A selective serotonin receptor agonist for weight loss and management of menopausal vasomotor symptoms in overweight midlife women: a pilot study

These changes are a result of aging, decreasing estrogen levels after menopause, and other unique influences in menopausal women that interfere with the adoption of healthy lifestyle measures, including vasomotor symptoms

Ekta Kapoor; Stephanie Faubion; Ryan T. Hurt; Karen Fischer; Darrell Schroeder; Shawn Fokken; Ivana T. Croghan

2020

Scholarcy highlights

  • These changes are a result of aging, decreasing estrogen levels after menopause, and other unique influences in menopausal women that interfere with the adoption of healthy lifestyle measures, including vasomotor symptoms
  • The weight loss-inducing properties of lorcaserin are well recognized from four large prospective randomized controlled trials, and the medication was Food and Drug Administration-approved for this indication in 2012.33–36 to our knowledge, this is the first report that demonstrates that the 5-HT2C receptor agonist may have a beneficial effect in menopausal VMS
  • In February 2020, several months after completion of the current pilot study, the US FDA recommended that lorcaserin be withdrawn from the market due to a concern regarding increased risk of cancer
  • Recent evidence suggests that VMS are not triggered by an increase in core body temperature, but instead may be triggered by thermoregulatory mechanisms resulting in a transient decrease in the core temperature threshold for sweating or may be related to nonthermoregulatory mechanisms altogether
  • The average weight at week 6 and week 12 was significantly decreased from baseline, with an average change of −1.9 kg at week 6 and −2.4 kg at week 12
  • Further support of a link between orexigenic neurons and VMS may be provided by a clinical trial investigating suvorexant, a dual orexin receptor antagonist that is FDA approved for treatment of insomnia, in the management of hot flash-associated insomnia
  • Keywords lorcaserin; serotonin receptor agonist; hot flash; vasomotor symptoms; obesity

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