Antidepressants may Help Treat Hot Flash Symptoms of Menopause

While hormone replacement therapy can combat the onset of menopause, stressful symptoms may linger, including night sweats or "hot flashes" and increased anxiety.

Yet a recent study suggests that certain antidepressants may be helpful in treating the health issue.

Lead study author Hadine Joffe, MD, MSc, of Brigham and Women's Hospital at Harvard Medical School in Boston, found that estradiol, an estrogen medication, and venlafaxine, more commonly known as Effexor, can help reduce hot flashes.

For the study, researchers examined 339 menopausal women who had not menustrated for at least a year or had both ovaries removed or were premenopausal and had not had a menstrual period for 60 days or more in the previous year. All of the participants were 40 to 62 years old, and had experienced at least two vasomotor symptoms per day, including the inability to properly regulate body temperature, depression or vaginal dryness.

All of the participants came in for three clinic visits and received two telephone assessments between December 2011 and October 2012. They were also asked to complete questionnaires regarding vasomotor symptoms and menstrual bleeding, and each participant was randomly assigned to receive low-dose estradiol (0.5 milligrams per day), a daily placebo or a daily dose of low-dose venlafaxine hydrochloride (75 milligrams per day) for a period of eight weeks, a drug that was recently approved by the U.S. Food and Drug Administration (FDA) for vasomotor symptom control.

In this study, 97 women took estradiol, 96 took venlafaxine and 146 received a placebo. At the end of eight weeks, those taking estradiol reported fewer vasomotor symptoms at around 3.9 per day. Those who took venlafaxine had 4.4 vasomotor symptoms per day and women on the placebo reported 5.5 symptoms per day.

The women rated their satisfaction with treatment, and more than 70 percent on estradiol were pleased with their treatment. This was also true for about 51.1 percent of women taking venlafaxine and 38.4 percent on placebo.

Though few negative effects were reported regarding the treatment, venlafaxine has been shown to increase blood pressure in some women. Estradiol is also not recommended for women at high risk for breast cancer.

"Low-dose oral estradiol and venlafaxine were effective and well-tolerated treatments for perimenopausal and postmenopausal women with bothersome [vasomotor symptoms]," the authors concluded, via dailyrx.com. "Treatment decisions should weigh the risk profile of each agent for each individual woman, taking into account her risk factor status and personal preferences regarding treatment options."

More information regarding the findings can be seen via May 26 in JAMA Internal Medicine.