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Effexor & Menopause

Menopause still continues to mystify the medical world, and hormone replacement therapy often disappoints doctors and patients. As a result, many doctors are practicing the "off-label" practice of prescribing antidepressants for menopausal symptoms.

  1. Menopause

    • Menopause is a stage in a woman's reproductive life when her menstrual cycle ends. About 70 percent of women experience symptoms that include hot flashes, mood swings and insomnia. For several years before menopause, women may experience a precursor stage, known as perimenopause.

    Antidepressants

    • Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are used to treat depression and anxiety disorder. The common antidepressants used to treat menopausal symptoms include Effexor, Paxil and Prozac.

    Why Antidepressants?

    • Effexor, along with Paxil and Prozac, are given to menopausal patients for hot flashes, insomnia and mood swings. One theory is that a reduced amount of estrogen, which occurs in menopausal patients, can cause a deficiency in serotonin reuptake, the amount of serotonin a neuron can absorb. The most compelling reason antidepressants are prescribed for menopause may be their proven ability to treat hot flashes. A Mayo Clinic study of 229 women--who were not clinically depressed but were given antidepressants--indicates a 60 percent rate of improvement in their symptoms. While researchers are unable to explain how the antidepressants counteract the hot flashes, the results offer an alternative for women who may not be able to use hormone treatment, which researchers admit is more effective than antidepressants.

    The Pros and Cons

    • Some doctors view "off-label" prescribing of Effexor for menopause as a benefit, relieving their patients of the torture of their menopausal symptoms. To them, it's more important to find things that mean relief for their patients, as long is it is not causing any harm. Other doctors view the off-labeling of antidepressants for menopause to be an unethical treatment, partly because it treats menopause like a mental illness. They also fear the repercussions of using a medicine for a use other than approved by the Food and Drug administration.

    Warnings

    • Effexor can have side effects that include sleeplessness, nausea, sweating, mood changes and digestive issues. Missing doses or halting use abruptly can add to these negative effects. If a patient misses a dose, she should take another as soon as she remembers, taking care not to double-dose. Any patient who wants to halt use of Effexor permanently is urged to seek a doctor's assistance. Effexor must be tapered off, and the doctor must monitor the patient through this process.

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