Monday, October 15, 2007

Antidepressants now popular remedy for menopause

Doctors are writing a new prescription for menopause: the antidepressant. It’s not that all menopausal women are depressed. Instead, the antidepressant has emerged as the drug of choice among women searching for new ways to cool the hot flash. There is no way to track how often antidepressants are prescribed to treat hot flashes. None are specifically approved for hot flashes, and doctors who prescribe them are doing so “off label.”

The link was made by chance in studies of women with breast cancer. Some cancer drugs set off hot flashes, and researchers noticed that women who were also taking the antidepressants known as a selective serotonin reuptake inhibitors had fewer flashes. Studies looking at the use of these and other serotonin-altering drugs to treat hot flashes in healthy menopausal women have been disappointing. But one interesting trend emerged. Women who were recently menopausal, meaning that they had just stopped having their periods, received the most benefits from antidepressant treatment. Women on either side of the menopausal transition, those who had been menopausal for a year or those who were just starting to experience the effects of hormonal fluctuations, fared worse on the drug.

The biggest concern about antidepressant use for menopause is that the drugs may worsen some symptoms already common during menopause — things like anxiety, sleep problems and loss of libido. For women who choose to try an antidepressant to relieve hot flashes, doctors advise a psychiatric workup and regular follow-up in the first weeks after starting the drug. In some patients, antidepressants can touch off severe manic symptoms if they have histories of bipolar disorder or manic personality traits, doctors say.

Bonnie - it is unconscionable for antidepressants to be used for this purpose, yet, medications are commonly prescribed off-label with little oversight. Unless a full neurological examination shows an imbalance, you should never take an antidepressant for this purpose.

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