The FDA approved a new drug called “Brisdelle” in 2013 for the treatment of hot flashes. I was excited to read all about this new therapy since treating perimenoausal symptoms is, after all, my specialty.

I was optimistic to learn all about a new breakthrough and that researchers finally figured out a way to regulate the body temperature to stop hot flashes. I wondered if researchers discovered how to regulate the hormone disruption during perimenopause, or possibly how to control the hypothalamic-pituitary-ovarian access to balance body thermoregulation.

Often times, new research in western medicine can give Chinese medicine practitioners, like myself, vital clues and new insight on ways of thinking about disease and how to improve our own treatments. I was hoping to learn from the actions of this new drug therapy and maybe I could find someway to reproduce the effects with acupuncture and Chinese herbal medicine.

What I discovered about the new pharmaceutical therapy was that it was not a new drug and it was not a new scientific breakthrough, but only the utilization and essentially rebranding of an already established drug… a depression drug.

The drug approved for the treatment of hot flashes is Paroxetine, a selective serotonin reuptake inhibitor (SSRI) that goes by the popular name Paxil. If you are not familiar with this drug, it is a drug primarily used to treat depression. http://www.fda.gov/newsevents/newsroom/pressannouncements/ucm359030.htm To say the least, I was very disappointed to find out that the new therapy of choice for treating menopausal women is to prescribe anti-depressants.

The main reason behind searching for new and innovative ways to treat hot flashes is because the standard traditional hormone replacement therapy (HRT) has potential cancer risks. But how is an anti-depressant any better? Have you read the side-effects these drugs carry? Look at what the modest Mayo Clinic has to say: http://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825?pg=1

If you want to live with nausea, diarrhea, nervousness, agitation, dizziness, sleep difficulty, headaches, or weight gain or loss, I guess, that’s the trade off. Maybe the anti-depressant drug tricks you into believing the hot flashes aren’t as bad as one once seemed? Who knows! All I know is these symptoms are also commonly found in perimenopausal women, and prescribing an anti-depressant drug, may in fact potentially amplify many of these symptoms.

If that isn’t enough, now researchers are looking into other anti-depressant drugs to treat hot flashes. This new study is on Venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI) that goes by the popular name Effexor. http://archinte.jamanetwork.com/article.aspx?articleid=1876676

Again, is it a big deal? I wonder. This study shows a 46% relief in treating hot flashes. Keep in mind, the placebo effect can range from 20-40% on average, so the study is not doing much better than a “sugar pill.” My 2009 acupuncture research showed a overall 69% relief, and with no harmful side-effects.

So, the final question women suffering from hot flashes need to ask themselves is do they want to start taking anti-depressants?

 

Dr. Brian Grosam