Journal of General Internal Medicine

, Volume 29, Issue 1, pp 204–213

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

Authors

    • National and Gulf Center for Evidence-Based Health PracticeKing Saud Bin Abdulaziz University for Health Sciences
    • Department of Obstetrics and GynecologyKing Saud Bin Abdulaziz University for Health Sciences
  • Belal Firwana
    • Department of Internal MedicineUniversity of Missouri
    • Knowledge and Evaluation Research Unit, Mayo Clinic
  • Farida Habib
    • National and Gulf Center for Evidence-Based Health PracticeKing Saud Bin Abdulaziz University for Health Sciences
    • Department of NursingKing Saud Bin Abdulaziz University for Health Sciences
  • Abeer Alshahrani
    • National and Gulf Center for Evidence-Based Health PracticeKing Saud Bin Abdulaziz University for Health Sciences
    • Department of Family MedicineKing Saud Bin Abdulaziz University for Health Sciences
  • Badria AlNouh
    • National and Gulf Center for Evidence-Based Health PracticeKing Saud Bin Abdulaziz University for Health Sciences
    • Department of Obstetrics and GynecologyKing Saud Bin Abdulaziz University for Health Sciences
  • Mohammad Hassan Murad
    • Knowledge and Evaluation Research Unit, Mayo Clinic
    • Division of Preventive MedicineMayo Clinic
  • Mazen Ferwana
    • National and Gulf Center for Evidence-Based Health PracticeKing Saud Bin Abdulaziz University for Health Sciences
    • Department of Family MedicineKing Saud Bin Abdulaziz University for Health Sciences
Review Aritcle

DOI: 10.1007/s11606-013-2535-9

Cite this article as:
Shams, T., Firwana, B., Habib, F. et al. J GEN INTERN MED (2014) 29: 204. doi:10.1007/s11606-013-2535-9

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.

KEY WORDS

SSRIhot flashesmenopause

Copyright information

© Society of General Internal Medicine 2013