title: SSRIs for hot flashes: a systematic review and meta-analysis of randomized trials.
abstract: BACKGROUND
  Hot flashes are the most commonly reported vasomotor symptom during the peri- and early post-menopausal period.
  
  
  OBJECTIVE
  To systematically review, appraise and summarize the evidence of the impact of different SSRIs on peri-menopausal hot flashes in healthy women in randomized, controlled trials.
  
  
  METHODS
  A comprehensive literature search was conducted of MEDLINE™, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science and Scopus through March 2013. Two independent reviewers selected studies and extracted data. Random effects meta-analysis was used to pool outcomes across studies, and Bayesian mixed treatment methods were used to rank SSRIs in terms of effectiveness.
  
  
  RESULTS
  We included a total of 11 randomized controlled trials with good methodological quality enrolling 2,069 menopausal and post-menopausal women (follow-up 1-9 months, mean age 36-76 years, mean time since menopause 2.3-6.6 years). Compared with placebo, SSRIs were associated with a statistically significant decrease in hot flash frequency (difference in means -0.93; 95 % CI -1.46 to -0.37; I(2) = 21 %) and severity assessed by various scales (standardized difference in means -0.34; 95 % CI -0.59 to -0.10; I(2) = 47 %). Adverse events did not differ from placebo. Mixed treatment comparison analysis demonstrated the superiority of escitalopram compared to other SSRIs in terms of efficacy.
  
  
  CONCLUSIONS
  SSRI use is associated with modest improvement in the severity and frequency of hot flashes but can also be associated with the typical profile of SSRI adverse effects.
authors.affiliation: National and Gulf Center for Evidence-Based Health Practice, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, ShamsT@ngha.med.sa.
authors.forename: Taghreed
authors.initials: T
authors.lastname: Shams
authors.forename: Belal
authors.initials: B
authors.lastname: Firwana
authors.forename: Farida
authors.initials: F
authors.lastname: Habib
authors.forename: Abeer
authors.initials: A
authors.lastname: Alshahrani
authors.forename: Badria
authors.initials: B
authors.lastname: Alnouh
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Murad
authors.forename: Mazen
authors.initials: M
authors.lastname: Ferwana
mesh_terms: D005260:Female; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D008593:Menopause; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors