Antidepressants for Hot Flashes

There are several antidepressants that are used to treat various disorders such as depressions, panic disorders, bulimia, severe PMS (postmenstrual syndrome) or premenstrual dysphoric disorder (PMDD). Antidepressants usually approved by the USFDA or U.S. Food and Drug Administration.

There are also available medications for treating hot flashes. However, Fluoxetine and paroxetine, antidepressants called selective serotonin reuptake inhibitors or SSRI are not USFDA approved to be used as treatment for hot flashes. Both, however, have been reported to be effective in random trials. The same is true for the drug venlafaxine. Venlafaxine is an atypical antidepressant. Meaning it is part of a subclass of antidepressants that are chemically unrelated to other antidepressants.

Some antidepressants are also used to treat other disorders such as fibromyalgia and chronic pain. Treatment of these problems with antidepressants is called unlabeled uses. Unlabeled use means that your doctor prescribes a medication for a purpose other than that for which it has been specifically designed and approved. It is a common practice among doctors.

How antidepressants work

Antidepressants, specifically SSRIs works by affecting the brain’s neurotransmitter called serotonin. Serotonin is in important in regulating anger, mood, body temperature, sexuality, sleep, appetite, metabolism and even vomiting. Increase in the brain’s use of serotonin has been shown to improve perimenopausal mood swings and irritability. Venaflaxine also affects the brain’s use of serotonin as well as norepinephrine – a chemical compound that has a dual purpose as a hormone and a neurotransmitter. Venaflaxine has been shown to improve moods. However, how it relieves hot flashes is yet unknown.

Use of antidepressants

Certain antidepressants are used to treat hot flashes that are common among menopausal women. They can also help with depression and moodiness, as well as irritability. Antidepressants can be used before and after menopause to relieve discomforts brought about by menopause symptoms. Antidepressant can also substitute for hormones (hormone replacement therapy and/or birth control pills).

How effective  antidepressants?

Reports of how effective antidepressants are as a treatment for hot flashes have shown very positive results.

In a trial of paroxetine involving postmenopausal women who have at least 14 hot flashes a per week, it has been reported that 60% of the participants have had a 50% decrease in the severity and frequency of hot flashes per day. This is after 6 weeks of treatment.

Venlafaxine, on the other hand has been reported to lower the frequency and severity of hot flashes for most women. This includes women who suffer from sever hot flashes from taking the drug tamoxifen which is a hormone drug for fighting cancer. In a number of studies, it has been reported that venlafaxine is most effective when used at a lower dosage than what is normally prescribed to treat depression.

Side effects of taking antidepressants

Taking antidepressants has several side effects, be it SSRI or venlafaxine. Some of these side effects are fairly common. However, some are quite serious. So ask your doctor first about the possible side effects before taking them.

Common SSRI side effects:

  • Anxiety or nervousness
  • Diarrhea
  • Dizziness or lightheadedness
  • Drowsiness
  • High blood pressure
  • Headache
  • Insomnia
  • Nausea
  • Loss of ability to reach orgasm during sexual activity
  • Loss of appetite
  • Nightmares

Some rare SSRI side effects include:

  • Constipation
  • Dry mouth
  • Urination problems

To reduce the risks of side effects, take time-released formulations and lower doses.

Venlafaxine side effects are similar to the common and rare side effects of taking SSRIs. However, venlafaxine has other more serious side effects which include:

  • Allergic reactions
  • Anxiety
  • Blurred vision
  • Dizziness
  • Fast heart rate
  • Increased blood pressure
  • Increase in cholesterol
  • Insomnia
  • Seizures

When not to take antidepressants

If you have an allergic reaction to these medications in the past, it is advisable not to take them. Also if you are currently taking monoamine oxidase inhibitors (MAOI), it is not advisable to take antidepressants. MAOIs are antidepressants and antianxiety medications. MAOIs are used as a last resort because of potentially lethal dietary and drug interactions.

Things to consider

The USFDA issued an advisory regarding antidepressants and suicide. The USFDA does not recommend the discontinuation of the use of these medications. The USFDA only recommends that people taking anti depressants should be watched for warning signs of suicide. This is particularly important at the start of treatment where dosages are usually changed.

The USFDA also warns about antidepressants and birth defects. Taking these medications within the first 12 weeks of pregnancy may increase the risks of having a baby with birth defects.

For off-label uses of SSRIs used to treat hot flashes, the most common reported side effects are headache, nausea and insomnia. 58% of women who use used these medications reported side effects.

It is not advisable to stop taking antidepressants abruptly. Use of antidepressants should be decreased gradually, under the supervision of your physician. Abruptly stopping taking antidepressants can cause headaches, nervousness, anxiety and insomnia.