MsFLASH-01: Escitalopram for Menopausal Symptoms in Midlife Women

NCT ID: NCT00894543

Last Updated: 2013-03-08

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

205 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-07-31

Study Completion Date

2010-06-30

Brief Summary

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The purpose of this study is to test whether a medication reduces the number, severity and bothersomeness of menopausal hot flashes. Escitalopram (also called Lexapro®) is a selective serotonin reuptake inhibitor (SSRI). It is sold by prescription for depression and general anxiety disorder. An SSRI increases serotonin, a brain substance that is believed to influence mood. Serotonin may also affect brain levels of estradiol, a hormone related to hot flashes. This research study will test whether escitalopram reduces menopausal hot flashes.

Detailed Description

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The MsFLASH-01 study, Efficacy of a Selective Serotonin Reuptake Inhibitor (SSRI) for Menopausal Symptoms in Midlife Women is a randomized, double-blind, placebo-controlled, parallel arm clinical trial. The design includes: 3 weeks of daily recording of hot flashes prior to drug treatment; 8 weeks of double-blind treatment with escitalopram or placebo with dose escalation at 4 weeks among non-responders; 1 week of drug taper for those on higher dose, followed by 2 weeks with no treatment; and a telephone follow-up post-treatment. This study is one of five clinical trials to be conducted as part of the Menopause Strategies - Finding Lasting Answers for Symptoms and Health (MsFLASH) study, a network of investigators and clinical trials designed to find new ways to alleviate the most common, bothersome symptoms of the menopausal transition.

Conditions

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Hot Flashes Menopause Vasomotor Symptoms

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Escitalopram

Escitalopram is a selective serotonin reuptake inhibitor (SSRI)

Group Type ACTIVE_COMPARATOR

Escitalopram

Intervention Type DRUG

10 mg (1 pill) escitalopram daily for the first four weeks. Dose increased to 20 mg (2 pills) escitalopram daily if relief from hot flashes has not occurred during the first four weeks of the daily 10 mg dose.

Placebo

Inactive pill

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Inactive pill (1 pill or 2 pills) daily for the 8-11 weeks of the trial.

Interventions

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Escitalopram

10 mg (1 pill) escitalopram daily for the first four weeks. Dose increased to 20 mg (2 pills) escitalopram daily if relief from hot flashes has not occurred during the first four weeks of the daily 10 mg dose.

Intervention Type DRUG

Placebo

Inactive pill (1 pill or 2 pills) daily for the 8-11 weeks of the trial.

Intervention Type OTHER

Other Intervention Names

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Lexapro®.

Eligibility Criteria

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Inclusion Criteria

* Females aged 40-62 years.
* Menopausal, including:

* Women with a uterus who have skipped 2 or more menstrual cycles with an amenorrhea interval ≥60 days in the past 12 months.
* Women who have had a bi-lateral oophorectomy (surgical removal of both ovaries).
* Women without a uterus who still have ovaries, under certain conditions determined during screening.
* Having bothersome hot flashes.
* In general good health as determined by medical history and physical measures.
* Signed informed consent.

Exclusion Criteria

* Use of hormone therapy or hormonal contraceptives during the 2 months before enrollment and for the duration of the study. Certain exceptions apply, determined during screening.
* Use of any other therapy that is taken specifically for hot flashes, including prescription, over-the-counter, or herbal therapies in the past month and duration of the study.
* Any current severe or unstable medical illness.
* Uncontrolled hypertension (\>160/100) or resting heart rate \>110.
* History of endometrial or ovarian cancer; MI, angina, or cerebrovascular events.
* Pregnancy, intending pregnancy, breast feeding.
* Current participation in another drug trial or intervention study.
* Inability or unwillingness to complete the study procedures.
* Certain other conditions, determined during screening.


* Use of selective estrogen receptor modulators (SERMS) or aromatase inhibitors during the two months before enrollment.
* Use of gabapentin, pregabalin, triptans, warfarin (Coumadin®), or St. John's Wort.
* Known hypersensitivity to escitalopram (Lexapro®) or citalopram (Celexa®).
* Use of antidepressants during the past 30 days before starting Study 01, including SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), and anxiolytics.
* Not using a medically approved method of birth control, if sexually active and not 12 or more months since last menstrual period.
* History of liver, gall bladder, renal disease, or uncontrolled seizure disorder.
* Certain other conditions, determined during screening.
Minimum Eligible Age

40 Years

Maximum Eligible Age

62 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

National Center for Complementary and Integrative Health (NCCIH)

NIH

Sponsor Role collaborator

Office of Research on Women's Health (ORWH)

NIH

Sponsor Role collaborator

Fred Hutchinson Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Fred Hutchinson Cancer Research Center

Principal Investigators

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Ellen W Freeman, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania Medical Center

Andrea Z LaCroix, PhD

Role: PRINCIPAL_INVESTIGATOR

Fred Hutchinson Cancer Center

Garnet L Anderson, PhD

Role: PRINCIPAL_INVESTIGATOR

Fred Hutchinson Cancer Center

Kris Ensrud, MD

Role: STUDY_CHAIR

University of Minnesota

Locations

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Northern California Kaiser, Division of Research

Oakland, California, United States

Site Status

Indiana University

Indianapolis, Indiana, United States

Site Status

Massachusetts General Hospital, Harvard Medical School

Boston, Massachusetts, United States

Site Status

Brigham and Women's Hospital

Chestnut Hill, Massachusetts, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

References

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Freeman EW, Guthrie KA, Caan B, Sternfeld B, Cohen LS, Joffe H, Carpenter JS, Anderson GL, Larson JC, Ensrud KE, Reed SD, Newton KM, Sherman S, Sammel MD, LaCroix AZ. Efficacy of escitalopram for hot flashes in healthy menopausal women: a randomized controlled trial. JAMA. 2011 Jan 19;305(3):267-74. doi: 10.1001/jama.2010.2016.

Reference Type RESULT
PMID: 21245182 (View on PubMed)

Carpenter JS, Guthrie KA, Larson JC, Freeman EW, Joffe H, Reed SD, Ensrud KE, LaCroix AZ. Effect of escitalopram on hot flash interference: a randomized, controlled trial. Fertil Steril. 2012 Jun;97(6):1399-404.e1. doi: 10.1016/j.fertnstert.2012.03.001. Epub 2012 Apr 3.

Reference Type RESULT
PMID: 22480818 (View on PubMed)

Ensrud KE, Joffe H, Guthrie KA, Larson JC, Reed SD, Newton KM, Sternfeld B, Lacroix AZ, Landis CA, Woods NF, Freeman EW. Effect of escitalopram on insomnia symptoms and subjective sleep quality in healthy perimenopausal and postmenopausal women with hot flashes: a randomized controlled trial. Menopause. 2012 Aug;19(8):848-55. doi: 10.1097/gme.0b013e3182476099.

Reference Type RESULT
PMID: 22433978 (View on PubMed)

Reed SD, Guthrie KA, Joffe H, Shifren JL, Seguin RA, Freeman EW. Sexual function in nondepressed women using escitalopram for vasomotor symptoms: a randomized controlled trial. Obstet Gynecol. 2012 Mar;119(3):527-38. doi: 10.1097/AOG.0b013e3182475fa4.

Reference Type RESULT
PMID: 22353950 (View on PubMed)

LaCroix AZ, Freeman EW, Larson J, Carpenter JS, Joffe H, Reed SD, Newton KM, Seguin RA, Sternfeld B, Cohen L, Ensrud KE. Effects of escitalopram on menopause-specific quality of life and pain in healthy menopausal women with hot flashes: a randomized controlled trial. Maturitas. 2012 Dec;73(4):361-8. doi: 10.1016/j.maturitas.2012.09.006. Epub 2012 Sep 30.

Reference Type RESULT
PMID: 23031421 (View on PubMed)

Joffe H, Guthrie KA, Larson J, Cohen LS, Carpenter JS, Lacroix AZ, Freeman EW. Relapse of vasomotor symptoms after discontinuation of the selective serotonin reuptake inhibitor escitalopram: results from the menopause strategies: finding lasting answers for symptoms and health research network. Menopause. 2013 Mar;20(3):261-8. doi: 10.1097/GME.0b013e31826d3108.

Reference Type RESULT
PMID: 23435022 (View on PubMed)

Diem SJ, LaCroix AZ, Reed SD, Larson JC, Newton KM, Ensrud KE, Woods NF, Guthrie KA. Effects of pharmacologic and nonpharmacologic interventions on menopause-related quality of life: a pooled analysis of individual participant data from four MsFLASH trials. Menopause. 2020 Oct;27(10):1126-1136. doi: 10.1097/GME.0000000000001597.

Reference Type DERIVED
PMID: 32701665 (View on PubMed)

Guthrie KA, Larson JC, Ensrud KE, Anderson GL, Carpenter JS, Freeman EW, Joffe H, LaCroix AZ, Manson JE, Morin CM, Newton KM, Otte J, Reed SD, McCurry SM. Effects of Pharmacologic and Nonpharmacologic Interventions on Insomnia Symptoms and Self-reported Sleep Quality in Women With Hot Flashes: A Pooled Analysis of Individual Participant Data From Four MsFLASH Trials. Sleep. 2018 Jan 1;41(1):zsx190. doi: 10.1093/sleep/zsx190.

Reference Type DERIVED
PMID: 29165623 (View on PubMed)

Guthrie KA, LaCroix AZ, Ensrud KE, Joffe H, Newton KM, Reed SD, Caan B, Carpenter JS, Cohen LS, Freeman EW, Larson JC, Manson JE, Rexrode K, Skaar TC, Sternfeld B, Anderson GL. Pooled Analysis of Six Pharmacologic and Nonpharmacologic Interventions for Vasomotor Symptoms. Obstet Gynecol. 2015 Aug;126(2):413-422. doi: 10.1097/AOG.0000000000000927.

Reference Type DERIVED
PMID: 26241433 (View on PubMed)

Newton KM, Carpenter JS, Guthrie KA, Anderson GL, Caan B, Cohen LS, Ensrud KE, Freeman EW, Joffe H, Sternfeld B, Reed SD, Sherman S, Sammel MD, Kroenke K, Larson JC, Lacroix AZ. Methods for the design of vasomotor symptom trials: the menopausal strategies: finding lasting answers to symptoms and health network. Menopause. 2014 Jan;21(1):45-58. doi: 10.1097/GME.0b013e31829337a4.

Reference Type DERIVED
PMID: 23760428 (View on PubMed)

Other Identifiers

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1U01AG032699-01

Identifier Type: NIH

Identifier Source: secondary_id

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1U01AG032656-01

Identifier Type: NIH

Identifier Source: secondary_id

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MsFLASH-01

Identifier Type: -

Identifier Source: org_study_id

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