Non-Hormonal Interventions for Hot Flashes

A number of non-hormonal remedies are available for the treatment of hot flashes. Their goal is not to eliminate hot flashes altogether, but to diminish their intensity and frequency. Some of these interventions (e.g., vitamin E, black cohosh and soy products) are available over-the-counter. Others are available by prescription.

Drug Dosage Side Effects
Evening Primrose Oil Variable Nausea, diarrhea, blood clots. Do not use if seizure history or on blood thinners
Black cohosh 20 mg twice a day Mild stomach upset. Safe up to 6 mos. Rare reports of liver damage
Soy (plant estrogen) Variable Appears safe if consumed in foods
Catapres 1 mg in am & at bedtime (also in patch form) Dry mouth, drowsiness, fatigue, lowers blood pressure
Celexa (Citalopram) 10-20 mg in am Sexual dysfunction
Prozac (Fluoxetine) 20 mg in am Dry mouth, nausea, insomnia, sexual dysfunction
FDA approved Brisdelle (Paroxetine) 7.5 mg at bedtime Fatigue, nausea no weight gain or sexual dysfunction which have been seen with higher doses of paxil (paroxetine)
Effexor (Venlafaxine) 37.5 mg to 75 mg a day Fatigue, nausea, headache, dry mouth, elevated blood pressure (at high doses)
Neurontin Gabapentin) Up to 300 mg three times a day Fatigue, dizziness, nausea

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