SSRI demonstrates efficacy in controlling hot flashes

Vasomotor symptoms during menopause strongly affect women's quality of life. Those who do not want to use hormone therapy to control these symptoms may have another treatment option in selective serotonin reuptake inhibitors (SSRIs).

Results from a randomized, placebo-controlled multicenter, double-blind clinical trial show that the SSRI escitalopram was significantly more effective than placebo in reducing hot flash interference.

Two hundred five healthy women aged 40-62 years who were menopausal (ie, no period within the previous 12 months) or in late menopausal transition were enrolled. All reported having at least 28 hot flashes or night sweats per week within 3 weeks; bothersome or severe hot flashes on 4 or more days per week; or hot flash frequency in week 3 did not decrease by at least 50% from the mean levels in the previous 2 weeks. They were randomized to receive 10 mg of escitalopram or placebo daily with follow-up at 4 and 8 weeks. Women whose hot flash frequency was not reduced by 50% by week 4 were increased to 2 escitalopram 10 mg or placebo pills per day.

"The fact that treatment effects did not vary by baseline demographic, clinical, or symptom variables is important clinically as it suggests that escitalopram's effect may be similar across diverse menopausal patient populations," the authors write. "Clinicians can use these findings to educate women about anticipated treatment effects for quality of life."

Carpenter JS, Guthrie KA, Larson JC, et al. Effect of escitalopram on hot flash interference: a randomized, controlled trial. Fert Steril. 2012. Epub ahead of print.