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Escitalopram versus black cohosh for relieving hot flashes in nondepressed menopausal women

Lofty, Mariam; Abdelmoez, Khaled

Journal of Evidence-Based Women’s Health Journal Society: August 2016 - Volume 6 - Issue 3 - p 101–105
doi: 10.1097/01.EBX.0000488776.94081.21
Original articles

Objective The aim of this study was to investigate the effectiveness and tolerability of escitalopram, a selective serotonin reuptake inhibitor versus black cohosh, Cimicifuga racemosa, for the treatment of hot flashes among menopausal women.

Background Hot flashes are one of the most agonizing symptoms of menopause, involving about 80% of women. Because of recent controversies about black cohosh as an alternative herbal treatment for hot flashes, the use of antidepressants to treat hot flashes has been an active area of research. However, most of the previous trials have included women with medical or psychiatric disorders that may affect drug response.

Patients and methods A total of 104 menopausal women aged 50–60 years were enrolled into randomized clinical trial. The women received either escitalopram or black cohsh with follow-up at 4 and 8 weeks. After 4 weeks, cases not reaching 50% reduction of hot flashes were treated with double the dose of either escitalopram or black cohosh. The main outcome measures were the frequency and severity of hot flashes using the Greene climacteric scale.

Results Over the course of the study, women reported significant decreases in both hot flash frequency and severity in the escitalopram group than in the black cohosh group (P=0.0001). Differences in decrease in hot flashes severity were significant as well (P=0.002). Both have similar safety profile.

Conclusion Escitalopram 10–20 mg/day is more effective compared with black cohosh at a dose of 20–40 mg/day for reducing hot flashes (frequency and severity) in nondepressed menopausal women; both are tolerable and safe.

Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ring Road, Ismailia, Egypt

Correspondence to Mariam Lofty, MD, Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Ring Road, Ismailia 41111, Egypt Tel: +2 01066149478; fax: +20643210111; e-mail:

Received June 7, 2016

Accepted June 7, 2016

© 2016 Lippincott Williams & Wilkins, Inc.
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