A few prescription medications, in addition to estrogen, can provide relief for hot flashes. While none of these drugs is as effective as estrogen, studies show that non-estrogen drugs may have up to 70% of the effectiveness of estrogen therapy when treating hot flashes.
- Selective serotonin reuptake inhibitors (SSRI's): This class of medication is used to treat depression and anxiety. In clinical studies, however, low doses of SSRI's have been shown to be effective in decreasing menopausal hot flashes. The SSRI that has been tested most extensively is venlafaxine (Effexor), although there is also evidence showing that paroxetine (Paxil, Paxil CR) and fluoxetine (Prozac) can be effective in controlling hot flashes.
- Clonidine: Clonidine (Catapres) acts in the brain to decrease blood pressure. It has a long history of being used for blood pressure control, but it has potentially annoying side effects, such as dry mouth, constipation, drowsiness, or difficulty sleeping. Clonidine effectively relieves hot flashes in some women but is completely ineffective in others. Clonidine is available in pill or patch form.
- Megestrol acetate (Megace): This medication is a type of progesterone, a female hormone. It can be effective in relieving hot flashes, but can only be taken over the short term (for several months). Serious effects can occur if the medication is abruptly discontinued, and megestrol is not usually recommended as a first-line drug to treat hot flashes. Megestrol use can also lead to weight gain.
- Studies of another form of progesterone, medroxyprogesterone acetate (Depo-Provera), which is administered by injection, have also shown that this medication can be useful in treating hot flashes. This drug can be used long-term but may have side effects that include weight gain and bone loss.
- Gabapentin: Gabapentin (Neurontin) is a drug that is primarily used for the treatment of seizures that appears to be moderately effective in treating hot flashes. The drug is well tolerated by most women, but often causes drowsiness.
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