Hot Flashes and Depression Medication

Estrogen can control nearly all hot flashes, but not nearly all women having hot flashes can safely take hormone therapy. Viable alternatives are avaliable for women who cannot take hormone therapy. A study of depression called the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) also looked at looked at menopausal hot flashes and vasomotor symptoms (VMS) after receiving antidepressant medication. Some earlier studies said that yes, antidepressant medication can fix hot flashes, but only for people who actually also have a mood component. Although for many years some antidepressants were prescribed off label for menopausal symptoms for those women only within the past gynos have not recommend long term antidepressants for treatment of just menopausal symptoms. But the FDA in June 2013 a 7.5-mg formulation of the selective serotonin reuptake inhibitor paroxetine mesylate, Brisdelle by Noven Therapeutics, an approved nonhormonal option for treating vasomotor symptoms (VMS) for  patients who either cannot use HT for medical reasons or who prefer not to use hormone therapy (HT). Women in menopause without contraindications can take low dose hormones, usually estrogen only for women without a uterus, estrogen and progesterone for women with a uterus, and the addition of testosterone has been used in the past for those having hot flashes still not controlled on hormone therapy. Gynos always  caution that estrogen treatment is only recommended to be given in the lowest dose and for the shortest treatment length of time to control their hot flashes, and once they have had no symptoms for over a year be tapered off hormones. For others the use of the antidepressant medications can be used in the tapering off of estrogen. Many women will not need hormone therapy and they can be treated by controlling their diet, their exercise, their weight, and the emotional responses to this. Women who use medication other than hormones for the control of hot flashes can have withdrawal side effects of the medications, and as an antidepressant we caution patients to notify providers if a patient taking the medicine has new symptoms of depression or suicidal thoughts. The antidepressants can reduce the effects of SERMS, tamoxifen for instance and may not be indicated for women on this medicine.


  1. In my opinion, the use of a psycho-active drug such as paroxetine,an SSRI anti-depressant, for treatment of symptoms caused by menopausal hormone deficiency is an abuse and mistreatment of women belonging in a medical museum as an example of medical iatrogenesis in women.

    Paroxetine, Paxil is medically ineffective for treatment of hot flashes, or any menopausal symptom for that matter, Paroxetine, Paxil is one of the most addictive of the SSRI drugs, with warnings about severe withdrawal effects, loss of libido etc.

    Menopause is a hormone deficiency state and the correct treatment is with hormones identical to those in the human body. Prescribing SSRI antidepressants for menopausal symptoms is a medical practice which should be halted immediately.

    for more

    jeffrey dach md

  2. All treatment strategies require appropriate risk benefit analysis with your own provider. Hormone therapy remains the gold standard for the treatment of vasomotor symptoms, and there is excellent evidence for the efficacy of hormones that are identical as well as those not identical to female estrogen(s). For those not eligible for hormone therapy, and in whom lifestyle management has also been unsuccessful, clinical trials indicate that alternative therapies can be administered safely.

  3. Anxiety and depression medications are generally similar. Whether you have anxiety or depression, it's very likely you will be prescribed antidepressants. Depression


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