Use of antidepressants for management of hot flashes.

[Janette]

Hi Kitty and welcome. Great to see you post and very helpful.

I would like to second about withdrawing from anti-depressants too quickly. Always check with your Dr.

[Kitty]

Hi

I am new on the forum, 10 years survival coming up! I was 42 and pre-menopausal when diagnosed. I have tried lots of things for the flushes, but Efoxor works best..though is not perfect. I find it takes the 'heat' out of them and I suffer very little in the winter...and it has the side effect of making me 'happy', so to speak.

I have gone off it and the withdrawals have been a bit disturbing, so be careful (you know that joke about how women certain charactertistics in men attractive at certain times of the month....usually with an axe through their skull? That would be a good description.... ). A pharmacist told me you can be swapped to something else and then come off that more easily.

I think I have tracked the reason flushes are worse at night, thanks to a vet of all people. Remember that old wife's tale about how you wouldn't grow if you didn't sleep as a kid? Its true, the pituitary kicks in the evening and at night and regulates your hormones...at night it realises there isn't the right amount of estrogen and tries to 'kick start' the production with a hot flush...of course we are taking drugs to stop that!

[gallopinggranny]

I used catapres fora while but got used to it and it didn't work any more. Hope you have more success (ps this drug is also used top assist heroin withdrawal so has a wide range of uses it seems)

I have been hot flushing for more than 10 years and the best way to cope with it is to keep cool, use a fan and drink cold water. My flushes are easing now, have been for a while, thank goodness

[surusue]

I used to take Efexor for the hot flushes but it gave me really bad headaches that just wouldn't shift so now I am trying Catapres which is normally for high blood pressure but also helps ease migraines and hot flushes. I have gone from 1/4 tablet twice a day to now 1/2 twice a day, I am still getting some flushes but not as bad as I was so that is good.
Sue

[schoolteacher]

Sue you do what you have to to get through!

Tanya I reduced my tablet to half a tablet a day months ago. And I often forget a day here and there so figured I could afford to stop. A bit light headed tonight after 5 days (could be sinus though?) but if not better tomorrow will have half again. I can't take less than half a day the tablet is too small lol

[SUE48]

Well I prefer to just tough it out with no treatment for hot flushes.....I did it for 2 years pre BC, so I figure I'll just keep soldiering on....
Although not sure if this is the best option...but I am so used to it now...I figure might as well just keep on keeping on.....
I just make sure I wear sleeveless nighties at night, have the fan going ( and that's on cold nights ) and air con on when its warm...my DH is soo used to it now, he just snuggles under his doona....oh did I mention I also have a single bed pushed up against our queen bed....DH generates so much heat that I usually end up on the other bed....seems to work for us...but not sure who else though !!
Anyway, I am happy with this, so I suppose that's all that matters....we all have to have a quality of life that is acceptable to us don't we.
Regards
Sue

[TanS]

I have been taking Venlafaxine (Efexor) 75mg a day as my Onc said it would help my hot flushes..........I get them at night.........but not during the day. The problem is I really dont know if it is helping.........but then I dont want to stop taking it........in case it is..... You cant just stop taking it.........you have to wean yourself off it. I think I will just keep taking it for now........it doesnt cause any SE's.

Tanya

[schoolteacher]

I have been on antidepressants for 3 years due to daughters medical condition. GP said to stay on them to manage menopausal symptoms this year. I stopped taking them this week. Will see how I go.

[Janette]

Carroll DG, Kelley KW.

Department of Pharmacy Practice, Harrison School of Pharmacy, Auburn University, Auburn, Alabama, USA. dgc0001@auburn.edu

A growing body of evidence suggests that antidepressant therapies, particularly selective serotonin reuptake inhibitors and venlafaxine, are effective in the management of hot flash symptoms. Several of these agents have the support of the American College of Obstetricians and Gynecologists and the North American Menopause Society. To review the literature on antidepressants for the treatment of hot flashes in women, we searched the PubMed, International Pharmaceutical Abstracts, and MEDLINE databases from inception through May 2009. All publication types that included human participants and that were published in English were eligible for review. These articles, relevant abstracts, and additional references were used to collect pertinent data. Although initial small pilot trials were conducted solely in breast cancer survivors, additional studies have been conducted both in breast cancer survivors and in relatively healthy menopausal women. Data on the benefits with many of these agents are conflicting. Venlafaxine and paroxetine have been studied more extensively than any of the other antidepressants and are more consistent in effectively reducing the frequency and severity of hot flashes, based on these study results. Desvenlafaxine, sertraline, fluoxetine, and citalopram should be considered second- or third-line options if patients fail therapy with or cannot tolerate venlafaxine or paroxetine, based on the current published data. Duloxetine, escitalopram, fluvoxamine, and mirtazapine should be reserved as last-line therapy until more rigorous studies are conducted assessing their use in the management of hot flashes.