Estrogen remains the "gold standard" for treating hot flashes in women without a uterus, while an estrogen-progesterone combination is often prescribed for women with an intact uterus, Pinkerton says. But doctors try to avoid prescribing hormones to women with a prior history of breast cancer. Large studies have found estrogen-progestin use increases chances of breast cancer, heart disease, stroke and blood clots.
In 1998, Charles Loprinzi, M.D., a medical oncologist at the Mayo Clinic looking for a safe alternative for his breast cancer patients, conducted a pilot study of a chemical cousin of Pristiq called venlafaxine (Effexor) and found it could reduce hot flashes. Studies have since shown that other antidepressants, such as paroxetine (Paxil) and citalopram (Celexa), have a similar effect, he says.
Pinkerton's study is in line with this research, Loprinzi says. "The results as I see them are similar to what has been seen with venlafaxine," he says.
It isn't the drugs' antidepressant activity that is suppressing the hot flashes, Loprinzi says. Many women see their symptoms decrease within a few days, long before the antidepressant effect is usually felt.
Doctors believe the antidepressants can reset the mechanism in the brain that regulates body temperature.
Pinkerton meanwhile predicts that as more boomers enter menopause "a substantial number of women" will want to discuss the possibility of using low-dose antidepressants to treat hot flashes.
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Michael Haederle is a freelance writer whose work has appeared in People, the New York Times and the Los Angeles Times.