Mental health: Pharmacological interventions

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Background
Grading of Clinical Practice Recommendations
Clinical Practice Recommendations and Practice Points
Summary of Evidence - Methodology
Summary of Evidence - Introduction
Summary of Evidence - Vasomotor symptoms
Summary of Evidence - Sleep disturbance
Summary of Evidence - Vulvovaginal symptoms and sexual function
Summary of Evidence - Depression and anxiety
Summary of Evidence - Mood and emotional wellbeing
Summary of Evidence - Mental health
- Mental health: Pharmacological interventions
- Mental health: Psychological and physical interventions
Summary of Evidence - Global quality of life
Summary of Evidence - Breast cancer recurrence
Strengths and Weaknesses of the Evidence
Unanswered Questions Regarding Treatments of Interest
International Guidelines
Ongoing and Additional Trials of Interest
Drug Contraindications and Side Effects
Evidence Matrix
References
Acknowledgements
Additional Information
Appendix 1: Grading Methodology
Appendix 2: Evidence Summaries
Appendix 3: Recommendation Grading Forms

Antidepressants

Three RCTs (with a moderate risk of bias) in women after breast cancer found no statistically significant differences in mental health between the SNRI venlafaxine (37.5mg/d or 75mg/d) and placebo,²¹ clonidine (0.05mg/d),²² and gabapentin (900mg/d).²⁴ Another RCT (with a moderate risk of bias) found an equivalent statistically significant improvement in mental health and menopause-specific quality of life for venlafaxine (75mg/d) and acupuncture (30min/twice a week).²⁵

Anticonvulsants

One RCT (with a moderate risk of bias) in women after breast cancer found a significant improvement in mental health for gabapentin (900mg/d) compared with baseline, but found no statistically significant improvement for vitamin E (800IU/d) compared with baseline. The study did not report change from baseline between group differences.³³

Mental health: Pharmacological interventions