The hormone estrogen is the recommended treatment for menopausal night sweats and hot flashes, but some women are unable or unwilling to use it. Now a clinical trial suggests that the antidepressant venlafaxine, often used as an alternative, is equally effective.
In an eight-week placebo-controlled double-blind study, researchers randomly assigned 339 perimenopausal and postmenopausal women to one of three treatments: 0.5 milligrams a day of estrogen (in the form of estradiol), 75 milligrams a day of the antidepressant venlafaxine (a generic form of Effexor), or a placebo. Before the start of the study, all the women had had symptoms at least 14 times a week.
Compared to the rate before the study — an average of 8.1 episodes a day — the frequency of hot flashes and night sweats declined by 52.9 percent in the estradiol group, 47.6 percent in the Effexor group, and 28.6 percent among those who took a placebo.
Both Effexor and estradiol were effective treatments, but the study,published online in JAMA Internal Medicine, was not large enough to show that one was significantly better than the other.
“Women have important choices of different medications to discuss with their doctors,” said the lead author, Dr. Hadine Joffe, an associate professor of psychiatry at Harvard. “They should know, as they think about these options, that both are effective.”