Previously published studies which examined the use of nonhormonal therapies for the treatment of menopausal hot flashes, have been subjected to a meta analysis. // This has revealed the efficacy of a few therapies but not as effective as estrogen. In addition they might have possible adverse effects which could restrict their use.

The results of the analysis have been published in the May 3 issue of JAMA.

Hot flashes are the most common symptom related to menopausal transition. They are experienced by more than 50 percent of menopausal women, can persist for several years after menopause, and for some women can interfere with activities or sleep to such a degree that treatment is requested, according to background information in the article. Estrogen has been used as a hormone supplement for nearly 60 years to treat menopausal symptoms. However, recent studies reporting adverse effects such as cardiovascular events and breast cancer have raised important concerns about its use and have led to increased interest in other therapies for improving menopausal symptoms. Evidence of the efficacy and adverse effects of nonhormonal therapies is generally lacking or unclear.

Heidi D. Nelson, M.D., M.P.H., of the Oregon Health and Science University and Providence Health System, Portland, Ore., and colleagues conducted a meta-analysis of randomized controlled trials to compare the efficacy and adverse effects of nonhormonal therapies for menopausal hot flashes. The researchers identified 43 relevant trials, including 10 trials of antidepressants, 10 trials of clonidine, 6 trials of other prescribed medications, and 17 trials of isoflavone extracts.

The researchers found: “This systematic review and meta-analysis of double-blind, randomized, placebo-controlled trials of nonhormonal therapies provides supportive evidence for the efficacy of selective serotonin reuptake inhibitors (SSRIs) or serotonin noradrenergic reuptake inhibitor
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