Easing Hot Flashes with Antidepressants

By: Red Hot Mamas

Published: October 11, 2007

Antidepressants are not strictly for depression anymore!  We may be able to use them to ease our hot flashes as well.  Menopause researchers recently presented information for the therapy at the 2007 North American Menopause Society (NAMS) Annual Meeting (October 3-6).

When people ask me what having a hot flash is like, I try to explain it without scaring them, but it really is like a long, seemingly never-ending walk in hell. They’re torturous and they like to return with a fiery vengeance. Most women are plagued with the ‘hot flash’ torment at some point in menopause.

Regardless of all the negative press it has received, estrogen is still considered the best treatment to relieve them (about 80% effectiveness). Many women are reluctant to take hormone therapy though, due to health risks. Former breast cancer patients are advised not to take hormone therapy at all.

Actually, the hot-flash fighting power of antidepressants was first noticed in studies of women with breast cancer. Many cancer drugs actually trigger hot flashes but researchers noticed a reduction while using antidepressants. So, they decided to see how effective they were on healthy, menopausal women. Antidepressants affect the regulation of serotonin in the brain. The antidepressants that are used for hot flashes include the agents selective serotonin reuptake inhibitors (SSRIs) and/or serotonin norepinephrine reuptake inhibitors (SNRIs).

If you’re a boomer like me, you’ll remember when antidepressants first came out. They’re not a new class of drug. They have been around since the early 1950s and originally developed as a treatment for tuberculosis. Nowadays, they are used for many conditions from anxiety to sleep disorders and now, hot flashes.

Currently, there is not an antidepressant on the market that is FDA (Food and Drug Administration) approved specifically for the management of hot flashes. Recent studies have not been entirely convincing but several doctors continue to write the prescription because many women find them enormously helpful.

In clinical trials, antidepressants are falling short of the “clinically significant” 50 percent reduction in hot flashes. A study of one antidepressant, Effexor reported a 60 percent reduction in hot flashes although it was found to work best at high doses. Side effects including dry mouth, nausea, constipation or sexual side effects are common.  And, these side effects are exacerbated by higher doses.

Different groups of menopausal women seem to respond differently to the treatment. In a recent trial for the antidepressant, Zoloft, researchers noticed some women’s hot flashes improved greatly while others worsened. Obviously, more studies need to be completed that can pinpoint the reason for this variation.

Like all therapies though, each person is different. All benefits and risks should be thoroughly discussed with your doctor before considering a treatment. For women who want to have a go at using antidepressants for their hot flashes, doctors recommend slowly transitioning into them and closely monitoring the progress.  For depression, antidepressants take about six weeks to effectively work. However, with hot flashes, you may see relief of hot flashes within a week.

Currently, no studies have yet examined the long-term risks of antidepressants for hot flashes.  Clearly, more research needs to be completed, but eventually this therapy may develop into a viable option for women suffering from the annoyances of hot flashes.

It is important for you to have a basic understanding of antidepressant medications and work closely with your doctor who is familiar with this medication. Many types of antidepressant medications exist. Some have side effects that cause women to switch from one drug to another. Antidepressants should be taken exactly as prescribed.

Antidepressants must be prescribed and monitored by a physician who is familiar with their use. Before taking any medication, you should ask the following questions:

1. What are the possible side effects and risks?
2. How long will I have to take this medication to effectively work?
3. Will taking this medicine affect my ability to work or drive?
4. Does this medication interact with over the counter medications or any other prescribed medications?
5. What happens if I skip a dose, or take a double dose?
6. Are there any side effects associated with this medication?
7. Should I take this medication with food?
8. Do I have to avoid drinking alcohol while taking this medication?

There are other non-pharmaceutical solutions which may be helpful in helping control hot flashes, irritability and improve your mood which include exercise and social support (i.e., Red Hot Mamas education and support programs, and psychotherapy which may be helpful during the menopause transition).

Other ways to manage hot flashes:

1. Avoid spicy foods, alcohol, caffeine, and very large meals
2. Reduce stress levels.  A stress can accelerate hot flashes.
3. Avoid smoking as it can increase hot flashes.
4. Stay cool by wearing natural fibers that breathe.
5. Exercise to decrease the severity of hot flashes.
6. Talk to your doctor about the medications that can effectively eliminate hot flashes.

References:

Kerwin, J.P., Gordon, P. R., Senf, J.H., 2007, The Variable Response of Women with Menopausal Hot Flashes when Treated with Sertraline; Menopause: The Journal of The North American Menopause Society, V. 14, No. 5, pp.841-845.

Parker-Pope, T., 2007. Antidepressants Emerge as Coolant for Hot Flashes, The New York Times.[Online] Available http://www.nytimes.com/2007/10/09/health/09well.html?ref=science, October 9, 2007.

Thurston, R.C., 2007. SSRIs for Menopausal Hot Flashes: a Promise Yet to be Delivered; Menopause: The Journal of The North American Menopause Society, Vol. 14, No. 5, pp.820-822.

Read more about hot flashes.

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