Antidepressants for Hot Flushes

Have you been prescribed antidepressants to treat hot flushes or hot flashes even though you do not feel depressed? Antidepressants can be used to treat hot flushes.

Antidepressants for Hot Flushes

Can antidepressants be used to treat hot flushes or hot flashes?

On page two in Menopause Management Options: Non-Hormonal Options – Non-hormonal Prescription Medication: Antidepressants the (Australian) Jean Hailes for Women’s Health (JH) explain:

“Some antidepressants have been shown to relieve hot flushes. For example, venlafaxine, paroxetine, escitalopram and fluoxetine. Side effects may include nausea, dry mouth, hot flushes, sweats and insomnia.

Note: Paroxetine and fluoxetine can reduce the effectiveness of some cancer treatment medications”.

In Hot Flashes: Diagnosis & Treatment – Treatment: Antidepressants the (United States) Mayo Clinic elaborate on:

Antidepressants for Hot Flushes“A low-dose form of paroxetine (Brisdelle) is the only nonhormone treatment for hot flashes approved by the U.S. Food and Drug Administration. Other antidepressants that have been used to treat hot flashes include:

  • Venlafaxine (Effexor XR)
  • Paroxetine (Paxil, Pexeva)
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)

These medications aren’t as effective as hormone therapy for severe hot flashes, but they can be helpful to women who can’t use hormones. Possible side effects include nausea, difficulty sleeping or drowsiness, weight gain, dry mouth or sexual dysfunction”.

In Hot Flashes: How Do I Treat A Hot Flash? Non-hormonal Medications the (United States) Cleveland Clinic explain:

“Certain antidepressants, called selective serotonin reuptake inhibitors (SSRIs), can reduce how often you have hot flashes and how bad they are. These medications include:

  • Venlafaxine (Effexor®)…
  • Desvenlafaxine (Pristiq®)…
  • Fluoxetine (Prozac®)…
  • Paroxetine (Paxil®, Brisdelle®)…
  • Escitalopram (Lexapro®)…
  • Gabapentin (Neurontin®)…
  • Clonidine (Catapres®)…”.

In The 2023 Practitioner’s Toolkit for Managing Menopause: Management – Menopausal Hormone Therapy, published online 30 October 2023, the authors elaborate on:

“The following non-hormonal therapies have evidence to support their use to alleviate VMS.

The selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are effective in some, but not all, women with VMS. Paroxetine, 7.5 mg/day, has regulatory approval for VMS in the USA.

Fezolinetant is a neurokinin 3B receptor antagonist that acts centrally in the brain to reduce VMS. It may improve sleep quality by reducing nocturnal VMS. Fezolinetant has been approved for the treatment of VMS at a dose of 45 mg/day in some countries.

Low-dose oxybutynin has been found to be effective for treatment of VMS either as a standard low-dose or extended-release formulation.

Other potential, but probably less effective, options include clonidine and gabapentin/pregabalin. Clonidine may be prescribed for VMS for women who cannot take estrogen at a dose of 100–150 μg/day, although the effect is modest and it is not consistently recommended…”.

2023 Nonhormone Therapy Position Statement of The North American Menopause Society

What did the Nonhormone Therapy Position Statement of The North American Menopause Society include?

In The 2023 Nonhormone Therapy Position Statement of The North American Menopause Society: Methods Prescription Therapies: Selective Serotonin Reuptake Inhibitors and Serotonin-Norepinephrine Reuptake Inhibitors, published May 2023, the authors elaborate on:

“Paroxetine, escitalopram, citalopram, venlafaxine, and desvenlafaxine have been shown to significantly reduce VMS in large, double-blind RCTs of symptomatic women. Duloxetine has been found to reduce VMS in smaller studies. Hot flash reductions vary from 25% to 69% with these treatments, with improvements in composite hot flash severity and frequency from 27% to 61%. Trends toward improvement have been seen with sertraline and fluoxetine, but these were statistically insignificant; therefore, they are not recommended”.

What is VMS?

VMS can be an abbreviation for Vasomotor Symptoms such as hot flushes and night sweats.

What is RCTs?

RCTs can be an abbreviation for Randomized Controlled Trials.

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Hot Flushes + Depression

Do antidepressants used to manage hot flushes also treat depression?

In Hot Flashes: What Can I Do? Non-Hormonal Medications To Treat Hot Flashes the (United States) National Institute on Aging (NIA) note:

“Women who use an antidepressant to help manage hot flashes generally take a lower dose than people who use the medication to treat depression”.

Health Care Provider

What if I would like to try an antidepressant to treat my hot flushes?

In Hot Flashes: What Can I Do? Non-Hormonal Medications To Treat Hot Flashes the NIA also note:

Antidepressants for Hot Flushes“As with any medication, talk with your doctor about whether this is the right medication for you and how you might manage any possible side effects”.

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New or Updated

  1. Askearlymenopause.org [Ask EM] [+ Video: What Is Early Menopause?]
  2. Dr Louise Newson: The Truth About the Menopause & HRT
  3. Find A Menopause Practitioner [United States and Other]
  4. Find An AMS Doctor [Australasian Menopause Society i.e. Australia and New Zealand]
  5. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  6. Hormone Therapy: Four Things A Mayo Clinic Women’s Health Specialist Wants You To Know [+ Video Courtesy: Mayo Clinic News Network. Name Super/CG: Taryn Smith, M.D./Internal Medicine/Mayo Clinic]
  7. Hot Flashes: Non-Hormonal Medications
  8. Hot Flashes: Diagnosis & Treatment – Treatment: Antidepressants
  9. Hot Flashes: What Can I Do? [+ Video: What Are the Signs and Symptoms of Menopause?]
  10. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – Hormone Replacement Therapy (HRT) [+ Video: Is HRT Bad for You?] [Other Languages and Formats]
  11. Menopause Map: My Personal Path Print Tools – Questions for Your Health Care Provider
    Antidepressants for Hot Flushes
  12. Menopause and HRT: Fact and Fiction
  13. Mayo Clinic Minute: Perimenopause and Menopause [+ Video Courtesy: Mayo Clinic News Network]
  14. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP 256
  15. Navigating Menopause: Expert Insights and Solutions | Dr Susan Davis | The Proof Podcast EP 245
  16. Navigating Menopause: Honest Answers To All Your Questions [+ Video: What To Expect in Menopause]
  17. Selective Serotonin Reuptake Inhibitors
  18. Selective Serotonin Reuptake Inhibitors (SSRIs)
  19. The 2023 Practitioner’s Toolkit for Managing Menopause
  20. The 2023 Nonhormone Therapy Position Statement of The North American Menopause Society
  21. The 2023 Nonhormone Therapy Position Statement of The North American Menopause Society
  22. The Women’s Health Initiative Randomized Trials and Clinical Practice
  23. Video Series-2023: NAMS 2023 Nonhormone Therapies Position Statement for Bothersome Menopause Symptoms
  24. Video Series-2023: New FDA-Approved Nonhormone Option for the Treatment of Hot Flashes
  25. Videos and Podcasts: Videos – Interviews: A Simple Approach To Menopause: The Menopause Quick Six (www.MQ6.ca)
  26. Webinars: Previous – Non-Hormonal Pharmacological Interventions For VMS
  27. Webinars: Previous – Non-Pharmacological Interventions For VMS
  28. What Are the Most Common Symptoms of Menopause? And Which Can Hormone Therapy Treat?
  29. What if HRT isn’t right for me? And is cold-water swimming really the answer to everything? Your Menopause Questions Answered
  30. What’s the Best Nonhormonal Therapy for Hot Flashes? Experts Release New Menopause Therapy Guidelines

Last Updated: 21 June 2024 – Last Revised: 19 June 2024
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