The People's Perspective on Medicine

Can an Antidepressant Really Help with Hot Flashes?

While an antidepressant might help with hot flashes and night sweats, stopping it could lead to withdrawal symptoms. A nondrug approach might be useful.

Menopause offers women numerous challenges, but the most significant symptom is probably hot flashes (vasomotor symptoms in doctor-speak). This may also be among the most variable symptoms. Some women break out in sweats and suffer unbearable heat waves several times an hour; others have only a few hot flashes every week. Because of concerns about hormonal therapies increasing the risks of heart attack, stroke and breast cancer, many women are looking for other approaches to help with hot flashes.

What Medicines Can Help with Hot Flashes?

Q. My sister is having a terrible time with hot flashes. She was taking a low dose of a hormone, but her doctor wanted her to stop. He was concerned about possible side effects. She has tried many OTC remedies with little relief; she cannot get a good night’s rest.

The doctor now wants her to try an antidepressant. I have been on an antidepressant for a number of years; it has helped me with irritability, but I’ve never had hot flashes. However, I know how hard it is to get off the antidepressant. I’ve tried several times and am still trying.

That’s why I’m concerned about her starting this medication. My question: can antidepressants really help with hot flashes?

Paroxetine May Help with Hot Flashes, But Will There Be Withdrawal Symptoms?

A. Like your sister, many women find the night sweats of menopause even more debilitating than daytime hot flashes. The FDA has approved the SSRI antidepressant paroxetine as a treatment for hot flashes. The brand name is Brisdelle. A review concludes that it may be effective but it can cause nausea and dizziness (Wei et al, BJOG, Oct. 2016).

Doctors sometimes prescribe a different antidepressant, venlafaxine, to control hot flashes. Neither of these medications should be discontinued abruptly. Even with gradual tapering of the dose, some people experience unpleasant withdrawal symptoms.

What Else Can Women Use to Help with Hot Flashes?

A group of experts in gynecology surveyed the literature a few years ago. They recommend cognitive behavior therapy, clinical hypnosis, weight loss when appropriate and mindfulness-based stress reduction as effective nonhormonal treatments for night sweats and hot flashes (Menopause, Nov. 2015).  Although acupuncture remains controversial, one study found it reduced hot flashes and improved quality of life (Avis et al, Menopause, June 2016).

Perhaps one of these nondrug options will give her some relief. She may also want to try one of the holistic approaches we wrote about in this post.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .

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I withdrew from Paxil over 9 months then was bedridden with withdrawal symptoms for 3 years. I still have symptoms. Some people are never able to stop taking it. Treating a normal condition with Paxil keeps the drug profitable for its manufacturers. Research “Paxil withdrawal.”

I have suffered from hot flashes for years, having many of them during a 24-hour period. Then 2 weeks ago, I saw Estroven advertised at Costco and tried it. It has cut my hot flashes back to just one or two during the same time period. I am amazed at how well it is working and thought I would suggest it to other women who are suffering from this aggravating symptom.

Going on an Antidepressant was the best decision I made for my hot flashes. I was getting them non stop to the point I was putting a bag of ice down my shirt to get relieve. I tried other thing like Black Cohosh but nothing worked. After a year I got of the meds to see if I still had the hot flashes and they came back with a vengeance. I had no problem getting of the meds. I requested to be put back on the meds and my hot flashes once again disappeared. I can only recommend the Antidepressant

Fascinating! When I went through menopause, I had very few hot flashes or night sweats and was surprised about that since I had seen my mother and many other women suffer a lot in this regard. However, one difference for me is that I was taking an antidepressant, Lexapro. I wonder if that was a factor. One thing I did notice is that two things seemed to trigger whatever hot flashes or night sweats I did experience: any vitamin supplement with niacin, and/or cinnamon (!). When I avoided both of these, my symptoms almost disappeared.

I tried several antidepressants for unbearable hot flashes. They all helped for a time, usually 3 to 6 months but all eventually stopped working. Not sure why this was for me, but did not want to continually increase the dose on these for the relief. Eventually have up and just lived with it. I am one of those who began the flashes early (hystetectomy) and it has persisted for 20 years.

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