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Harvard Medical School

Citalopram (Celexa) Effective for Treating Hot Flashes

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.

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9 Responses to Citalopram (Celexa) Effective for Treating Hot Flashes

  1. kathleen hewitt April 17, 2010 at 1:42 pm #

    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.

  2. Jean June 17, 2010 at 3:22 pm #

    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.

  3. Jadees mom August 7, 2014 at 5:57 pm #

    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.

  4. Dawn January 3, 2016 at 12:54 am #

    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.

  5. MGH Center for Women's Mental Health January 3, 2016 at 3:10 pm #

    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.

  6. kim wiltshire January 6, 2016 at 9:33 pm #

    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.

  7. Crystal January 29, 2016 at 11:45 pm #

    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.

  8. MGH Center for Women's Mental Health February 1, 2016 at 2:36 pm #

    Estrogen is the best treatment for hot flashes and other menopausal symptoms.

  9. Jenny February 29, 2016 at 5:41 pm #

    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?

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