Abstract
Purpose: Hormone therapy (estrogen with or without progestin) remains the gold standard treatment for hot flashes in menopausal women, but concerns for the risk of hormone therapy have resulted in its decline and a demand for nonhormonal treatments with demonstrated efficacy for hot flashes. Aim of this study was to examine the efficacy of selective serotonin reuptake inhibitor escitalopram on hot flashes in a healthy sample of non-depressant menopausal women in Japan. Methods: We retrospectively analyzed the medical records of 11 menopausal patients with hot flashes, who received escitalopram (10 mg daily) for 2 weeks between March and August 2012. Hot flashes severities and scores were recorded on a scale of 0 to 10 points, at beginning and end of 2 weeks treatment. Results: At 2 weeks of therapy, 9 of 11 patients reported significant decreases in hot flash frequency and severity, but the remission of the symptom was not observed in 2 patients. Speed of relief from hot flashes was rapid (within one week). Conclusions: Escitalopram 10 mg/day may be a prompt and effective option for treating hot flashes in menopausal women who do not want to use hormone replacement therapy.
Highlights
Because many of the physiological changes that occur during menopause result from decreased levels of estrogen, hormone replacement therapy has historically been considered as a first-line treatment for hot flashes
Hormonal treatments, despite the fact that they represent the most effective therapies, are not used for the treatment of hot flashes in theses women because of concerns that they may increase for estrogen-dependent cancers [3,4]
Hot flash score and frequency changes during treatment week 2 were available for all 11 patients
Summary
Hot flashes are the predominant menopausal symptoms, with up to 80% - 90% of women reporting hot flashes around menopause [1,2]. Because many of the physiological changes that occur during menopause result from decreased levels of estrogen (estradiol level < 10 pg/ml), hormone replacement therapy (estrogen with or without progestin) has historically been considered as a first-line treatment for hot flashes. Hormonal treatments, despite the fact that they represent the most effective therapies, are not used for the treatment of hot flashes in theses women because of concerns that they may increase for estrogen-dependent cancers (e.g. breast cancer and endometrial cancer) [3,4]. Many women who have concerns regarding the safety of hormonal therapy are seeking novel nonhormonal interventions to help them cope with menopausal hot flashes. The nonhormonal prescription therapy has been studied mostly in women with breast cancer and endometrial cancer or who are at risk for these cancers for their effectiveness at relieving hot flashes. Escitalopram was selected because it is well-tolerated and has little drug-drug interaction [11] but has not been systematically studied as a treatment of hot flashes in Japan
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