Journal of General Internal Medicine

, Volume 29, Issue 1, pp 204–213 | Cite as

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

  • Taghreed Shams
  • Belal Firwana
  • Farida Habib
  • Abeer Alshahrani
  • Badria AlNouh
  • Mohammad Hassan Murad
  • Mazen Ferwana
Review Aritcle



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


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.


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.


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.


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.


SSRI hot flashes menopause 



Source of Funding



This study was made possible by support from the Center for the Science of Healthcare Delivery, Mayo Clinic, and CTSA grant UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

Conflict of Interest

The authors declare that they do not have a conflict of interest.


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Copyright information

© Society of General Internal Medicine 2013

Authors and Affiliations

  • Taghreed Shams
    • 1
    • 2
  • Belal Firwana
    • 3
    • 4
  • Farida Habib
    • 1
    • 5
  • Abeer Alshahrani
    • 1
    • 6
  • Badria AlNouh
    • 1
    • 2
  • Mohammad Hassan Murad
    • 4
    • 7
  • Mazen Ferwana
    • 1
    • 6
  1. 1.National and Gulf Center for Evidence-Based Health PracticeKing Saud Bin Abdulaziz University for Health SciencesRiyadhSaudi Arabia
  2. 2.Department of Obstetrics and GynecologyKing Saud Bin Abdulaziz University for Health SciencesRiyadhSaudi Arabia
  3. 3.Department of Internal MedicineUniversity of MissouriColumbiaUSA
  4. 4.Knowledge and Evaluation Research Unit, Mayo ClinicRochesterUSA
  5. 5.Department of NursingKing Saud Bin Abdulaziz University for Health SciencesRiyadhSaudi Arabia
  6. 6.Department of Family MedicineKing Saud Bin Abdulaziz University for Health SciencesRiyadhSaudi Arabia
  7. 7.Division of Preventive MedicineMayo ClinicRochesterUSA

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