SSRI shows efficacy in reducing menopausal symptoms

Escitalopram (Lexapro; Forest Laboratories Inc, New York, New York), a selective serotonin reuptake inhibitor approved by the US Food and Drug Administration for the treatment of anxiety and depression, significantly reduces the frequency, severity, and bother of hot flashes, according to the findings of a multicenter, 8-week, randomized, double-blind, placebo-controlled trial.

The trial enrolled 205 women aged 40 through 62 years between July 2009 and June 2010. The women were either in menopause transition (ie, amenorrhea for 60 days or more in the past year) or postmenopausal (ie, 12 months or more since last menses or bilateral oophorectomy).

At baseline, the women experienced a mean of almost 10 hot flashes daily. By week 8, the women taking escitalopram 10 to 20 mg per day experienced a mean reduction in hot flash frequency of 4.6 (95% Confidence Interval [CI], 3.74-5.47) per day versus 3.20 (95% CI, 2.24-4.15) for those taking placebo, for a difference of 1.41 per day (95% CI, 0.13-2.69). More than half (55%) of the treatment group versus 36% of the placebo group reported a decrease of at least 50% in hot flash frequency (P=.009) at 8 weeks.

Similarly at baseline, the mean bother score was 3.14 on a 4-point scale. By week 8, the mean score was 2.48 (95% CI, 2.32-2.64), a 20% decrease, in the treatment group versus 2.76 (95% CI, 2.61-2.91), an 18% decrease, in the placebo group.

Discontinuation because of adverse events was 4% (7 in the active group; 2 in the placebo group). Three weeks after treatment concluded, women in the treatment group reported a mean 1.59 (95% CI, 0.55-2.63; P=.02) more hot flashes daily than women in the placebo group.

Freeman EW, Guthrie KA, Caan B, et al. Efficacy of escitalopram for hot flashes in healthy menopausal women. JAMA. 2011;305(3):267-274.