How are antidepressants used to treat hot flashes?

Prescription antidepressants can do double duty in menopause, relieving both depression and hot flashes. Those shown to work for both conditions in clinical trials include venlafaxine (Effexor), 25 to 150 mg daily; fluoxetine (Prozac), 20 mg daily for four weeks; and paroxetine (Paxil), 10 to 20 mg daily.

Dr. Julia Schlam Edelman
OBGYN (Obstetrician & Gynecologist)

Low doses of certain antidepressants such as Paxil, Prozac, Effexor, or Lexapro can be used to decrease hot flashes. In some cases, the dose is lower than the dose used to treat depression. Antidepressants are not associated with a risk of breast cancer or uterine cancer.

Antidepressants should not be stopped suddenly. As the hot flashes become more manageable, or subside completely, taper off the medication under your doctor's supervision to avoid unnecessary side effects.

Each antidepressant medication will affect each individual differently. If one antidepressant is associated with unacceptable or unpleasant side effects (for example, weight gain or sexual problems), a sister antidepressant medication may provide relief from hot flashes without the same difficulties. You may end up trying several different medications before you find the one that is best for you.

Donna Hill Howes, RN
Family Practitioner

The North American Menopause Society, the Endocrine Society, and the American College of Obstetricians and Gynecologists list antidepressants as an optional treatment for hot flashes. These drugs may be an option for women who cannot use hormone therapy or do not wish to.

Fluoxetine, paroxetine, escitalopram, desvenlafaxine, and venlafaxine are antidepressants that have been studied and used to treat hot flashes. These are all drugs called serotonin reuptake inhibitors (SRIs). Only a low-dose form of paroxetine named Brisdelle has been approved by the FDA for this use. 

This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.