One of the biggest shifts in menopause treatment in recent years has been the prescribing of antidepressant drugs to treat hot flashes. The drugs aren't approved by the Food and Drug Administration as a hot-flash remedy, but doctors now prescribe them off label for the purpose.Popular antidepressants act by increasing levels of a brain chemical called serotonin. While the drugs are effective against depression, nobody really knows how or why altering a woman's brain chemistry might work to stem hot flashes. It may be that adjusting a woman's serotonin levels affects the part of her brain that controls body temperature.
Studies show that antidepressants do appear to curb hot flashes, but not as well as estrogen. And while the benefits of antidepressants in treating hot flashes appear to be small, some of the side effects may make women feel worse.
In May, the Journal of the American Medical Association reported that there have been only six small studies of serotonin-altering antidepressants for the treatment of hot flashes. However, only two of them -- trials of Effexor and Paxil -- met scientific standards for good quality. (WSJ)
That means most of what we know about antidepressants and hot flashes comes from just 386 women who took the drugs for six weeks or less.
