From the Research
Estrogen therapy via oral contraceptive pills (OCPs) may be considered to help manage night sweats associated with Lexapro (escitalopram) in teenagers, but this approach should only be undertaken with medical supervision. Night sweats are a common side effect of selective serotonin reuptake inhibitors (SSRIs) like Lexapro, and the estrogen in OCPs may help regulate body temperature and reduce these vasomotor symptoms.
Key Considerations
- If considering this option, a low-dose combination OCP containing ethinyl estradiol (typically 20-35 mcg) with a progestin component would be the usual starting point 1.
- The medication would be taken daily, typically in a 21-day active pill cycle followed by 7 days of placebo or no pills.
- Before starting this treatment, a thorough medical history and examination are essential to rule out contraindications to estrogen therapy such as history of blood clots, migraines with aura, or liver disease.
Mechanism and Alternative Approaches
- This approach works because estrogen can help stabilize the hypothalamic temperature regulation that may be disrupted by SSRIs.
- However, it's essential to note that OCPs come with their own potential side effects and risks, and alternative approaches such as adjusting the timing of Lexapro administration, lowering the dose, or switching to another antidepressant might be considered first 2.
Evidence and Recommendations
- The most recent and highest quality study on the topic of hormone therapy, including the use of estrogen for managing menopausal symptoms, suggests that estrogen therapy can be effective in reducing vasomotor symptoms, but the decision to use it should be based on individual risk-benefit evaluation 1, 3.
- Given the potential benefits and risks, the use of estrogen therapy via OCPs for managing night sweats in teenagers taking Lexapro should be carefully considered and monitored by a healthcare professional.