The Use of Antidepressant Drugs in Climacteric Syndrome - Revista Brasileira de Ginecologia e Obstetrícia
Rev Bras Ginecol Obstet. 2020;42(1):1-4
Vasomotor symptoms (VMS) or hot flashes interfere with women’s quality of life and are the probable cause of sleep disorders, lack of energy, depression and tiredness in the peri- and postmenopausal period. These symptoms normally last between 2 and 10 years, with an average of 7.4 years or more. Estrogen therapy is the treatment of choice for VMS and reduces both the weekly frequency and the severity of these symptoms. For hot flashes relief, hormone treatment lasts 3 to 5 years and discontinuity may lead to recurrence in up to 50% of symptoms. On the other hand, by considering the benefits of hormone therapy for osteoporosis prevention, quality of life improvement and treatment of persistent VMS, there is a current trend to extend treatment until the age of 60 or 65 years old.
Other drug therapies are suggested for women who do not wish to undergo estrogen therapy, usually for fear of cancer, and those with contraindications to hormone treatment, although the results of these therapies are far lower than conventional estrogen therapy. These include selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and norepinephrine reuptake inhibitors (SNRIs). Despite the inferior therapeutic results, after estrogen, these are the most used drugs for the treatment of VMS, and they have a very fast action (in days) in reducing hot flashes, while their antidepressant action will occur later (in weeks).
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Vasomotor symptoms (VMS) or hot flashes interfere with women's quality of life and are the probable cause of sleep disorders, lack of energy, depression and tiredness in the peri- and postmenopausal period. These symptoms normally last between 2 and 10 years, with an average of 7.4 years or more. Estrogen therapy is the treatment of choice for VMS and reduces both the weekly frequency and the severity of these symptoms. For hot flashes relief, hormone treatment lasts 3 to 5 years and discontinuity may lead to recurrence in up to 50% of symptoms. On the other hand, by considering the benefits of hormone therapy for osteoporosis prevention, quality of life improvement and treatment of persistent VMS, there is a current trend to extend treatment until the age of 60 or 65 years old.
Other drug therapies are suggested for women who do not wish to undergo estrogen therapy, usually for fear of cancer, and those with contraindications to hormone treatment, although the results of these therapies are far lower than conventional estrogen therapy. These include selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and norepinephrine reuptake inhibitors (SNRIs). Despite the inferior therapeutic results, after estrogen, these are the most used drugs for the treatment of VMS, and they have a very fast action (in days) in reducing hot flashes, while their antidepressant action will occur later (in weeks).
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