Medical researchers have done some studies on Zoloft and hot flashes. There have been a few more studies on Paxil and hot flashes. Twice as many published studies have focused on black cohosh and hot flashes, and there are even more on black cohosh and other menopause-related symptoms. Why so many studies?
Traditional herbal remedies are often the subject of scientific scrutiny, because modern medicine would like to “prove” or “disprove” their efficacy. They would also like to know “why” botanical remedies are effective; therefore, many studies revolve around the isolation of the active component.
Researchers began studying antidepressants such as Zoloft and hot flashes in 2002, around the same time the Women’s Health Initiative published findings on the long-term health risks associated with hormone replacement therapy. Research on Paxil and hot flashes before 2002 focused on breast cancer survivors who are unable to use estrogen replacement therapy.
Scientists and researchers cannot explain why these drugs might be effective, or even why their use would be considered. It is likely that they were prescribed for women suffering from depression, which sometimes accompanies menopause. These women may have reported a reduction in hot flashes, leading clinicians to suggest that they might be helpful in managing hot flashes.
Both Zoloft and Paxil belong to a group of drugs known as selective serotonin reuptake inhibitors, or SSRIs. These medications are FDA-approved to treat depression, and some are approved to treat PMDD. They are not FDA-approved to treat hot flashes, other menopause-related symptoms, or to treat PMS, but doctors often prescribe them for these purposes.
Although not FDA-approved for relieving hot flashes, both the American College of Obstetricians and Gynecologists (ACOG) and the North American Menopause Society recommend that women with moderate to severe menopause-related hot flashes should consider an SSRI, if unable to do so. or choose not to take hormone replacement therapy. Interestingly, a brochure published by ACOG mentions that herbs and botanicals are not FDA-approved, but never mentions that SSRI drugs are not FDA-approved to treat menopausal symptoms.
A study on Paxil and hot flashes experienced by breast cancer survivors is similar to a more recent study on black cohosh use. (Black cohosh is an herb traditionally used by Native American healers and passed down through generations for the relief of hot flashes and other symptoms of menopause.) As mentioned above, women who have had breast cancer cannot take estrogen replacement therapy, in fact they must take a drug that limits the effects of estrogen for several years after surgery. Even in women who are not close to menopause, this drug causes severe hot flashes.
In the Paxil and hot flashes study, the antidepressant was shown to reduce the frequency of hot flashes by up to 79%. Black cohosh has been shown to reduce the frequency of hot flashes by up to 100%. Of the 90 women who participated in the black cohosh study, none reported adverse side effects and none dropped out. Of the 30 women who participated in the Paxil and hot flashes study, three (10%) withdrew due to drowsiness and one withdrew due to anxiety, a possible adverse reaction to Paxil.
Recently, the University of Arizona School of Medicine did research on Zoloft and hot flashes. A group of women between the ages of 40 and 65 who suffered from hot flashes but were not taking hormone replacement therapy were recruited. The researchers used a number called the “hot flash score,” which is equal to the number of hot flashes a woman experiences multiplied by the numerical expression of hot flash severity, to assess the effectiveness of the SSRI over a four-week period. The Mayo Clinic conducted a similar study on black cohosh and hot flashes.
In the Zoloft and hot flashes study, the average number of hot flashes the women experienced per week was 45. In the black cohosh trial, the average was 8 per day or 56 per week. Zoloft reduced the frequency of hot flashes by 5 per week or 11%. Black cohosh reduced the frequency by 28 per week or 50% and reduced the average “hot flash score” by 56%.
In the study of Zoloft and hot flashes, there was no significant reduction in severity, but in their final statement the researchers say that “sertraline (the generic name for Zoloft) reduced the number of hot flashes and improved the hot flash score relative to with placebo and may be an acceptable alternative treatment for women experiencing hot flashes. Therefore, these investigators believe that an 11% reduction in hot flash score represents an effective alternative treatment. Numerous studies have shown that placebo treatment can reduce hot flashes by 20-40%.
In the Zoloft and hot flashes study, 15 women dropped out, six due to adverse drug reactions, 9 without giving reason. None of the women dropped out of the black cohosh trial. No adverse events or unwanted side effects of any kind were reported. The women noted that their sleep improved, they were less tired and had less abnormal sweating.
Unwanted side effects associated with the use of Zoloft include sleep disturbances, weakness, dizziness, tremors, confusion, nausea, vomiting, decreased sexual desire, and inability to achieve orgasm. It can induce mood swings. At least one study has shown that it increases the risk of suicide in older people, as well as in teens and tweens. In fact, the FDA has issued a public health advisory stating that “anyone currently using Zoloft for any reason has an increased likelihood of exhibiting suicidal thoughts or behavior, regardless of their age.”
Globally, 20% of all patients in Paxil-related clinical trials withdrew due to unwanted side effects. The side effects are similar to those of Zoloft. Both drugs can cause increased sweating, which makes it even more difficult to understand why researchers would conduct studies on Zoloft and hot flashes, Paxil and hot flashes, or any other drug that can cause increased sweating, since increased Sweating is what frustrates women the most about hot flashes. and sweatshirts at night.
Over the years, hundreds and hundreds of studies have been conducted on the safety of black cohosh. No one knows how long native healers have used the herb. The only known side effect is stomach pain and this is a rare complaint. Recent scientific evaluations have shown that it does not increase the risk of breast or endometrial cancer. So it’s not clear why doctors and societies would recommend something with as many side effects as Zoloft and Paxil, when there is a safer and more effective treatment.
If you want to read more published research on Zoloft and hot flashes or Paxil and hot flashes, you can visit PubMed, a service of the National Library of Medicine and the National Institutes of Health. Just type the phrases in the search box.
For more information on black cohosh and other dietary supplements that can safely relieve hot flashes, visit Guide to Menopause and PMS.