Dr. Mary Claire Haver

It's the neurokinin 3 receptor, which is in our thermoregulatory center.

It binds and stabilizes it.

So hot flashes in most patients will improve.

It specifically is targeting the mechanism where the hot flashes happen.

And so without having to, you know, have estrogen in any other part of your body, if you have been advised that that is not in your best interest.

So it's great for hot flashes.

So if you're an active breast cancer patient who's been told you're not a candidate for estrogen, these medications can be really helpful.

A new one has come on the market from Bayer.

I cannot remember the name of it of the day, but there's competitors coming out.

These are new.

We're probably five to six years away from any generics being available.

So again, cost can be a huge issue here.

The only SSRI is paroxetine.

That's the generic name or Brisdell.

That has been FDA approved specifically for hot flashes.

It's a lower dose version of paroxetine.

It's 7.5 milligrams.

It can reduce hot flash frequency by 50 to 65% in some women, and it's not a hormone.

So if you're on tamoxifen...

However, and you're having hot flashes because you're on tamoxifen, paroxetine is contraindicated because it does inhibit the enzyme, very long name, enzyme that converts tamoxifen to its active metabolite.