Nov 30 For about a third of the women taking
antidepressants to treat menopause symptoms, some of the
problems - such as hot flashes and night sweats - will return
after discontinuing the drug, according to a U.S. study.
Escitalopram, an antidepressant sold under the brand name
Lexapro, is not approved to treat menopause symptoms, but
physicians may prescribe it because some studies, though not
all, have found it can reduce the number and severity of hot
"It's important for people to understand that... the benefit
of the treatment is related to the duration of the treatment,"
said Hadine Joffe, lead author of the study, which appeared in
the journal Menopause, and an associate professor of psychiatry
at Harvard Medical School.
"Just because symptoms come back after you stop it doesn't
mean it didn't make a big different when you took it," added
Joffe, who is also director of research in the Center for
Women's Mental Health at Massachusetts General Hospital.
Lexapro does not eliminate hot flashes, but it can make "a
very meaningful improvement in somebody's life," Joffe added.
Antidepressants of the same type as Lexapro, called selective
serotonin reuptake inhibitors (SSRIs) are also used to treat
Joffee said there have not been enough studies to determine
just how long women should take an antidepressant to treat hot
flashes, nor whether the symptoms return once they stop the
To address the second question, she and her colleagues asked
200 women to take 10 or 20 milligrams of Lexapro a day for eight
The final analysis included 76 women who showed at least a
20 percent improvement on the drug, dropping from 10 hot flashes
a day down to eight or fewer.
After the two-month treatment period, the women stopped
taking the pills and the researchers tracked their symptoms for
another three weeks. The team was also careful to screen for
withdrawal symptoms from the drug itself.
Menopause symptoms returned for about a third of the women
who had seen an improvement on the drugs. Results were similar
whether the women had reported experiencing less severe symptoms
while on the drug or had said they felt less bothered by their
symptoms during treatment.
Among 49 women who said they had benefited on all three
symptom measures - number, severity and bothersomeness - 44
percent experienced a relapse within three weeks of
discontinuing the drug. For most of them, symptoms rebounded to
about the same levels as before treatment.
Among the women who didn't relapse, symptoms dropped from
about 9.5 a day before treatment to 4.4 per day three weeks
Patients who experienced insomnia before taking the
antidepressant or who didn't find a large benefit from the drug
were more likely to relapse than other women. Some also
experienced the withdrawal symptoms typical of going off an
antidepressants, including sweating and dizziness.
Joffe and some of her colleagues have relationships with
pharmaceutical companies, two of them with Lexapro maker Forest
Joffe said the company provided the pills but had no
participation in the study, which was funded by government
grants. The company declined to comment on the study because it
was not involved.