PEP Topic 
Hot Flashes

Bupropion is used in the treatment of depression, as well as for seasonal affective disorder and smoking cessation. Bupropion is an antidepressant; it increases certain types of activity in the brain. Bupropion is available as a tablet and a sustained-release or extended-release tablet to take by mouth. Bupropion has been examined for effectiveness in the management of cancer-related fatigue and hot flashes.

Effectiveness Not Established

Research Evidence Summaries

Nunez, G.R., Pinczowski, H., Zanellato, R., Tateyama, L., Schindler, F., Fonseca, F., & Del Giglio, A. (2013). Bupropion for control of hot flashes in breast cancer survivors: A prospective, double-blind, randomized, crossover, pilot phase II trial. Journal of Pain and Symptom Management, 45, 969–979.

doi: 10.1016/j.jpainsymman.2012.06.011

Study Purpose:

To evaluate the efficacy of a smoking cessation medication in controlling symptoms of hot flashes in patients with breast cancer receiving hormonotherapy

Intervention Characteristics/Basic Study Process:

In the first phase of this crossover clinical trial, the intervention group received bupropion 150 mg for three days and 300 mg during the rest of the four-week period. The control group received placebo in the same four weeks. After one week of washout time, the groups were combined and crossed over to receive the same dose as the intervention or placebo at the beginning for four more weeks. The study was 10 weeks in length for both groups.

Sample Characteristics:

  • N = 55  
  • MEAN AGE: 49 years (33–71 years)
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: Women with breast cancer undergoing hormonal therapy, with seven or more hot flashes per week
  • OTHER KEY SAMPLE CHARACTERISTICS: Not tumor disease, already completed active treatment at least three months prior


  • SITE: Single site  
  • SETTING TYPE: Not specified   
  • LOCATION: Foundation School of Medicine, Sao Paulo, Brazil

Phase of Care and Clinical Applications:

  • PHASE OF CARE: Late effects and survivorship
  • APPLICATIONS: Elder care, palliative care

Study Design:

  • Double-blinded clinical trial
    • Randomized, placebo-controlled, crossover, pilot

Measurement Instruments/Methods:

  • A daily diary on the number and severity of hot flashes
  • ASEX scale to assess sexual function
  • Beck Depression Inventory (BDI)
  • Cancer Quality of Life Questionnaire (EORTC QLQ-C30)
  • Blood pressure and heart rate to evaluate physical signs


The reduction in hot flashes for the intervention group was 1.26 per day, without any difference in sexual function occurring nor statistical significance of side effects experienced between groups.


There was no activity shown for bupropion over placebo for control of hot flashes.


  • Small sample (< 100)


Nursing Implications:

Bupropion is not recommended in practice for women with breast cancer. It was not statistically significant in controlling the symptoms of hot flashes in comparison with the placebo group.