Evaluating the role of serotonin in hot flashes after breast cancer using acute tryptophan depletion

Janet S. Carpenter, Menggang Yu, Jingwei Wu, Diane Von Ah, Jennifer Milata, Julie L. Otte, Shelley Johns, Bryan Schneider, Anna Maria Storniolo, Ronald Salomon, Zeuresenay Desta, Donghua Cao, Yan Jin, Santosh Philips, Todd C. Skaar

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

OBJECTIVE: Among women with breast cancer, hot flashes are frequent, severe, and bothersome symptoms that can negatively impact quality of life and compromise compliance with life-saving medications (eg, tamoxifen and aromatase inhibitors). Clinicians' abilities to treat hot flashes are limited due to inadequate understanding of physiological mechanisms involved in hot flashes. Using an acute tryptophan depletion paradigm, we tested whether alterations in central serotonin levels were involved in the induction of hot flashes in women with breast cancer. METHODS: This was a within-participant, double-blind, controlled, balanced, crossover study. Twenty-seven women completed two 9-hour test days. On one test day, women ingested a concentrated amino acid drink and encapsulated amino acids (no tryptophan) according to published procedures that have been shown to have specific effects on serotonin within 4.5 to 7 hours. On the other test day, women ingested a control drink. Serial venous blood sampling and objective hot flash monitoring were used to evaluate response to each condition. RESULTS: Response to acute tryptophan depletion was variable and unexplained by use of selective serotonin reuptake inhibitors, antiestrogens, breast cancer disease and treatment variables, or genetic polymorphisms in serotonin receptor and transporter genes. Contrary to our hypothesis, hot flashes were not worsened with acute tryptophan depletion. CONCLUSIONS: Physiologically documented and self-reported hot flashes were not exacerbated by tryptophan depletion. Additional mechanistic research is needed to better understand the etiology of hot flashes.

Original languageEnglish
Pages (from-to)644-652
Number of pages9
JournalMenopause
Volume16
Issue number4
DOIs
StatePublished - Jul 2009

Fingerprint

Hot Flashes
Tryptophan
Serotonin
Breast Neoplasms
Amino Acids
Serotonin Plasma Membrane Transport Proteins
Aromatase Inhibitors
Breast Diseases
Estrogen Receptor Modulators
Serotonin Receptors
Serotonin Uptake Inhibitors
Genetic Polymorphisms
Tamoxifen
Cross-Over Studies
Quality of Life

Keywords

  • Breast cancer.
  • Hot flashes
  • Menopause
  • Serotonin
  • Tryptophan

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Evaluating the role of serotonin in hot flashes after breast cancer using acute tryptophan depletion. / Carpenter, Janet S.; Yu, Menggang; Wu, Jingwei; Von Ah, Diane; Milata, Jennifer; Otte, Julie L.; Johns, Shelley; Schneider, Bryan; Storniolo, Anna Maria; Salomon, Ronald; Desta, Zeuresenay; Cao, Donghua; Jin, Yan; Philips, Santosh; Skaar, Todd C.

In: Menopause, Vol. 16, No. 4, 07.2009, p. 644-652.

Research output: Contribution to journalArticle

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