Anti-depressants for hot flashes?

justjudeOctober 4, 2004

I went off HRT (Femhrt) in early June and suffered a terrible summer with hot flashes and night sweats. Woke 6-8 times a night with sweats, then had a hard time getting back to sleep. Needless to say, this affected my mood. By early September I was a basket case: hot flashes, depression, irritability. My prescription was still good, so I went back on the HRT without even calling my doctor.

I had an appointment with her today (this is about 3 weeks after going back on the HRT) and she suggested I consider a low dose of anti-depressants; she has had good luck treating her patients with anti-depressants for hot flashes. She also refilled the prescription for the HRT, leaving the decision up to me.

What she prescribed was Effexor, 75 mg/day. (The dosage for depression is 150 mg/day.) Has anyone been treated for hot flashes with a low dose of anti-depressants? What should I be considering as I make this decision?

I have a family history of heart disease and stroke, but no breast cancer. I have osteopenia in my hips and spine, for which I took Fosamax but am now switching to Actonel.


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I don't know anything about Efexor. A friend of mine at work was given Paxil for hot flashes and various menopausal symptoms. The result for her was a complete absence of affect--she didn't care about anything. So, she stopped taking it.

    Bookmark   October 8, 2004 at 4:20PM
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Flat affect is a sign of over-medicating, not what your doctor is doing. I'd try the Effexor before HRT.

    Bookmark   October 12, 2004 at 2:18AM
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I'm on a low dose of Zoloft because I needed an anti depression - even though I have never been depressed in my life I knew something was wrong. It has helped so far and today she upped my dosage to 150mg (she said up to 300 is the range most people are on) and that it should help with the night sweats. Guess I'll know in good time. A lot of her patients have had good luck with the anti dpression but I think you also need to be depressed for them not to overmedicate you. I have never had a flat effect from them yet.

    Bookmark   October 29, 2004 at 6:05PM
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i would avoid Effexor if at all possible
as i have been taking it for for several months
and if i miss 1 day of taking it i get rather
irrational and grouchy .

    Bookmark   December 29, 2004 at 9:17PM
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I take Prozac, doesn't help much with the hot flashes, but sure helps with the mood swings! I would be in prison for murder without it.

    Bookmark   January 19, 2005 at 1:04PM
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In my opinion anti-depressants are way over-prescribed. No one should be taking ADs unless they've been truly diagnosed as being depressed.

Anti-depressants can set a bipolar person into a manic state. There are many more undiagnosed functioning low level bipolar people than you would think. Using mood altering drugs for menopause is just too risky in my book.

I wish our culture would stop treating every stage of a woman's life as an "illness" to be dealt with. It's been done with pregnancy and childbirth, and now with menopause. We should be spending more time teaching girls and women about these natural occurences and take the fear out of it.

I have friends who haven't even had a hot flash yet who are already worrying about what they will take for them.

As for me, when I get a hot flash I throw off the cover or remove my coat or whatever and focus on breathing. Drinking some cool water helps too. It's not like they last forever. Moods swings were a problem for me with PMS and were also really strong during the first year of menopause. Knowing what they were due too and being open about the problem with family helped a lot. Knowledge is power.

Prozac suddenly became the drug of choice for "women's issues" when the patent ran out. How convenient for the drug company.

    Bookmark   February 2, 2005 at 9:55AM
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Wildchild, I am handling my hot/cold flashes as you described. I am lucky that I am past (or so it seems) the PMS, moodiness, etc. I am constantly throwing covers/clothes off or grabbing a blanket because I am cold all of a sudden. I am hoping to not take HRT, I am taking black cohosh, but don't think it is helping, who knows it could be, might be alot worse if I weren't taking it. I'm 51 and it sure seems the worst part is past...I sure hope it is.

    Bookmark   March 31, 2005 at 12:23PM
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I agree with Wildchild - why do some doctors have a pill for everything? I think we are an over-medicated society looking for a quick fix to things that have practical, no-meds solutions.

    Bookmark   April 10, 2005 at 4:40AM
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I was also prescribed Effexor for hot flashes. I really do not understand the reason.
I am menopausal, NOT depressed. When I asked the Dr why I was being prescribed an anti depressant for hot flashes, she said she really didn't understand the relation.
Oh, that gave me great faith in her...NOT
I took a few dosages anyhow, and I felt nauseous, light headed, dizzy, could not drive and was still experiencing hot flashes 24/7.
Hmm, something is not right here.
I need the hormones, and they do not give me the symptoms that the anti depressant meds did.
My life w/o hrt therapy is not pleasant.
I have a phone call in to her, and hope to hear from her soon.
I will sign ANOTHER disclaimer to take the hormones if I must. I am the best judge of what my body feels like and is telling me, not some biased study or a Dr who has not experienced menopause.
Thanks for allowing me to get this off my sweaty chest.

    Bookmark   March 6, 2006 at 10:47PM
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I also have to agree with Wildchild. Antidepressants are not something to be taken lightly. I tried three different kinds and had a bad reaction to each one. That was when I said, "No more!" My heart would race like you wouldn't believe. And you did mention you have a history of heart disease in your family. It doesn't affect everyone in the way it affected me, but it was bad enough to give me a serious medication phobia that I still struggle with, and that was ten years ago. I don't have a heart disorder except for Mitral Valve Prolapse, but let me tell you, I thought I was dying right on the spot! My blood was pounding in my ears so loud and my heartrate was so fast I couldn't even count it. And this was after only take 1/4 of the dose I was prescribed! I hate to think what might have happened if I'd taken the full dose! I'm not trying to scare you, but antidepressants are well known for having a whole host of bad side effects - some of them dangerous. I'd seriously consider other things before I'd pop one of those if I were you.


    Bookmark   March 7, 2006 at 2:15PM
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I was told once, yer not menopausing, yer depressed! :o) I was like... hmmm never heard of depressed people having hotflashes and night sweats...
I don't take anti-depressants, I get too many side affects... ie double vision... how can you live with constant double vision? Happy...but can't do anything cuz I can't see! :o) No thank you...

    Bookmark   March 7, 2006 at 2:21PM
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My doctor explained that both HRT and anti-depressants work on the same part of the brain.

    Bookmark   March 9, 2006 at 7:55AM
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Well, that's sort of simplistic... hormones do so many things that anti-depressants don't, but maybe the lack of hormones affect the part of the brain that anti-depressants work on.

    Bookmark   March 9, 2006 at 12:13PM
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I finally was able to get in touch w/ my ob-gyn.
I told her about my neg. reaction to Effexor and she agreed to put me back on hrt.
I am now back on the hormones and feeling better, much better.
While they do not stop all the hot flashes and night sweats, there are only a few in 24 hours, so it is tolerable.
I still do not understand the resoning behind using Effexor for menopause.

    Bookmark   March 10, 2006 at 12:00AM
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Effexor is a serotonin reuptake inhibitor. During perimenopause, the lack of hormones can cause the brain to absorb serotonin at a different rate, which can cause mood swings and depression. I don't really understand how they think it can help the night sweats and hot flashes, but for some it works, for some it doesn't. For me, it doesn't do a thing for the sweating, but helps my PMS... not my perimenopause! :D

Serotonin A neurotransmitter involved in many functions, including mood, appetite, and sensory perception.

A hormone found in the brain, platelets, digestive tract, and pineal gland. It acts both as a neurotransmitter (a substance that nerves use to send messages to one another) and a vasoconstrictor (a substance that causes blood vessels to narrow). A lack of serotonin in the brain is thought to be a cause of depression. Also called 5-hydroxytryptamine.

An important neurochemical whose effects upon the human brain include mood elevation. Production of serotonin in the brain is increased by ingestion of the amino acid tryptophan (a chemical precursor to serotonin) and the pharmaceutical anti-depressant Prozac (trademarked product of Eli Lilly & Company). ...

    Bookmark   March 10, 2006 at 11:23AM
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I agree that anti-depressants (and anti-anxiety meds) are over prescribed! But boy, oh boy, there are some people out there that really benefit from them but you have to use your own best judgement whether or not they are right for you!

I was diagnosed wiht moderate clinical depression years ago and went on zoloft. I never realized that "feeling good" was something that happened to people on a daily basis! After counselling I discovered that I was depressed all my life. I never knew it, because if you feel one way all the time, you think it's normal. You don't know anything thing else.

Then dh got involved and was totally against me taking zoloft he said that it was just example of doctors over medicating.

We got into a big hoo haa - and me being insecure (goes along with depression) decided he was right, so, I stopped the zoloft. HUGE mistake!

I went through early menopause (peri started at 40) and the depression got so bad that I wouldn't/couldn't get out of bed. Dh would yell at me to "get with it". That I was not the only woman going through this - blah blah blah I kept a journal of that period in my life and let's say I had to burn it - it was that bad. Let's also say that if anything had ever happened to dh - that journal could have earned me a life sentence without parole. LOL

To make a long story short I went back to the dr's and went back on zoloft. I swear it saved my husband's life! LOL Really. I sat down with him and said "look buddy, you have NO IDEA how *I* feel let alone what women go through with hormonal changes." I slapped the zoloft down in front of him and said don't you ever tell me how I feel or how I should feel and WHAT I should do about it (he always said to just "suck it up")

Anyway, I've never felt better - ever - I'm 49 and have been post menopause for 5 years! And really, it was the best thing for "me".

As for dh, yes I am still with him (25 years) and realize now how narrow minded / and passive agressive he can be. So, I've taken steps to improve THAT too! The bisggest lesson I learned was that you have to be true to yourself. You also can't let anyone tell you how you should feel especially when they haven't a clue.

I really believed dh and thought that I was weak. I am approaching 50 at a steady pace and feel more independent than ever before. I will probably be on zoloft for the rest of my life, as life is ugly without it. But at least it's MY choice and no one else's.

I recently started a new career and love it and enjoy being in the driver's seat of MY life. As for DH - well I think he likes me better this way and life with him has been better.

Whew! What a rant.


    Bookmark   April 14, 2006 at 10:01AM
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BJ, it's ALWAYS better to take care of yourself! I can't understand men.... my Significant Other is just like that. Some men seem to feel that if it doesn't happen to them, it isn't happening to other people. Or if it WAS happening to him, other's were going through it too. I just gave up... when he started into saying what your hubby said, I just told him that "I had explained it before, just rerun that explanation in your head" and walked off. I am fairly lucky, because his sister is going through the pause, he finds it okay for me to too, but if not... I am sure he'd not understand. I just ignore it and go one with my life. the one thing about menopause is, I have gotten greatly tired with other people's foibles (not that I don't have my own) and so I tend to not let them affect me like I used to. "If you don't like it, lump it" has kind of gotten to be my mantra. Funny thing is... he lumps it. :o) If you have to take your zoloft, and he doesn't like it... he can LUMP it! :o)

    Bookmark   April 14, 2006 at 11:51AM
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heathen (love your name, btw) I've always wondered exactly what "lumping it" means! *L*

I guess it must be a male thing, but sometimes I'm really not so sure. I have friends who's husbands are a LOT more "tuned in" and sensitive to what their wives are going through - not completely sensitive but at least they seem to have an understanding and seem to listen.

And this I don't get. I'm not a whiner so it's not like I ramble on incessantly about how I feel, how I don't feel etc. I just don't tell him much of anything anymore because he'll try to tell me how I should handle it in a very impatient "don't you know" kind of tone. He won't offer "advice" or even pretend to be empathetic - it's just like you said, if it's not happening to him/them then it's not happening at all. I couldn't agree more.

I'll tell you another thing, I really didn't realize just how "self" he was like this until I restarted the Zoloft.

I don't want to turn this into a male bashing session (too late? :~) because I know that *all* aren't the same. How did we get so lucky, heathen?

Oh and he IS lumping it, alrighty! He's lumping a lot of things these days while I look after myself, for a change.


    Bookmark   April 14, 2006 at 3:34PM
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My DD was having depression problems related to some things going on in her married life and was prescribed an antidepressant which she took for awhile. Not liking the side effects and that it wasn't really helping she went to a nurse practitioner and was recommended natural progesterone cream and she went to health food store and bought some. She tried it for awhile with poor results and a friend recommended another brand and she didn't really think it would do any good, but she says she feels like a new person now and wouldn't be without it.

    Bookmark   April 14, 2006 at 10:33PM
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BJ, thank you! I don't understand men much, my BF is fairly considerate about most things... just not health problems, for some reason. I think that his manhood is wrapped up with it somehow. :D
LOL! I don't know what "lumping" is either... must look that up.
Donna... I think that's the thing, just keep trying things that work... everyone is different....

    Bookmark   April 15, 2006 at 12:48PM
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Hello All,

I have heard that Black Cohosh (a herbal remedy) has fantastic effects on hot flushes caused by menopausal symptoms.

Good luck!

Can be ordered online in Britain certainly. A good site is

    Bookmark   April 19, 2006 at 8:21AM
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Some people never give up.
jess, take it some place else.
blah, blah, blah.
Pay for an ad if you need to advertise.

    Bookmark   May 19, 2006 at 1:05AM
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To be honest i am not surprised women get depressed with all the symptoms some seem to suffer needlessly, weight gain (which we all hate) water retention, etc etc and side effects of HRT which can be horrendous, its not surprising when pumped full of chemicals and a lot of which contain animal hormones totally unsuitable to match human hormones, that these poor women suffer so, and nobody seems to listen and hear what they're saying, but its the cause that needs to be treated not the depression, that will surely go once they feel better, lose the weight and are happier once again. I am now trying a natural progesterone to put my hormones back to balance and am very fit now working out every day etc so hopefully this will be the icing on my case. Its very sad reading how all these lovely women have been suffering for years, lets hope Drs now change their views on natural products. Fiona (UK)

    Bookmark   May 24, 2006 at 8:10PM
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I've read that Effexor withdrawal is hard. I took Prozac for a couple of years for various menopausal reasons including anxiety. I quit one day when I decided I didn't need it anymore, and was fine....Lynn

    Bookmark   June 6, 2006 at 12:33AM
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For the women who take AD only intermittently (not every day), I don't understand how it works since I think it needs to reach a therapeutic level in the blood and that doesn't happen overnight. How can they feel good so quickly when the therapeutic level hasn't been reached yet?

Placebo effect?

And if you are taking an AD, are you also exercising, eating right, eliminating (or significantly reducing) alcohol and caffeine intake, and other lifestyle habits that contribute to overall health and wellbeing?

    Bookmark   June 10, 2006 at 6:04PM
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What you really need is to adjust your estrogen instead of taking an anti-depressant. You need to try different forms and dosage levels of estrogen, preferably natural estrogen (estradiol, not ethinyl estradiol) instead of a one-size-fits-all synthetic estrogen & progestin like FemHrt.

    Bookmark   June 13, 2006 at 12:17PM
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Try 5-HTP it's a natural SSRI. Take 100mg 3xday, if you get sick to your stomach, introduce one pill at a time. You can get them at, NOW is a good brand. DO NOT take these if you are taking ant prescription anti-depressants.


    Bookmark   July 17, 2006 at 6:32PM
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Some people enjoy great relief from taking anti-depressants. My doctor had me on clonidine, which did jack squat. He then had me on Effexor. If Effexor works, fine and dandy. For me, it was bloody evil and I wish I'd never heard of the stuff.

I understand Paxil is pretty toxic and that a lot of doctors will not prescribe it.

ps: I am now using the clondine and nicorettes to quit smoking. That seems to work

    Bookmark   July 22, 2006 at 1:49PM
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I was anti depressants way before I got menopause and although it cured my depression it caused a ton of other problems, which is when I decided to go for herbal remedies for things. When I got started menopause my doctor told me try hormone therapy but I wanted to try herbal remedies first. My friend recomended this product called Changes For Women, which has been helping with my hot flashes, anyone else try herbal remedies yet?

    Bookmark   February 16, 2007 at 5:46PM
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Of course! I use Meno-cream, an over the counter wild yam progesterone cream... over the years I've had to increase the dose, guess I'm sinking farther into menopause.... sigh... but it sure helps with the hot flashes and night sweats and mood swings for ME.

    Bookmark   February 17, 2007 at 11:07PM
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I don't think so unless the AD help you from totally going crazy DURING meno. I've been on AD for 10+ yrs. and it IS NOT helping me with HF. In fact I'm even using a bio-identical progesterone cream and nothing is helping right now. But everyone is different, so good luck.


    Bookmark   February 18, 2007 at 6:12PM
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I have been on effexor for about 3 years, 75 mg a day. What a difference! But it lasts about 8 hours, so evenings and nights are not the best.

I have discovered that if I forget to take it, I am irritable and hot, or is that hot and irritable. Which came first, the chicken or the egg?

    Bookmark   September 5, 2007 at 11:24AM
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I suffered from hot flashes for nine years, until I started taking Zoloft. My hot flashes were every fifteen minutes all morning and evening, with a little relief during the day. For women who have severe symptoms of menopause, precription meds are sometimes needed. If you have no quality of life because of your symptoms and you are completely miserable, like I was, thoughts of suicide can enter your brain -- prescription meds are a much better option. I tried all forms of natural remedies and NOTHING helped.

    Bookmark   June 6, 2011 at 9:52AM
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