SSRIs RDEUCE HOT FLASHES

J Gen Intern Med. 2013 Jul 26. [Epub ahead of print]

SSRIs for Hot Flashes: A Systematic Review and Meta-Analysis of Randomized Trials.

Shams T, Firwana B, Habib F, Alshahrani A, Alnouh B, Murad MH, Ferwana M.

Source

National and Gulf Center for Evidence-Based Health Practice, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, ShamsT@ngha.med.sa.

Abstract

BACKGROUND:

Hot flashes are the most commonly reported vasomotor symptom during the peri- and early post-menopausal period.

OBJECTIVES:

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; I² = 21 %) and severity assessed by various scales (standardized difference in means -0.34; 95 % CI -0.59 to -0.10; I² = 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.

CONCLUSION:

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.