For decades, estrogen has been used to treat menopausal symptoms, including night sweats and hot flushes. However, after studies reported that estrogen may have an adverse effect on risk for cardiovascular disease and breast cancer, many patients and clinicians have looked into alternative treatments for hot flashes, including selective serotonin reuptake inhibitors (SSRIs).
The North Central Cancer Treatment Group studied the use of the SSRI citalopram (Celexa) to decrease hot flashes in a randomized, placebo-controlled phase III trial as reported in a poster session at the annual meeting of the American Society of Clinical Oncology. This group found that citalopram performed twice as well as placebo in decreasing the frequency or severity hot flashes.
This study included 254 post-menopausal participants who had a history of breast cancer or who wanted to avoid hormones due to breast cancer risk. The participants needed to have at least 14 hot flashes per week for at least 1 month and could not be taking any other antidepressants or hot flash therapies. These participants were divided into 4 separate groups with 57 participants in each of the treatment arms and 83 participants in the placebo group. For week one, all the participants recorded their hot flashes prior to treatment. The groups received the following interventions during weeks 2-7:
Group 1: Citalopram 10mg (per day) during weeks 2-7
Group 2: Citalopram 10mg during week 2, followed by 20mg during weeks 3-7
Group 3: Citalopram 10mg for week 2, 20mg for week 3, and 30mg for weeks 4-7
Group 4: Placebo
This study showed that the participants receiving placebo (Group 4) had a 23% reduction in their mean hot flash score, while groups 1, 2, and 3 had mean reductions of 49%, 50%, and 55%, respectively. Similarly, the mean reduction in hot flash frequency was noted to be 20% in the placebo group, while groups 1, 2, and 3, had mean reductions of 46%, 43%, and 50%, respectively. All of the comparisons to placebo noted here were noted to be statistically significant.
Women in all three groups receiving citalopram arms also had greater improvements in the quality of work, leisure, sleep, mood, relationships, enjoyment of life, and overall quality of life that those on placebo on the Hot Flash Related Daily Interference Scale (HFRDIS).
This study further supports the use of citalopram as a possible treatment option for patients looking to reduce hot flashes and is consistent with previous studies documenting the effectiveness of other serotonergic antidepressants, including paroxetine (Paxil) and venlafaxine (Effexor), for the treatment of hot flushes. These studies also indicate that these antidepressants may be helpful for managing other menopausal symptoms, including mood changes and sleep disturbance.
Betty Wang, MD
Kalay AD, Demir B, Haberal A, Kalay M, Kandemir O. Efficacy of citalopram on climacteric symptoms. Menopause 14(6):1069-1070, 2007.
Poster session by Debra Barton, PhD and colleagues from the Mayo Clinic in Rochester, MN, at the annual meeting of the American Society of Clinical Oncology, as reported in: Wachter K. Citalopram Appears Effective for Reducing Hot Flashes. Clinical Psychiatry News 36 (7): 48, 2008.
I totally agree with the use of Celexa. My gynecologist was surprised when I told her that if I missed a day or two of Celexa (I only take 10 mg daily), I would have flashes and I would cry. The kind of deep crying associated with sadness. I do not have a history of depression. I started Celexa when I was in treatment for rectal cancer in 2005 and went into menopause secondary to chemotherapy.
If I take, though, more than 10mg per day, I feel too much anxiety so sometimes, if I’m having a particularly stressful time, I might alternate 10mg with 20mg. every other day, making sure that I take it very early in the morning because I feel that increased dose interferes with sleep.
I take 20 mg a day before bedtime. Hot flashes and night sweats have been reduced a lot though not eliminated. That’s why I’m taking it. Unfortunately I seem to have the side effect of fatigue and am more tired now than when I woke up every 30 minutes in a sweat. I don’t have any other side effect. I’ve been on it for 3 months. I guess it’s back to the doctor for another consult.
I had a total hysterectomy 2 days ago and was already on celexa (30mgs a day) for panic disorder and was told by gyno I may want to bump it up to 40 mgs in a few days to help with the menopause symptoms that will hit me in a week or so. I will do the 40 tonight and see if it helps to keep the hot flashes and night sweats at bay.
Can you please tell me if this is to be taken in the morning or night, I am confused. I take it in the morning, 10 Mg and am still having terrible hot flashes and feel tired during the day.
Usually most people take SSRIs once per day. Some people feel tired after taking citalopram, so it might make sense to take it before bed. There is also room to increase the dose if you are not getting a response at 10 mg.
Yes same for me. 10 mg of citalopram didnt help hardly ,but when increased to 20mg stops my hot flushes, still have a few sweats but nothing like previously, 30mg stopped all my menopause symptons, but i cant tolerate that dose as feel too lethargic,like im wading through mud during the day, Have retried twice, so 20mg is best balance for me.Also when i go back to 10mg i get that awful wet, dribbling sensation on my face, which has taken me 2 years to realise is caused by hormones during menopause. would wake in night having scratched at my face.
I was just prescribed Celexa because I had a total done in May, I am on the Estradiol 0.5 mg patch, and my doctor wants me to also start taking this medicine, however In reading up on it, and I’m afraid it’ll make me depressed!! I just want the hot flashes to stop and be able to sleep all night long.
Estrogen is the best treatment for hot flashes and other menopausal symptoms.
I’ve been taking Celexa to manage hot flashes and it worked great for me. I take 10 mg. I recently started Humira for ulcerative colitis and the hot flashes are back with a vengence. Should I ask my gyno to bump up it?
I entered full swing into menopause last year, and I thought I was losing my mind. I was incredibly irritable, & impatient. I really had to work hard at controlling my temper, because any little thing would set me off. I also had crazy hot flashes, severe joint pain, and trouble sleeping. My doctor started me on 20 mgs & warned me it would take 4 to 6 weeks before I noticed anything. I was nauseous the first 4 weeks, every morning, and during the 4th & 5th week I would get jittery but I was starting to sleep better. I also noticed no more hot flashes. During week 6, I finally got my appetite back, and there wasn’t as much pain in my joints as before. The best part, however, was not losing my temper over stupid things anymore, and feeling like I had regained my sanity. I’ve been on it for three months; I sleep great, I’m no longer tired all the time, I can think clearly again (my job requires critical thinking skills & quick judgment calls), and people don’t run when I enter a room. I didn’t know this drug was primarily prescribed for depression, but I’m grateful that it’s helping me get through this stage in life.
I am 67 years old. I had a total mastectomy cancer right breast when I was 45 years old. My doctor put me on Celexa 10 mg 23 years ago. I feel great..exercise every day. 120lbs 5’3. I have been feeling depressed lately so decided to increase my dosage to 15. Its been 1 year. Feeling good. Then now this week 8/4/2018 feeling depressed again, so I have increased to 20mg. I hope it works. Wish me luck.
I agree with Viva. I’ve found 20mg of citalopram has has helped my hot flushes and night sweats. I was so irritable before I started on it I felt almost insane! I also felt like me whole body aches and I had joint pain everywhere. I’ve been on the meds for a year and feel pretty much back to normal, don’t know how I would have coped without it. I think my husband would have left me, I was horrible to live with.
I’ve read all your coments, Thank you all for useful information, its so awful we have to go through this in life& feel this way, wid our body, feelings& emotions, worse is hot flushes, through out day& nght, all time, unbearable, sleep is nghtmare, not being calm& getting irritated, angry, feeling not understood. Ive been suffering for 5 yrs, tryed almost everything, even had hysterectomy. Doctor as just given me citalopram 20mg. Worth a try i spose, but antidepressant, for our symptons is not good really. Good luck to us all. Lot worse situations& illnesses& problems in life, id like to help& care& support. But this women health issues, Bloody Menopausal, stops u helping anyone, sort of! Why cant they make a tablet that just takes it all a way& its don with. May b i will one day! Whats worse, why do some of us suffer terribly, some dont suffer at all. Makes me angry, lol ive got be one that suffer’s terribly.?but its good to read u all do as well. I mean in a kind way.
?????
I have been on 20mg of Citralopram my hot sweats went away however they have increased again, I’m thinking of upping the dose to 30 mg. I take the medication in the morning can anyone advise me if it’s brtter taken at night thanks
I do NOT think Celexa helps with hot flashes!!!! If anything I think it makes them way worse!!
Celexa does not work for everybody, but there are other options for the management of hot flashes and other menopausal symptoms, including venlafaxine, gabapentin, and estrogen replacement. I would discuss some of these options with your doctor.
I’ve just started taking 10 mg daily of Celexa for hot flashes. It’s encouraging to me to read the comments. I’m hopeful that it will work for me. My doctor prescribed Celexa mainly because I have had a blood-clot in the past and estrogen would be too much of a risk for me. Are there any other medication options (other than Celexa) out there for someone in my situation? Just in case this doesn’t work for me.
Gabapentin is an excellent option.
Read more HERE and HERE.