title: The efficacy and tolerability of SSRI/SNRIs in the treatment of vasomotor symptoms in menopausal women: a systematic review.
abstract: OBJECTIVE
  To systematically review the evidence related to the efficacy and tolerability of selective serotonin reuptake inhibitors (SSRIs) and serotonin/norepinephrine reuptake inhibitors (SNRIs) used for the treatment of vasomotor symptoms in perimenopausal and postmenopausal women.
  
  
  METHODS
  Medline, CINAHL, and the Cochrane Library databases were searched to identify randomized controlled trials (RCTs). Eighteen trials met the criteria for review.
  
  
  CONCLUSIONS
  Results from these trials indicate that paroxetine, citalopram, escitalopram, venlafaxine, and desvenlafaxine are effective in reducing the frequency and severity of hot flashes. Fluoxetine and sertraline appear to be less effective and should be considered second-line options for treatment.
  
  
  CONCLUSIONS
  The SSRIs and SNRIs can reduce hot flashes by 65% and begin working within the first week. Patient response is variable and if one drug does not improve hot flashes, another can be tried after a 1- to 2-week drug trial. Paroxetine, citalopram, and escitalopram appear to have the fewest adverse effects. Considering cost, paroxetine and citalopram are the most cost-efficient.
authors.affiliation: College of Nursing, Brigham Young University, Provo, Utah.
authors.forename: Amy P
authors.initials: AP
authors.lastname: Handley
authors.forename: Mary
authors.initials: M
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use; D000069468:Desvenlafaxine Succinate / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects / Q000627:therapeutic use; D019584:Hot Flashes / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D008593:Menopause / Q000187:drug effects* / Q000378:metabolism / Q000502:physiology; D008875:Middle Aged; D017374:Paroxetine / Q000009:adverse effects / Q000627:therapeutic use; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D020280:Sertraline / Q000009:adverse effects / Q000627:therapeutic use; D014666:Vasomotor System; D000069470:Venlafaxine Hydrochloride / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000068760:Serotonin and Noradrenaline Reuptake Inhibitors; D005473:Fluoxetine; D015283:Citalopram; D017374:Paroxetine; D000069470:Venlafaxine Hydrochloride; D020280:Sertraline; D000069468:Desvenlafaxine Succinate
keywords: Hot flashes; hormone replacement therapy; menopause; selective serotonin reuptake inhibitors (SSRI); vasomotor symptoms