NEW TREATMENT OPTIONS FOR HOT FLUSHES WITH SEROTONERGIC COMPOUNDS?

Abstract
Hot flushes are experienced by the majority of menopausal women. They are the most characteristic symptom of the menopause. Estrogen withdrawal is thought to be the main cause of hot flushes. Therefore a hormone replacement therapy is the first treatment option for hot flushes. However this treatment is not always tolerated and it takes a couple of weeks before the effect of this treatment becomes evident. In the search for the mechanism behind hot flushes it appeared that the neurotransmitter serotonin (5-hydroxytryptamine; 5-HT) might play a prominent role. This role of serotonin and especially the role of the 5-HT_2A and 5-HT_2C receptor subtypes is discussed. It is concluded that in case a non-hormonal treatment for hot flushes is desired, treatment with a 5- HT_2A receptor antagonist or a 5-HT_2C receptor agonist might be considered as a first-line pharmacotherapy.

Key words
Hot flushes, menopause, serotonin, 5-HT_2A receptors, 5-HT_2C receptors

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