Can venlafaxine (Effexor) be used to treat hot flashes?

From the Guidelines

Venlafaxine can be used to treat hot flashes, particularly in women experiencing menopause or those who cannot take hormone therapy, with a recommended dosage of 75 mg daily, as it has been shown to reduce hot flash score by 61% compared to a 27% reduction with placebo 1. The medication works by affecting brain chemicals (serotonin and norepinephrine) that help regulate body temperature. Key points to consider when prescribing venlafaxine for hot flashes include:

• Starting with a lower dose, such as 37.5 mg daily, and increasing as needed, to minimize side effects such as nausea, dry mouth, and dizziness
• Monitoring patients for common side effects, which often improve over time
• Tapering the dosage gradually under medical supervision if discontinuation is necessary, to avoid withdrawal symptoms
• Considering the use of venlafaxine in breast cancer patients, as it has been shown to be more effective than clonidine in reducing the frequency and severity of hot flashes, and has a beneficial effect on daily living 1. It's also worth noting that desvenlafaxine, the major active metabolite of venlafaxine, has also been shown to be effective in reducing hot flashes, with a significant reduction of 64% at 12 weeks of treatment with the 100 mg dose, compared to 51% with placebo 1.

From the Research

Treatment of Hot Flashes with Venlafaxine

• Venlafaxine, also known as Effexor, has been studied as a potential treatment for hot flashes in various patient populations, including postmenopausal women and breast cancer patients 2, 3, 4, 5, 6.
• The evidence suggests that venlafaxine can decrease the frequency and severity of hot flashes, with studies showing a reduction in hot flash frequency of around 60% 2.
• Venlafaxine has been compared to other treatments for hot flashes, such as clonidine, and has been found to be more effective in reducing hot flash frequency 3.
• The use of venlafaxine for hot flashes is supported by several organizations, including the American College of Obstetricians and Gynecologists and the North American Menopause Society 5.
• Venlafaxine is considered a nonhormonal alternative to traditional hormone replacement therapy, which may be contraindicated in certain patients, such as those with a history of breast or uterine cancer 2, 4, 6.

Efficacy and Safety

• Studies have shown that venlafaxine is well-tolerated and effective in reducing the frequency and severity of hot flashes in postmenopausal women and breast cancer patients 3, 4, 5, 6.
• The efficacy of venlafaxine in reducing hot flashes has been compared to other antidepressants, such as paroxetine, and has been found to be similar or superior 3, 5.
• The safety profile of venlafaxine is generally considered favorable, although side effects such as nausea, headache, and dizziness have been reported 3, 5.

Clinical Use

• Venlafaxine may be considered as a treatment option for hot flashes in patients who are unable or unwilling to use hormone replacement therapy, or in those who have contraindications to hormone therapy 2, 4, 6.
• The dosage of venlafaxine used for hot flashes is typically lower than that used for depression, and may be titrated based on patient response and tolerability 3, 5.