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Escitalopram for hot flashes
Since the Women's Health Initiative was published in 2003, the use of hormone therapy for the treatment of postmenopausal hot flashes has dropped dramatically. Both selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) have been studied to relieve postmenopausal symptoms, but no agent has been conclusively shown to be effective. A new study suggests that escitalopram (Lexapro) may offer some relief.
In a study recently published in the Journal of the American Medical Association, 205 menopausal women were randomized to 10-20 mg per day of escitalopram or matching placebo for 8 weeks. The primary outcome was the frequency and severity of hot flashes with the average hot flash frequency at nearly 10 per day at baseline. Escitalopram resulted in 1.41 fewer hot flashes per day compared to placebo (P < 0.001), although both the active drug group and placebo groups noted reductions. Escitalopram also reduced hot flash severity. There was no difference among women of different races, and the discontinuation rate was small. The authors concluded that escitalopram 10-20 mg per day compared with placebo resulted in fewer and less severe menopausal hot flashes at 8 weeks (JAMA 2011;305:267-274). Whether the same effect can be expected with racemic citalopram (Celexa) is unknown.