SSRIsDescription of results
Citalopram (Celexa)Two studies (n = 254 and n = 100) showed significant reductions in vasomotor symptom scores compared with placebo (P ≤ .002 and P = .0001). The first study had a 20% withdrawal rate, and the second was a single-blind study with regard to dose titration.
Escitalopram (Lexapro)One study (n = 205) found a significant reduction in hot flash frequency (47% vs. 33%; P < .001) and severity (24% vs. 14%; P < .001) when compared with placebo. The study found that this response was not significantly affected by race.
Fluoxetine (Prozac)One small crossover analysis (n = 81) showed improved vasomotor symptom scores (24% reduction; P = .02) and frequency (19% reduction; P = .01) compared with placebo. A second analysis comparing fluoxetine, citalopram, and placebo showed a significant reduction in symptoms but no differences between groups.
Paroxetine (Paxil)One study (n = 56) showed a significant reduction in hot flash frequency with paroxetine controlled release compared with placebo (6.1 vs. 2.8 per week; P = .03). Two additional studies compared a lower and a higher dose with placebo, demonstrating an improvement in scores with both doses but increased adverse effects (nausea) with higher doses.
Sertraline (Zoloft)Two small studies (n = 46 and n = 99) found no reduction in symptom frequency or composite scores compared with placebo. A third trial (n = 97) showed a moderate reduction in vasomotor symptom frequency compared with placebo (five fewer hot flashes per week; P = .002).
SNRIs
Desvenlafaxine (Pristiq)Two studies (n = 541 and n = 452) showed a significant decrease in frequency and severity of hot flashes in the treatment group vs. placebo. The first study also had a significantly higher dropout rate because of adverse effects (28.5% in the treatment group vs. 8.9% in the placebo group; P < .001). A third 52-week study (n = 620) comparing three different doses (100 mg, 150 mg, and 200 mg) found significantly higher withdrawal rates at the higher doses because of adverse effects.
VenlafaxineThree studies comparing venlafaxine with placebo demonstrated significant decreases in hot flash measures. Another study (n = 80) showed a nonsignificant reduction in hot flash scores. Common adverse effects included constipation, nausea, and dry mouth.