How Effective are Antidepressants for Menopause?

Marlene de Wilde

Many women are being prescribed antidepressants for menopause symptoms, mainly to treat hot flashes and night sweating. The lessening popularity of hormone replacement therapy (HRT) due to adverse side effects has resulted in the need to find a replacement therapy for menopause symptoms. While studies show that antidepressants may indeed be effective in lessening the severity of hot flashes, the side effects of taking the drug may result in other problems.

Women usually start to show signs of menopause by their late 40s.
Women usually start to show signs of menopause by their late 40s.

Taking antidepressants for menopause and depression is an approved therapy, as antidepressants were designed to treat major depression. Taking them for other reasons like mood swings, anxiety and hot flashes, however, is not an approved treatment regime. Menopause symptoms can sometimes become so severe that women will try any treatment to ease their suffering. Scientists are not quite certain why prescribing antidepressants for menopause works, but it seems to be effective if menopause is still in the early stages. It seems that women who have been experiencing menopause symptoms for a year or more continue to suffer from hot flashes even while taking antidepressants.

Antidepressants can alleviate some menopause symptoms, but also can increase the severity of others.
Antidepressants can alleviate some menopause symptoms, but also can increase the severity of others.

Long-term use of antidepressants is linked to many adverse side effects that may exacerbate menopause symptoms, including anxiety, disturbed sleep, and decreased libido. Swapping lack of sleep due to night sweats and hot flashes for lack of sleep due to use of antidepressants is self-defeating. Putting on weight, nausea, and vomiting are other well known side effects, in addition to the risk of dependency.

Menopause is a natural process of the reproductive system that signifies the end of a woman's fertility and menstrual cycles.
Menopause is a natural process of the reproductive system that signifies the end of a woman's fertility and menstrual cycles.

The types of antidepressants found to be effective in the treatment of menopause symptoms in clinical trials are the selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Paxil, and the serotonin norepinephrine reuptake inhibitors (SNRIs) such as Effexor. Some of these drugs are being marketed in the U.S. for treatment of premenstrual syndrome and its more severe form, premenstrual dysphoric disorder. Pristiq is an SNRI that is being developed specifically for the treatment of menopause.

Antidepressants may be taken to treat hot flashes.
Antidepressants may be taken to treat hot flashes.

Serotonin is a neurotransmitter, a chemical that is involved in the regulation of mood, appetite, sleep, and body temperature. The decrease in estrogen associated with menopause is thought to disrupt serotonin function, and this is why the body is no longer able to control body temperature. Antidepressants artificially restore the balance so that hot flashes, night sweats, and mood swings become less of a problem. More doctors are prescribing antidepressants for menopause, and the consensus is that for severe menopause symptoms that impact quality of life, it is an effective treatment. For milder cases, however, less drastic options may be advisable.

Some menopausal women benefit from taking antidepressants to help control mood swings and other symptoms.
Some menopausal women benefit from taking antidepressants to help control mood swings and other symptoms.
Long-term use of antidepressants may exacerbate menopause symptoms.
Long-term use of antidepressants may exacerbate menopause symptoms.

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