Are antidepressants the magic pill to end hot flashes?

This nonhormone treatment holds promise for all women, but some remain skeptical.

By Susan J. Landers, AMNews staff. April 8, 2002.

Washington -- As the debate continues over the safety of hormone replacement therapy, an alternative treatment for the hot flashes that can plague postmenopausal women -- and some men undergoing treatment for prostate cancer -- has recently emerged.

Studies have shown that at least some medications among the new generation of antidepressants, the serotonin reuptake inhibitors, can provide safe and effective relief for hot flashes.

The finding emerged from attempts to control hot flashes in women undergoing treatment for breast cancer, which can bring with it severe menopausal symptoms.

"We've looked into this for our patients because it is a big quality-of-life issue," said Charles Loprinzi, MD, a Mayo Clinic oncologist, who has been seeking ways to alleviate hot flashes for several years.

"We've looked at soy, which didn't work; vitamin E, which worked a little and is nontoxic; and a blood pressure medication, which works a little but has side effects," he said.

"More recently we started looking at the newer antidepressants based on some anecdotal evidence."

Fluoxetine was found to have vanquished one patient's hot flashes, and venlafaxine and sertraline were believed to do the same.

In an eight-week, double-blind, randomized study with an enrollment of 102 women, Dr. Loprinzi and his Mayo colleagues put venlafaxine to the test and found that women who received the antidepressant reported an approximate 60% drop in hot flashes.

The study examined the effectiveness of daily doses ranging from 37.5 mg to 150 mg before settling on an optimum dose of 37.5 mg to 75 mg daily. [...]