Medical researchers have conducted a few studies concerning Zoloft and hot flashes. A few more studies have been done concerning Paxil and hot flashes. Twice as many published studies have focused on black cohosh and hot flashes and there are even more concerning this herb and other symptoms related to menopause. Why so many studies?
Traditional herbal remedies are often the subject of scientific scrutiny, because modern medicine would like to either "prove" or "disprove" their effectiveness. They would also like to know "why" botanical remedies are effective; so, many studies revolve around isolating the active component.
Researchers began studying antidepressants like Zoloft and hot flashes in 2002, around the same time that the Women's Health Initiative released conclusions concerning the long-term health risks associated with hormone replacement therapy. Research concerning Paxil and hot flashes prior to 2002 focused on breast cancer survivors who are unable to use estrogen replacement therapy.
Scientists and researchers are unable to explain why these drugs may be effective, or even why they would be considered for use. It is likely that they were prescribed to women who were suffering from depression, which sometimes accompanies menopause. These women may have reported a reduction in hot flashes, leading doctors to suggest that they might be useful for controlling hot flashes.
Both Zoloft and Paxil belong to a group of drugs known as Selective Serotonin Reuptake Inhibitor or SSRI. These drugs are approved by the FDA to treat depression and some are approved for the treatment of premenstrual dysphoric disorder. They are not approved by the FDA to treat hot flashes, other symptoms related to menopause, nor are they approved to treat PMS, but doctors often prescribe them for these purposes.
Even though they are not approved by the FDA to relieve hot flashes, both the American College of Obstetricians and Gynecologists (ACOG) and the North American Menopause Society recommend that women with moderate to severe, menopause related hot flashes should consider an SSRI, if they cannot or choose not to take hormone replacement therapy. Interestingly, a brochure released by the ACOG mentions that herbs and botanicals are not approved by the FDA, but they never mention that SSRI drugs are not approved by the FDA to treat menopausal symptoms.
One study concerning Paxil and hot flashes experienced by breast cancer survivors is similar to a more recent study concerning the use of black cohosh. (Black cohosh is an herb used traditionally by Native American healers and passed down from generation to generation for the relief of hot flashes and other menopausal symptoms.) As previously mentioned, women who have had breast cancer are unable to take estrogen replacement therapy, in fact they must take a drug that limits the effects of estrogen for several years following surgery. Even in women who are not near menopause, this drug causes severe hot flashes.
In the study of Paxil and hot flashes, the antidepressant was shown to reduce hot flash frequency by as much as 79%. Black cohosh was shown to reduce hot flash frequency by as much as 100%. Of the 90 women who participated in the black cohosh study, none reported adverse side effects and no one dropped out. Of the 30 women who participated in the study of Paxil and hot flashes, three (10%) dropped out because of drowsiness and one dropped out because of anxiety, a possible adverse reaction to Paxil.
Recently research was conducted by the College of Medicine at the University of Arizona concerning Zoloft and hot flashes. A group of women aged 40-65, currently suffering from hot flashes, but not taking hormone replacement therapy, were recruited. The researchers used a number called the "hot flash score", which is equal to the number of hot flashes a woman experiences multiplied by the numerical expression of their severity, to evaluate the effectiveness of the SSRI over a four week period. A similar study concerning black cohosh and hot flashes was conducted by the Mayo Clinic.
In the study of Zoloft and hot flashes, the average number of hot flashes the women experienced per week was 45. In the black cohosh trial, the average was 8 per day or 56 per week. Zoloft reduced the frequency of hot flashes by 5 per week or 11%. Black cohosh reduced the frequency by 28 per week or 50% and reduced the average "hot flash score" by 56%.