Hot flashes are one of the most common complaints of women going through menopause, with an incidence rate of approximately 88%. In severe cases, hot flashes can interfere with daily functioning and negatively impact quality of life. Traditionally, hormone replacement therapies have been the standard approach to dealing with the physiologic symptoms of menopause. However, this approach has gradually fallen out of favor. The risks of hormone replacement are now better understood, forcing many women and their doctors to seek out alternatives to hormone-based treatments. One such possibility includes the use of antidepressant medications. Indeed, there is some evidence of a link between mood states such as anxiety and the occurrence of hot flashes.
Lexapro (escitalopram) has been singled out as a possible treatment for hot flashes. As a well-tolerated and generally safe antidepressant medication, Lexapro has a low risk of side effects or dangerous drug interactions. An eight-week, placebo-controlled study involving 205 participants revealed that Lexapro reduced the frequency of hot flashes by 50% or more. Lexapro also significantly lessened the severity of flashes.
When the study ended, participants in the drug group reported a return of previous hot flash severity within three weeks, a further indication that the benefits of Lexapro are significant. Only nine women withdrew from the study early because of adverse effects. In general, side effects were minor and included dizziness, vivid dreams, nausea, and sweating.
Interestingly, Lexapro appears to lessen the frequency and severity of hot flashes regardless of the mental state of the woman. People who potentially have depression or anxiety show improvement on par with those who do not have depression. Clearly, the effects of Lexapro in relation to hormonal balance are at least partially independent of its effects on mood. This may allow for lower doses of the medication to be prescribed for treating hot flashes as opposed to depression. For women who’ve seen their quality of life diminish because of menopausal symptoms, Lexapro offers a safe and highly effective alternative to traditional treatments like hormone replacement.
Future research should investigate whether other members of the selective serotonin reuptake inhibitor class of antidepressants can provide equivalent or greater relief from hot flashes. Some women may not tolerate Lexapro, and having more options will be beneficial for both doctors and patients.
Freeman, E. W., Guthrie, K. A., Caan, B., Sternfeld, B., Cohen, L. S, Joffe, H., et al. (2011). Efficacy of escitalopram for hot flashes in healthy menopausal women: a randomized controlled trial. Journal of the American Medical Association, 305(3), 267-274.
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