***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: PURPOSE Nonhormonal pharmacologic interventions are recommended for the treatment of hot flashes in breast cancer survivors .  Antidepressants and gabapentin have been shown to be both effective and well tolerated ; however , it is not clear which is preferred . PATIENTS AND METHODS This was a group-sequential , open-label , r and omized , cross-over trial of 4 weeks of venlafaxine ( 37.5 mg daily for 7 days followed by 75 mg daily for 21 days ) versus gabapentin ( 300 mg once per day for 3 days , then 300 mg twice per day for 3 days , then 300 mg three times per day for 22 days ) , with patient preference as the primary outcome . Postmenopausal women with at least 14 bothersome hot flashes per week for the prior month were eligible . A 2-week baseline period and a 2-week tapering/washout time was used before the first and second treatment periods , respectively . Diaries were used to measure hot flashes and potential toxicities throughout the study . Participants completed a preference question naire at the end of the study . A predefined Pocock stopping rule was applied . Patient preference and hot flash and toxicity outcomes were compared between treatments . RESULTS Sixty-six patients were r and omly assigned , 56 of whom provided a preference ( eight dropped out and two had no preference ) ; 18 ( 32 % ) preferred gabapentin and 38 ( 68 % ) preferred venlafaxine ( P = .01 ) . Both agents reduced hot flash scores to a similar extent ( 66 % reduction ) . Venlafaxine was associated with increased nausea , appetite loss , constipation , and reduced negative mood changes compared with gabapentin , whereas gabapentin was associated with increased dizziness and appetite compared with venlafaxine ( all P < .05 ) . CONCLUSION Breast cancer survivors prefer venlafaxine over gabapentin for treating hot flashes Purpose Breast cancer patients with treatment-induced menopause experience frequent and severe hot flashes ( HF ) .  We compared venlafaxine and clonidine for the treatment of HF with regard to side effects , efficacy , quality of life and sexual functioning . Methods In a double-blind , cross-over study , 60 breast cancer patients experiencing HF were r and omized to 8 weeks venlafaxine followed by 2 weeks wash-out , and 8 weeks clonidine or vice versa . HF frequency and severity , side effects , quality of life and sexuality were assessed . Results Thirty patients started with venlafaxine and 30 with clonidine . Premature discontinuation for toxicity occurred in 14/59 during venlafaxine and 5/53 during clonidine ( P = .038 ) . Venlafaxine induced more side effects . Median reduction in HF score was 49 % for venlafaxine and 55 % for clonidine ( ns ) . Conclusion Venlafaxine and clonidine are equally , but moderately effective in HF reduction . Side effects are the main reason for drug discontinuation , occurring more often with venlafaxine BACKGROUND Classical hormone replacement therapy for hot flashes is contraindicated in breast cancer especially in endocrine responsive disease . PATIENTS AND METHODS In a double-blind , r and omized phase III study , breast cancer patients suffering from hot flashes at least twice a day , who were not taking any medication against hypertension and depression received either clonidine 0.075 mg twice a day or venlafaxine 37.5 mg twice a day for 4 weeks . The primary end point was defined as the frequency of hot flashes after 4 weeks of treatment . A self-reported 1-week hot flash and other symptom question naire were kept before the start of treatment until the end of treatment course . RESULTS From April 2002 to October 2004 , 80 patients were recruited of whom 64 were assessable for efficacy analyses . Thirty-three received clonidine and 31 venlafaxine , nine patients stopped early because of side-effects and seven withdrew consent . At the end of treatment week 4 , the median hot flash frequency dropped by 7.6 hot flashes per day for patients receiving venlafaxine and 4.85 hot flashes per day for those receiving clonidine ( P = 0.025 ) . CONCLUSION Venlafaxine is significantly more effective in reducing the frequency of hot flashes in breast cancer patients than clonidine BACKGROUND Hot flashes can be troublesome , especially when hormonal therapy is contraindicated . Preliminary data have suggested that newer antidepressants , such as venlafaxine , can diminish hot flashes . We undertook a double-blind , placebo-controlled , r and omised trial to assess the efficacy of venlafaxine in women with a history of breast cancer or reluctance to take hormonal treatment because of fear of breast cancer . METHODS Participants were assigned placebo ( n=56 ) or venlafaxine 37.5 mg daily ( n=56 ) , 75 mg daily ( n=55 ) , or 150 mg daily ( n=54 ) . After a baseline assessment week , patients took the study medication for 4 weeks . All venlafaxine treatment started at 37.5 mg daily and gradually increased in the 75 mg and 150 mg groups . Patients completed daily hot-flash question naire diaries . The primary endpoint was average daily hot-flash activity ( number of flashes and a score combining number and severity ) . Analyses were based on the women who provided data throughout the baseline and study weeks . FINDINGS 191 patients had evaluable data for the whole study period ( 50 placebo , 49 venlafaxine 37.5 mg , 43 venlafaxine 75 mg , 49 venlafaxine 150 mg ) . After week 4 of treatment , median hot flash scores were reduced from baseline by 27 % ( 95 % CI 11 - 34 ) , 37 % ( 26 - 54 ) , 61 % ( 50 - 68 ) , and 61 % ( 48 - 75 ) in the four groups . Frequencies of some side-effects ( mouth dryness , decreased appetite , nausea , and constipation ) were significantly higher in the venlafaxine 75 mg and 150 mg groups than in the placebo group . INTERPRETATION Venlafaxine is an effective non-hormonal treatment for hot flashes , though the efficacy must be balanced against the drug 's side-effects . Confirmation of the results of this 4-week study awaits the completion of three ongoing r and omised studies to assess the effects of other related antidepressants for the treatment of hot flashes PURPOSE Vasomotor symptoms are common adverse effects of antiestrogen hormone treatment in conventional breast cancer care . Hormone replacement therapy is contraindicated in patients with breast cancer .  Venlafaxine ( Effexor ) , the therapy of choice for these symptoms , has numerous adverse effects . Recent studies suggest acupuncture may be effective in reducing vasomotor symptoms in menopausal women . This r and omized controlled trial tested whether acupuncture reduces vasomotor symptoms and produces fewer adverse effects than venlafaxine . PATIENTS AND METHODS Fifty patients were r and omly assigned to receive 12 weeks of acupuncture ( n = 25 ) or venlafaxine ( n = 25 ) treatment . Health outcomes were measured for up to 1 year post-treatment . RESULTS Both groups exhibited significant decreases in hot flashes , depressive symptoms , and other quality -of-life symptoms , including significant improvements in mental health from pre- to post-treatment . These changes were similar in both groups , indicating that acupuncture was as effective as venlafaxine . By 2 weeks post-treatment , the venlafaxine group experienced significant increases in hot flashes , whereas hot flashes in the acupuncture group remained at low levels . The venlafaxine group experienced 18 incidences of adverse effects ( eg , nausea , dry mouth , dizziness , anxiety ) , whereas the acupuncture group experienced no negative adverse effects . Acupuncture had the additional benefit of increased sex drive in some women , and most reported an improvement in their energy , clarity of thought , and sense of well-being . CONCLUSION Acupuncture appears to be equivalent to drug therapy in these patients . It is a safe , effective and durable treatment for vasomotor symptoms secondary to long-term antiestrogen hormone use in patients with breast cancer INTRODUCTION Hot flashes represent a significant problem in men undergoing and rogen deprivation therapy . MATERIAL S AND METHODS Via a prospect i ve , double-blind , placebo-controlled clinical trial , men with hot flashes , on a stable and rogen deprivation therapy program for prostate cancer , received a placebo or gabapentin at target doses of 300 , 600 , or 900 mg/day . Hot flash frequencies and severities were recorded daily during a baseline week and for 4 weeks while the patients took the study medication . RESULTS In the 214 eligible patients who began the study drug on this trial , comparing the fourth treatment week to the baseline week , mean hot flash scores decreased in the placebo group by 4.1 units and in the three increasing dose gabapentin groups by , 3.2 , 4.6 , and 7.0 units . Comparing the three combined gabapentin arms to the placebo arm did not result in significant hot flash differences . Wilcoxon rank-sum P values for change in hot flash scores and frequencies after 4 weeks of treatment were 0.10 and 0.02 , comparing the highest dose gabapentin arm to the placebo arm , respectively . The gabapentin was well tolerated in this trial . CONCLUSION These results support that gabapentin decreases hot flashes , to a moderate degree , in men with and rogen ablation-related vasomotor dysfunction BACKGROUND Hot flushes are the most common complaints reported by men undergoing and rogen suppression treatment for prostate cancer . We design ed a r and omised double-blind trial to compare the efficacy of three drugs , each of which has proven effective for preventing hot flushes in previous studies . METHODS Men with prostate cancer with an indication for and rogen suppression were enrolled in the study at 106 urology centres in France between April 14 , 2004 , and April 20 , 2007 . All patients were treated for 6 months with leuprorelin ( 11.25 mg ) . At month 6 , patients who spontaneously asked for treatment , or those who presented with 14 hot flushes or more during the week before the visit , were r and omly assigned to either venlafaxine 75 mg daily , medroxyprogesterone acetate 20 mg daily , or cyproterone acetate 100 mg daily . All patients received two indistinguishable pills in the morning and one in the evening from week 1 to week 8 , and one indistinguishable pill in the morning from week 9 to week 10 , to comply with the double-blind design . R and om assignment with a block size of three was done central ly , by fax , and each patient was given a r and omisation number . The allocation sequence was stratified by centre . Assessment was done at inclusion , at r and omisation , and then at 4 weeks , 8 weeks , and 12 weeks after r and omisation . Participants completed a daily hot-flush diary for 1 week , and a quality of life question naire before each visit throughout the study . The primary outcome was the change in median daily hot-flush score between r and omisation and 1 month . All patients who received at least one study treatment dose were included in the efficacy analysis . This trial is registered with Clinical Trials.gov , number NCT01011751 . FINDINGS Of the 919 men initially enrolled , 311 were r and omly assigned to one of the study treatments at 6 months : 102 to venlafaxine , 101 to cyproterone , and 108 to medroxyprogesterone .  309 patients were included in the efficacy analysis , since two were excluded for protocol deviations ( one in the cyproterone and one in the medroxyprogesterone group ; both were excluded because they were already undergoing treatment with serotonin reuptake inhibitor antidepressants at r and omisation ) . The change in median daily hot-flush score between r and omisation and 1 month was -47.2 % ( IQR -74.3 to -2.5 ) in the venlafaxine group , -94.5 % ( -100.0 to -74.5 ) in the cyproterone group , and -83.7 % ( -98.9 to -64.3 ) in the medroxyprogesterone group . The decrease from baseline was significant for all three groups ( p<0.0001 ) . Pairwise comparison of treatment groups adjusted by the Bonferroni method confirmed that the decreases in hot-flush score were significantly larger in the cyproterone and medroxyprogesterone groups than in the venlafaxine group , regardless of the interval considered ( p<0.0001 in all cases ) . There was no significant difference between the cyproterone and medroxyprogesterone groups ( p>0.2 in all cases ) . Serious side-effects occurred in four , seven , and five patients in the venlafaxine , cyproterone , and medroxyprogesterone groups , respectively , of which none , one ( dyspnoea ) , and one ( urticaria ) were considered related to the drug , respectively . INTERPRETATION After 6 months of treatment with leuprorelin , venlafaxine , cyproterone , and medroxyprogesterone proved to be effective in reducing hot 
    Output:
    
Conclusion Venlafaxine/gabapentin significantly improved hot flashes in cancer patients under hormone manipulation therapies