Can Antidepressants Treat Hot Flashes? - Hormone Replacement Therapy

Can Antidepressant Treat Hot Flashes - Hormone Replacement Therapy
  • Dr. David Nazarian
  • September 21, 2021
  • 0 Comment
  • blog

A woman’s life is full of turns and transformation.

Menopause is a significant transformation in a woman’s life that marks the end of her menstrual period and fertility. Most women near age 50 meet menopause with many of its symptoms. A hot flash is one such symptom that affects your life immensely.

The hot flash is a sudden feeling of heat in your body’s upper part that accompanies sweating, shivering, and a blushing red face. They can be disturbing and annoying. So, many take different medications, including antidepressants, as their treatment.

However, can antidepressants treat hot flashes? Research shows that low doses of antidepressants (SSRIs or SNRIs) may help reduce night sweats and hot flashes, nearly 50% less than average.

What is A Hot Flash?

A hot flash is a sudden warm feeling that you feel in your upper body. It’s more intense in your neck, chest, and over the face. During a hot flash, your skin, especially your face, may turn red, almost like blushing. It can also cause sweating. You may feel chilled later if your body heat decreases excessively.  Hot flashes may also occur at night, waking up suddenly all drenched and sweaty. It’s called night sweats, a real disruption to your sound sleep.

Causes of Hot Flashes

Hot flashes are common symptoms of the menopausal transition. However rare, other medical conditions can cause them too – medication side effects, thyroid problems, certain cancers, and their treatments, stress, etc.

Before, during, and after menopause, your body goes through severe hormonal changes. When your estrogen level decreases, your body’s thermostat or hypothalamus becomes extra sensitive to slight fluctuations in body temperature. Therefore, if your hypothalamus thinks your body is warm, it ignites a series of events to cool you down. Thus you encounter a hot flash.

There is no specific timeline for hot flashes. Many women encounter it for a short period. In the worst cases, many deal with it years after years. However, on average, women experience hot flashes or night sweats for approximately 7 to 10 years.

Symptoms of Hot Flashes

Symptoms, frequency, and intensity may vary from woman to woman. However, on average, maximum women face the following symptoms.

  •  A sudden feeling of fiery heat flowing through your chest, neck, and face
  • A flushed face with red, blotchy skin
  • Sweat, mostly on your upper body
  • Rapid heartbeat
  • A chilled sensation as the hot flash decreases
  • Stress and anxiety

What Are Antidepressants?

Antidepressants are medications that patients take to treat depression. Neurotransmitters are brain chemicals that carry messages between the cells in your brain. Certain neurotransmitters: serotonin, norepinephrine, and dopamine, have a direct connection with depression.

Most antidepressants affect these neurotransmitters and relieve depression. Though antidepressants are familiar for treating depression, doctors prescribe them to treat many other conditions such as anxiety, insomnia, migraines, menopause symptoms, etc. Yes, you have heard me correct. The research found that antidepressants may also reduce menopause symptoms, mainly hot flashes and night sweats.

Can Antidepressants Treat Hot Flashes?

Antidepressants for hot flashes, is it possible? Yes, they may help you reduce your many menopausal symptoms, including hot flashes. Hot flashes are inevitable for most menopausal women that can change the quality of their life.

To treat menopausal symptoms, doctors used to suggest menopausal hormone therapy previously. However, when an NIH-funded study shows the overall risk of hormone therapy like heart disease, stroke, blood clots, and breast cancer, menopausal hormone therapy decreases.

A recent study (NIH-funded) shows that certain antidepressants medications may help to relieve hot flashes. However, much research is yet to be done. In the analysis, a group of researchers gave several women either a daily dose of escitalopram or a placebo for eight weeks to survey their hot flashes’ frequency, intensity, and irritation.

After four weeks, the researchers found that women taking escitalopram experienced nearly 50% fewer hot flashes. On the other hand, women taking a placebo had hot flashes almost 26% less. After eight weeks, those women recorded even more reduction of hot flashes frequency, severity, and intensity. They also recorded fewer side effects of these medications.

Though the research is assuring, experts still couldn’t answer how antidepressants reduce hot flashes. However, few experts suggest that antidepressants can affect and balance certain neurotransmitters to help sustain your body’s temperature.

What Is The Best Antidepressant For Hot Flashes?

SSRIs, aka selective serotonin reuptake inhibitors, and SNRIs, aka serotonin-norepinephrine reuptake inhibitors, are the two U.S. Food and Drug Administration-approved antidepressants that may help reduce hot flashes. SSRIs and SNRIs are shown to balance the amounts of certain brain chemicals-serotonin and norepinephrine that can stabilize your temperature.

A low SSRI paroxetine (Paxil) dose is the antidepressant best for hot flashes and sleep. The women, who took part in the research, recorded improved sleep and fewer night sweats while taking paroxetine.

Best Antidepressant For Hot Flashes - Hormone Replacement Therapy

The FDA suggests Brisdelle, one effective antidepressant to reduce hot flashes and night sweats during menopause. Doctors may recommend antidepressant treatment for hot flashes in older women too.

Other antidepressants to treat hot flashes include:

  • Venlafaxine (Effexor XR)
  • Paroxetine (Paxil, Pexeva)
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)

However, remember that antidepressants are helpful to treat hot flashes and night sweats only. If you want to treat other menopausal symptoms, doctors may suggest hormone therapy.

The Risk of Antidepressant

SSRIs usually cause fewer side effects; however, antidepressants can cause the following side effects in many.

The common side effects of antidepressants are:

  • Headaches
  • Nausea
  • Anxiety
  • dry mouth
  • Fatigue
  • Insomnia
  • Drowsiness and  dizziness

Some severe side effects of antidepressants are-

Serotonin syndrome

It is a rare but life-threatening side effect of antidepressant treatment. It happens when you use two drugs together that can raise serotonin levels in your brain. It can cause hallucinations, poor coordination, fever, rapid heart rate, and vomiting.

Avoid the following medications with your antidepressant medication to avoid serotonin syndrome.

  • Dextromethorphan, the over-the-counter cold and cough medication
  • Triptans, the antimigraine medication
  • Ginseng and St. John’s wort, herbal supplements
  • Illicit drugs like LSD, ecstasy, cocaine, and amphetamines

Sexual Strikes

Loss of libido, poor sexual drive, and inability to attain orgasm are usual symptoms of menopause. However, SSRI or SNRI treatment may often reduce your sexual desire and performance.

Suicidal Tendency

Antidepressants medication can increase the risk of suicide in young people.

Precautions You Can Take

Can Antidepressants Treat Hot Flashes? Yes, certain antidepressants like SSRI and SNRI may reduce hot flashes. However, take some precautions to avoid the side effects.

  • Start with a low dose. Take a low dose to minimize side effects and assess the drug’s effectiveness for one to two weeks.
  • Don’t stop medications abruptly. It can cause agitation, irritability, anxiety, confusion, nightmares, nausea, insomnia, and electric shock sensations.
  • A dose with food. If you are nauseated, take your medication during your meal or just after the meal.
  • Medication at bedtime. If you feel drowsy, don’t take your medicines during the day. Instead, take them at night.
  • Limit alcohol. It can harm you while taking antidepressants.
  • Say no to paroxetine with the breast-cancer drug tamoxifen. Paroxetine may block the effect of your cancer medication.

Hot Flashes Treatment

If you don’t want to rely on antidepressants, there are other medications you can take to treat your hot flashes.

  • Gabapentin (Neurontin, Gralise, others) is an anti-seizure medication that may reduce hot flashes.
  • Pregabalin (Lyrica) is another anti-seizure medication that can be useful in treating hot flashes.
  • Oxybutynin (Ditropan XL, Oxytrol) is a pill or patch. Doctors suggest it treat urinary conditions like an overactive bladder that may relieve hot flashes.
  • Clonidine (Catapres, Kapvay, others) is a pill or patch. It’s typically used to treat high blood pressure that may give you slight relief from hot flashes.

Change Your Lifestyle

How to stop hot flashes fast? There are no medications to prevent hot flashes instantly. However, lifestyle changes can help you considerably to manage your hot flashes.

  • Keep it cool. Wear loose-fitting cotton clothing in layers so that you can remove them when you feel warm. Besides, try to keep your room cool by using a fan, air conditioner, or open window.
  • Avoid potential hot-flash triggering food. Hot and spicy foods, caffeinated beverages, and alcohol can trigger hot flashes.
  • Relaxing meditations. Try slow, deep breathing or other stress-reducing meditation or yoga. They can lessen hot flashes as well as improve your sleep.
  • Avoid smoking. Smoking can increase hot flashes.
  • Lose some weight. It may help relieve your hot flashes.
  • Drink cold water. Keep water nearby so that you can take a sip during hot flashes. Water helps.

Final Thought

Hot flashes can be disrupting and annoying symptoms of menopause that can affect your life adversely. However, can antidepressants treat hot flashes? Yes, antidepressants (SSRI and SNRI) can reduce the frequency and intensity of your hot flashes.

If you are experiencing hot flashes and night sweats, Contact Dr. David Nazarian at Hormone Replacement Therapy Los Angeles. He specializes in hormone replacement therapy and internal medicine and provides a quality life by managing your hot flashes.

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Dr. David Nazarian

Dr. Nazarian is board certified in Internal Medicine and practices integrative medicine in the heart of Beverly Hills. In his career he has worked in the Emergency Department as well as in the hospital setting as a hospitalist. He has extensive medical training in hormone replacement therapy.

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