Hot flash (also called hot flush) symptoms are one of the more bothersome symptoms of menopause. Traditionally treated with estrogens, alternative medications have been sought to avoid the risks of hormone replacement therapy. A recent randomized trial evaluated the effectiveness of escitalopram for reducing the frequency and severity of hot flash symptoms. Women with menopausal symptoms (N=205) were randomized to escitalopram (Lexapro) 10-20 mg/day vs. placebo for 8 weeks and maintained a hot flash diary. Escitalopram reduced daily hot flash frequency and severity (level 1 [likely reliable] evidence). Comparing escitalopram vs. placebo, daily frequency of hot flash episodes decreased by 4.6 vs. 3.2 (p < 0.001), with at least 50% reduction in frequency in 55% vs. 36% of women (p = 0.009, NNT 6). Mean hot flash severity scores were also reduced with escitalopram (p < 0.001). The benefits did not persist after the end of treatment: 3 weeks after discontinuation, women from the escitalopram group reported an increase in the frequency of hot flashes (mean 1.59 more hot flashes per day) compared to the placebo group (JAMA 2011 Jan 19;305(3):267).
For more information, see the Menopause topic in DynaMed.