Citalopram May Effectively Reduce Hot Flashes in Postmenopausal Women

March 23, 2007 — Citalopram was an effective alternative therapy in reducing climacteric symptoms, such as hot flashes, in postmenopausal women who did not want to use hormone therapy (HT), according to the results of a study reported in the March/April issue of Menopause.

"The aim of this study was to evaluate the efficacy of citalopram for climacteric symptoms and to assess the combined effect of citalopram and hormone therapy (HT) on climacteric symptoms in women inadequately responsive to HT alone," write Aysegul E. Kalay, MD, from the Alanya Sifa, Medical Center in Antalya, Turkey, and colleagues. "The most effective therapy for relieving vasomotor symptoms is hormone therapy (HT). However, based on the results of the estrogen/progestin arm of the Women's Health Initiative study, women who fear the potential for breast cancer and thromboembolism as a result of HT do not to want to take estrogen/progestin therapy."

Climacteric symptoms, especially hot flashes, involve vasoactive and endocrine factors as well as estrogen deficiency. The selective serotonin reuptake inhibitors (SSRIs) have been shown to reduce hot flashes by 50% to 60%, and citalopram is the most selective of the clinically used SSRIs.

In this study, 100 postmenopausal women were assigned to 1 of 4 groups: (1) citalopram, (2) placebo, (3) citalopram + HT, or (4) placebo + HT. Women who were unable or unwilling to take HT were randomized to groups 1 or 2, and those who were inadequately responsive to HT were randomized to groups 3 or 4. In groups 1 and 3, citalopram was started at 10 mg/day and increased to 20 mg/day after 1 week. Follow-up visits occurred during the fourth and eighth weeks of treatment, when women completed 2 questionnaires: a modified Kupperman index and the Menopause-Specific Quality-of-Life Questionnaire (MENQOL).

In all groups, mean hot flash scores improved significantly (P < .05), by 37% in group 1, 13% in group 2, 50% in group 3, and 14% in group 4. Psychosocial complaints and mean values on the Kupperman index also decreased in all groups (P < .05). In groups 1, 3, and 4, physical well-being significantly improved (P < .05). The decrease in all scores was significantly greater in groups 1 and 3 compared with groups 2 and 4 (P < .01).

"Citalopram is an effective alternative treatment option for patients who do not want to take HT for the alleviation of climacteric symptoms," the authors write. "Adjuvant treatment with a selective serotonin reuptake inhibitor increases the effectiveness of HT for the treatment of climacteric symptoms in women who had responded inadequately to HT."

Study limitations include lack of double-blinding.

The authors have disclosed no relevant financial relationships.

Menopause. 2007;14:223-229.

Source: http://www.medscape.com/viewarticle/554039?src=mp