Escitalopram reduces number and severity of menopausal hot flashes

Escitalopram at does of 10 mg/d or 20 mg/d significantly reduced hot-flash frequency and severity compared with placebo, according to a recent multicenter, double-blind study published in JAMA.

Women aged 40 to 62 were included in the study. Of the 205 women in the study, 95 were African American, 102 white, and 8 other.

The study determined that among women receiving escitalopram, 55% reported that hot-flash frequency decreased by at least 50% from baseline compared to 36% in the placebo group at the 8-week follow-up. At the starting dose of 10 mg/d, 44% of women improved at 4 weeks; another 11% improved with a single-dose increase to 20 mg/d. In addition, reduction in hot-flash severity scores was significantly greater in those receiving the drug. Race did not significantly affect the response to escitalopram.

Satisfaction with treatment was significantly greater in patients taking escitalopram than those taking placebo. Among those in the placebo group, 46% indicated that their treatment had no benefit compared with 16% in the escitalopram group. There were no serious adverse events requiring medical intervention or study withdrawal. Newly emergent (withdrawal) symptoms that were reported by more than 10% of those taking escitalopram were dizziness or lightheadedness (14%), vivid dreams (13%), nausea (11%), and excessive sweating (11%).

Women in the escitalopram group reported a mean 1.59 more hot flashes per day than women in the placebo group 3 weeks after the end of treatment. From weeks 8 to 11, ratings of severity and bother worsened in the escitalopram group but were unchanged in the placebo group.

The authors reported that the present study supports previous clinical trials that found selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors are effective in treating hot flashes. They also believe that their study is the first clinical trial to examine the relationship between race and response to selective serotonin reuptake inhibitor treatment for hot flashes.