Antidepressants May Bring Hot Flashes Down

June 3, 2003 -- Antidepressants may be the new answer for 25 million women suffering from hot flashes.

About 75 percent of menopausal women suffer debilitating hot flashes, which can begin at the onset of menopause and last for as long as five years. Until recently, most women in their 50s and 60s sought hormone replacement therapy to alleviate their discomfort — but then came news linking HRT to an increased risk of heart disease, stroke and Alzheimer's disease.

That left many women suffering, afraid to continue a potentially harmful therapy.

"My head would get really hot, almost as if a furnace was turned on inside, and it would just radiate throughout [my body] to where I was just very, very warm," said Debbie Stafford.

She said she perspired a lot and was very uncomfortable at work. "I had people ask me if I was OK. My face would get very red."

Now, a new study published in the Journal of the American Medical Association suggests antidepressants are an effective alternative to treat hot flashes.

Hot Flashes Were Cut in Half

For women like Stafford, the antidepressants came as a godsend.

Stafford was suffering from as many as 15 hot flashes per day, but she didn't want to use hormone replacements. So she became one of 165 menopausal women to test an alternative, the antidepressant drug Paxil.

Paxil and drugs like it — Prozac, Effexor and Zoloft — are called selective serotonin reuptake inhibitors, and increase serotonin levels in the brain. Serotonin helps to regulate the body's temperature.

By the sixth week of the study, patients taking the antidepressant cut their number of hot flashes almost in half. Women taking a 25- milligram daily dose went from 6.4 hot flashes per day on average to 3.2 per day. Women taking a 12.5-milligram dose went from 7.1 to 3.8 hot flashes per day.

Best We Have Right Now

Dr. Vered Starnes and colleagues who did the study at Johns Hopkins School of Medicine in Baltimore believe antidepressant medication is more promising than other alternative therapies such as soy, black cohosh or vitamin E.

"The evidence would suggest that the antidepressants are the best non-hormonal treatment for hot flashes that we have right now," Starnes said.

Doctors at the University of California at San Francisco told ABCNEWS that "lots of women" have contacted their institution, wanting to switch from HRT to antidepressants.

SSRI antidepressant medication is effective for mild, moderate, and severe hot flashes, according to the study, and the most common side effects were headache, dizziness or nausea.

Researchers say these drugs work rapidly, usually reducing hot flashes within a few days. The study also found symptoms could be alleviated by using only about half the standard dose of an antidepressant.

"The hot flashes just stopped," Stafford said. "I thought it would just taper off, but I actually had none. I couldn't believe it."