Is escitalopram effective for treating menopausal hot flashes?

January 01, 0001

Is escitalopram effective for treating menopausal hot flashes?

Menopausal hot flashes can significantly impact patients lives, but hormonal treatments carry health risks. These US researchers examined the efficacy and tolerability of escitalopram for menopausal hot flashes via a multicenter, 8-week, randomized, double-blind, placebo-controlled, trial that (n=205 women). Enrollees were randomized to 10 to 20 mg/d of escitalopram or a matching placebo and the frequency and severity of hot flashes assessed by prospective daily.

The researchers found: "Mean daily hot flash frequency was 9.78 at baseline. In a modified intent-to-treat analysis that included all randomized participants who provided hot flash diary data, the mean difference in hot flash frequency reduction was 1.41 fewer hot flashes per day at week 8 among women taking escitalopram, with mean reductions of 4.60 and 3.20 hot flashes per day in the escitalopram and placebo groups, respectively. Fifty-five percent of women in the escitalopram group vs 36% in the placebo group reported a decrease of at least 50% in hot flash frequency at the 8-week follow-up. Reductions in hot flash severity scores were significantly greater in the escitalopram group. Race did not significantly modify the treatment effect. Overall discontinuation due to adverse events was 4% (7 in the active group, 2 in the placebo group). Three weeks after treatment ended, women in the escitalopram group reported a mean 1.59 more hot flashes per day than women in the placebo group."

The researchers concluded: "Among healthy women, the use of escitalopram (10-20 mg/d) compared with placebo resulted in fewer and less severe menopausal hot flashes at 8 weeks of follow-up."

This study finds that escitalopram, and SSRI, provides some improvement in menopausal vasomotor symptoms

For the full abstract, click here.

JAMA 305(3):267-274, 19 January 2011
© 2011 American Medical Association
Efficacy of Escitalopram for Hot Flashes in Healthy Menopausal Women. Ellen W. Freeman, Katherine A. Guthrie, Bette Caan, et al.

Category: T. Endocrine/Metabolic/Nutritional. Keywords: menopause, hot flash, severity, frequency, escitalopram, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 1 February 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.