Hot flashes

Paroxetine HCL & Venlafaxine HCL

Monthly Plan: $35.00 / month
Quarterly plan: $30.00 / month

Both are recommended by the North American Menopause Society as a non-hormonal treatment for hot flashes

  • Paroxetine and venlafaxine HCL are both estrogen and progesterone free
  • Paroxetine is shown to decrease the frequency of moderate to severe hot flashes in menopausal women by up to 67 percent
  • Venlafaxine (75mg) has been shown to be as effective as a low dose (0.5mg) oral estradiol at reducing the frequency of hot flashes

This information isn’t a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns, please talk to your doctor.

Both are not suitable for patients who have moderate to severe kidney or liver disease, take MAOIs, or might be or are pregnant or breastfeeding. Patients with depression, bipolar, or anxiety should seek care from a psychiatrist. For more about safety, including the boxed warning for increased suicidal thoughts in young people, please read paroxetine important safety information and venlafaxine important safety information.

The use of paroxetine and venlafaxine for the treatment of hot flashes is an “off-label” use. Rory-affiliated physicians have the discretion to prescribe these drugs off-label to meet the unique needs of individual patients. For more on off-label prescribing, see the Rory FAQs.

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Paroxetine HCL & Venlafaxine HCL

how the medication works

The science behind paroxetine.

Paroxetine, in low doses, has been shown to be an effective and safe non-hormonal treatment for reducing the frequency and severity of hot flashes in menopausal women. Many women are not eligible for systemic hormone therapy, and others are concerned about the risks. Paroxetine is a powerful alternative to systemic estrogen-based medications (hormone replacement therapy).

Paroxetine is one of the selective serotonin reuptake inhibitors (SSRI) antidepressants that have been studied and found to be effective for the treatment of moderate to severe hot flashes in menopausal women. It’s important to note that paroxetine is commonly used to treat anxiety and depression.

Rory-affiliated doctors prescribe paroxetine at 10 mg which is lower than the usual starting doses for treating anxiety and depression. SSRIs, like paroxetine, work by adjusting serotonin levels in the brain, which is thought to play a role in temperature regulation and their effectiveness in treating hot flashes.

how the medication works

The science behind venlafaxine.

Venlafaxine has been shown to be an effective and safe non-hormonal treatment for significantly reducing the frequency and severity of hot flashes for menopausal women. Venlafaxine is in the family of medication called serotonin-norepinephrine reuptake inhibitors (SNRIs) and is most commonly used to treat anxiety and depression. However, it is also effective in decreasing the frequency and severity of hot flashes.

Prior to non-hormonal treatments for hot flashes, the majority of care options were oral estrogen and progesterone, and now women have the option of effective non-hormonal treatment. Similar to the SSRI medications like paroxetine, venlafaxine, and other SNRIs, work by adjusting serotonin levels in the brain, which is thought to play a role in temperature regulation and be responsible for their effectiveness in treating hot flashes.

A study of perimenopausal and postmenopausal women comparing the effectiveness of low dose systemic estrogen therapy and venlafaxine in relieving hot flashing showed similar results between the two medications, proving that venlafaxine is an effective treatment for hot flashes.

Frequently Asked Questions

What is paroxetine?

Paroxetine is part of a family of drugs called selective serotonin reuptake inhibitors (SSRIs) most commonly used to treat anxiety and depression. Rory-affiliated providers can prescribe paroxetine at lower doses than are typically required to treat anxiety and depression. At these lower doses, paroxetine may be effective in decreasing the frequency and severity of hot flashes.

The use of paroxetine for the treatment of hot flashes is an off-label use. Rory-affiliated providers have the discretion to prescribe paroxetine off-label if they believe it is an appropriate course of treatment based on a patient’s unique medical history, symptoms, and preferences.

Paroxetine is not appropriate for everyone—you and your Rory-affiliated provider will decide if paroxetine is appropriate for you. To learn more about who should not take paroxetine and the side effects that it may cause, including the boxed warning for increased suicidal thoughts in people under 25, please see the FAQ below regarding side effects and the important safety information for paroxetine.

How do I use paroxetine?

Paroxetine is a tablet that is typically taken daily with or without food. Please, always follow your healthcare provider’s instructions for how to take your medication and what dose to take. If you have any questions about your medication, once prescribed, please contact your Rory-affiliated provider on your My Ro account.

How long does it take for paroxetine to start working?

The North American Menopause Society (NAMS) reviewed clinical research pertaining to the treatment of hot flashes. NAMS found that women who benefited from SSRI treatment experienced a rapid reduction in the frequency and severity of hot flashes. Based on its review, NAMS recommends a trial of 2-4 weeks. If you are not getting any relief after 4 weeks, reach out to your Rory-affiliated physician, as this treatment does not work for everyone.

What is off-label prescribing?

The FDA requires that drugs go through a clinical testing process to establish that they’re safe and effective to treat a particular condition. Healthcare providers generally may prescribe a drug for an unapproved use when they judge that it is medically appropriate for their patient. This type of prescribing is called “off-label” prescribing. Off-label prescribing practices are sometimes validated by clinical experience and research and may be a widely recognized clinical practice. Rory-affiliated providers have the discretion to prescribe certain drugs off-label based on a patient’s unique medical history, symptoms, and preferences.

What is venlafaxine?

Venlafaxine is part of a family of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs) most commonly used to treat anxiety and depression. Rory-affiliated providers can prescribe venlafaxine at lower doses than are typically required to treat depression and anxiety. At these lower doses, venlafaxine may be effective in decreasing the frequency and severity of hot flashes.

The use of venlafaxine for the treatment of hot flashes is an “off-label” use. Rory-affiliated providers have the discretion to prescribe venlafaxine off-label if they believe it is an appropriate course of treatment based on a patient’s unique medical history, symptoms, and preferences.

Venlafaxine is not appropriate for everyone—you and your Rory-affiliated provider will decide if venlafaxine is appropriate for you. To learn more about who should not take venlafaxine and the side effects that it may cause, including the boxed warning for increased suicidal thoughts in people under 25, please see the FAQ below regarding side effects and the important safety information for venlafaxine.

How do I use venlafaxine?

Venlafaxine is a tablet that is typically taken daily with or without food.
Please, always follow your healthcare provider’s instructions on how to take your medication and what dose to take. If you have any questions about your medication, once prescribed, please contact your Rory-affiliated provider on your My Ro account.

How long does it take for venlafaxine to start working?

The North American Menopause Society (NAMS) reviewed clinical research pertaining to the treatment of hot flashes. NAMS found that women who benefited from SNRI treatment experienced a rapid reduction in the frequency and severity of hot flashes. Based on its review, NAMS recommends a trial of 2-4 weeks. If you are not getting any relief after 4 weeks, reach out to your Rory-affiliated physician, as this treatment does not work for everyone.