Hot flashes (HF) are commonly reported during the menopausal transition. Thus, identifying effective drugs to alleviate HF is crucial. The present study systematically reviewed published clinical trials on the efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for treating HF in healthy menopausal women.

The study included the relevant articles published during 2003-2019 in PubMed, MEDLINE, Web of Science, Scopus, Science Direct, PsycINFO, CINAHL, the Cochrane Central Register of Controlled Trials, and Google Scholar, as well as Iranian databases such as SID, and Magiran.

The study found-

• Thirty-six relevant articles, out of which 27 articles had acceptable and nine had poor methodological quality. 
• Escitalopram, paroxetine, and fluoxetine have higher efficacy and safety in treating menopausal HF than other drugs of SSRIs class. 
• Limited studies on the effectiveness of sertraline, citalopram, and fluvoxamine, rendered inconsistent results. Therefore, further high-quality studies are needed to confirm their effectiveness in alleviating HF.  
• Venlafaxine and desvenlafaxine have significant efficacy for treating menopausal HF within the SNRIs class. 
• Limited studies exist on the effectiveness of duloxetine, which requires further research.

This study found some antidepressants, such as SSRIs and SNRIs, to be efficient and safe in decreasing the frequency and severity of HF. These drugs are therefore recommended for treating menopausal HF.

Iranian Journal of Medical Sciences. 2022. (DOI): 10.30476/IJMS.2020.87687.1817