Arm II (medium-dose citalopram hydrobromide): Patients receive 1 tablet of oral citalopram once daily in week 2 and 2 tablets once daily in weeks 3-7.
  • Arm III (high-dose citalopram hydrobromide): Patients receive 1 tablet of oral citalopram once daily in week 2, 2 tablets once daily in week 3, and 3 tablets once daily in weeks 4-7.
  • Arm IV (placebo): Patients receive 1-3 placebo tablets once daily in weeks 2-7. All patients complete a diary of hot flash incidence in weeks 1-7 and undergo blood collection periodically during study treatment for translational research studies.

A Symptom Experience diary is completed weekly and Profile of Mood States and Hot Flash-Related Interference Scale questionnaires are completed at baseline and in week 7.

PROJECTED ACCRUAL: A total of 220 patients will be accrued for this study.


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No


  • Must meet 1 of the following criteria:

    • History of breast cancer

      • No current malignant disease
    • No history of breast cancer and refused estrogen replacement therapy due to perceived increased risk of breast cancer
  • Bothersome hot flashes, defined as hot flashes ≥ 14 times/week and of sufficient severity to make the patient desire therapeutic intervention
  • Presence of hot flashes ≥ 1 month prior to study entry
  • Hormone receptor status not specified


  • Female
  • Postmenopausal, as defined by 1 of the following criteria:

    • Absence of a menstrual period in the past 12 months
    • Bilateral oophorectomy
    • Absence of a menstrual period in the past 6 months with follicle-stimulating hormone (FSH) level > 40 mIU/mL
  • ECOG performance status 0-1
  • Life expectancy ≥ 6 months
  • Willing to provide blood samples during study participation
  • No history of allergic or other adverse reactions to citalopram hydrobromide or other selective serotonin reuptake inhibitors (SSRIs)
  • No documented mania or hypomania


  • At least 4 weeks since prior and no concurrent antineoplastic chemotherapy
  • At least 4 weeks since prior and no concurrent androgens, estrogens, or progestational agents
  • At least 3 months since prior antidepressant use, including Hypericum perforatum (St. John's wort)
  • Concurrent tamoxifen, raloxifene, or aromatase inhibitors allowed if on a constant dose for ≥ 4 weeks and continuing medication during study period
  • No other concurrent or planned agents for treating hot flashes (e.g., phenobarbital, megestrol, or clonidine)

    • Stable dose of vitamin E allowed as long as it was started > 30 days prior to study entry
  • Concurrent soy allowed
  • Concurrent gabapentin allowed for reasons other than hot flashes if on a constant dose for ≥ 1 month and continuing during study period
  Contacts and Locations
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Please refer to this study by its identifier: NCT00363909

  Show 198 Study Locations
Sponsors and Collaborators
North Central Cancer Treatment Group
Investigator: Debra Barton, RN, PhD, AOCN, FAAN Mayo Clinic
Investigator: Beth La Vasseur, RN, MS Saint Joseph Mercy Cancer Center
Investigator: Charles L. Loprinzi, MD Mayo Clinic
  More Information

Additional Information:
Publications: Identifier: NCT00363909     History of Changes
Other Study ID Numbers: CDR0000489567, NCCTG-N05C9
Study First Received: August 10, 2006
Last Updated: December 4, 2010
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
psychosocial effects of cancer and its treatment
hot flashes
breast cancer

Additional relevant MeSH terms:
Hot Flashes
Signs and Symptoms
Anti-Dyskinesia Agents
Antidepressive Agents
Antidepressive Agents, Second-Generation
Antiparkinson Agents
Autonomic Agents
Central Nervous System Agents
Cholinergic Agents
Cholinergic Antagonists
Molecular Mechanisms of Pharmacological Action
Muscarinic Antagonists
Neurotransmitter Agents
Neurotransmitter Uptake Inhibitors
Peripheral Nervous System Agents
Pharmacologic Actions
Physiological Effects of Drugs
Psychotropic Drugs
Serotonin Agents
Serotonin Uptake Inhibitors
Therapeutic Uses processed this record on June 30, 2015