Abstract : Abstract Because of the increasing importance of prostatic carcinoma in developed societies, the    more

Abstract : Abstract Because of the increasing importance of prostatic carcinoma in developed societies, the benefit-harm of treatments provided for this condition should be carefully considered. Extensive knowledge is currently required because of the increasingly complex therapeutic approach to prostatic carcinoma. Androgen deprivation plays a major role in this condition. Treatment of resulting toxicity such as hot flashes, metabolic syndrome, osteoporosis, cognitive disorders, etc. acquires an increasing interest. Drug treatment of hot flashes requires hormone management that is not free from oncological risk and also has a non-negligible toxicity. Antidepressants play a significant role in nonhormonal treatment for this condition. Trazodone, a SARI antidepressant (serotonin-2 antagonists/reuptake inhibitors) with a more selective action profile on receptors implicated in hot flashes, could have a great interest. Trazodone shows a great affinity for 5-HT2A receptors and a moderate affinity for 5-HT1A receptors. As known, serotonin (5-hydroxytriptamine or 5-HT) levels are decreased in postmenopausal women, and are normalized by replacement therapies. This suggests that sudden deprivation of sexual hormones leads to a decreased serotonin circulation, with the resultant increase in its hypothalamic 5-HT2A receptors. These receptors would be involved in the pathogenesis of hot flashes, and their blockade is one of the main therapeutic measures. Use of trazodone to increase serotonin concentrations and block the 5-HT2A and 5-HT1A may be considered as a new approach more consistent with the physiopathology of hot flashes. Well conducted comparative studies are required to ascertain its effectiveness. Other pending questions would be the adequate doses and the most effective treatment duration for controlling hot flashes. Keywords: Prostatic carcinoma. Hot flashes. Hormone deprivation. Treatment. Antidepressants. Trazodone. 5-HT2A receptors.- Slides    less