Antidepressant Use Reduced Hot Flashes in Menopausal Women

January 24, 2011

Peri-menopausal and postmenopausal women who took the antidepressant medication escitalopram – brand name Lexapro® – experienced a reduction in the frequency and severity of hot flashes as compared to women who received placebo according to a new study led by the University of Pennsylvania School of Medicine. The study was published in the January 19th issue of the Journal of the American Medical Association.

“Our findings suggest that among healthy women who were not depressed or anxious, a 10 to 20 milligram dose of escitalopram – which is well below the dosage level for psychiatric use – provides a nonhormonal, off-label option that is effective and well-tolerated in the management of menopausal hot flashes,” said Ellen W. Freeman, PhD, Penn research professor of Obstetrics and Gynecology and principal investigator of the national, multi-site study.

At the end of the study after eight weeks, participants showed a significant decrease in hot flash frequency and intensity in the escitalopram group compared to the placebo group – 55 percent vs. 36 percent. The three-week study participant follow-up also showed that hot flashes increased after cessation of escitalopram but not after cessation of placebo, further proving the drug’s effectiveness. Dr. Freeman and her colleagues note that while the reduction in hot flash frequency and severity seem modest, the study participants perceived these improvements as “meaningful,” greatly improving their quality of life and reinforcing their desire to continue the treatment.

Hormone replacement therapy has been the predominant treatment for menopausal hot flashes. Its use has greatly decreased, however, since the Women’s Health Initiative Estrogen plus Progestin randomized controlled trial identified health risks – primarily the increase in risk of heart disease. Despite this, no other treatments for menopausal hot flashes have FDA approval. And while selective serotonin and serotonin norepinephrine reuptake inhibitors (SSRIs and SNRIs) have been investigated to treat hot flashes, the previous studies were pilot investigations, conducted only on small samples and in unblinded trials.

Source: University of Pennsylvania

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