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Lexapro for Hot Flashes - Medical Victimization or Joke ?

Posted Jan 19 2011 8:13am

Lexapro Escitalopram ssri antidepressant hotflashes jamaLexapro for Hot Flashes - 
Medical Victimization or a Joke?

by Jeffrey Dach MD

An NIH funded trial at the University of Pennsylvania found marginal efficacy for Lexapro compared to placebo for relief of hot flashes. Lexapro for Hot Flashes is merely another example of the medical victimization of women.  SSRI antidepressants (Prozac, Zoloft, Lexapro, etc) were shown to be no better than placebo for depression ( JAMA2010;303(1):47-53 ). 

Above left image courtesy of wikimedia commons Lexapro .

Medical Research Reaches a New Low Point

This  new JAMA study  by Ellen W Freeman shows that Lexapro is "marginally" more effective than placebo for Hot Flashes.  This is laughable.  Surely you must be joking? SSRI drugs are addictive drugs with adverse side effects including loss of sexual function, akasthesias, agitation, movement disorders and violence and suicide. See  this message board  to read hundreds messages describing Lexapro adverse effects.

Abrupty stopping Lexapro (Escitalopram) may cause  withdrawal symptoms such as "electric shock" sensations (also known as "brain shivers" or "brain zaps"), dizziness, acute depressions and irritability, as well as akathisia.

NIH Funded Study

This JAMA study is a cruel farce and a hoax. Why is the NIH using public funds for this kind of study?  This is an outrage.  What will they study next? Rat poison or drain cleaner for relief of hot flashes?  This JAMA study reveals that medical research has reached a new low point in the history of western medicine.

SSRI drugs are addictive chemicals that do not address the hormone deficiency of menopause.  To suggest them as a treatment for hormone deficiency is ludicrous, and creates a new population of women as medical victims.

Correct and Effective Treatment : BioIdentical Hormones

The proper, correct and effective treatment for hot flashes and all other menopausal symptoms is bioidentical hormones.  A biodentical hormone program is safe and effective.  Synthetic Hormones are associated with increased risk of cancer and heart disease.  On the other hand, Bioidentical Hormones are safe and not associated with increased cancer or heart disease.

Articles with related content
The Safety of Bioidentical Hormones.

The Importance of Bioidentical Hormones.

Paxil, Prozac and SSRI Induced Suicide

Jeffrey Dach MD
7450 Griffin Road
Davie, Fl 33314

Links and References
Lexapro Feedback and Side Effects

Efficacy of Escitalopram for Hot Flashes in Healthy Menopausal WomenA Randomized Controlled Trial Ellen W. Freeman, PhD;

Context Concerns regarding the risks associated with estrogen and progesterone to manage menopausal symptoms have resulted in its declining use and increased interest in nonhormonal treatments with demonstrated efficacy for hot flashes.
Objective To determine the efficacy and tolerability of 10 to 20 mg/d escitalopram, a selective serotonin reuptake inhibitor, in alleviating the frequency, severity, and bother of menopausal hot flashes.

Design, Setting, and Patients A multicenter, 8-week, randomized, double-blind, placebo-controlled, parallel group trial that enrolled 205 women (95 African American; 102 white; 8 other) between July 2009 and June 2010.
Intervention Women received 10 to 20 mg/d of escitalopram or a matching placebo for 8 weeks.

Main Outcome Measures Primary outcomes were the frequency and severity of hot flashes assessed by prospective daily diaries at weeks 4 and 8. Secondary outcomes were hot flash bother, recorded on daily diaries, and clinical improvement (defined as hot flash frequency ≥50% decrease from baseline).

Results Mean (SD) daily hot flash frequency was 9.78 (5.60) at baseline. In a modified intent-to-treat analysis that included all randomized participants who provided hot flash diary data, the mean difference in hot flash frequency reduction was 1.41 (95% CI, 0.13-2.69) fewer hot flashes per day at week 8 among women taking escitalopram (P < .001), with mean reductions of 4.60 (95% CI, 3.74-5.47) and 3.20 (95% CI, 2.24-4.15) hot flashes per day in the escitalopram and placebo groups, respectively. Fifty-five percent of women in the escitalopram group vs 36% in the placebo group reported a decrease of at least 50% in hot flash frequency (P = .009) at the 8-week follow-up. Reductions in hot flash severity scores were significantly greater in the escitalopram group (−0.52; 95% CI, −0.64 to −0.40 vs −0.30; 95% CI, −0.42 to −0.17 for placebo; P < .001). Race did not significantly modify the treatment effect (P = .62). Overall discontinuation due to adverse events was 4% (7 in the active group, 2 in the placebo group). Three weeks after treatment ended, women in the escitalopram group reported a mean 1.59 (95% CI, 0.55-2.63; P = .02) more hot flashes per day than women in the placebo group.

Conclusion Among healthy women, the use of escitalopram (10-20 mg/d) compared with placebo resulted in fewer and less severe menopausal hot flashes at 8 weeks of follow-up.
Antidepressant Lexapro cuts hot flashes: study By Julie Steenhuysen
CHICAGO | Tue Jan 18, 2011 5:33pm EST

While the difference in the effect between the Lexapro and placebo groups was modest, it was statistically significant.
Women in the Lexapro group also were significantly more likely to want to continue on their assigned medication, with 64 percent of women taking Lexapro saying they wanted to stay on the study drug versus 42 percent who took the placebo.
Antidepressants relieve hot flashes By Rob Stein
An antidepressant can help alleviate hot flashes that plague many menopausal women, according to new federally funded research.
Forest's Lexapro Antidepressant Eases Hot Flashes for Menopausal Women
By Nicole Ostrow - Jan 18, 2011 4:00 PM ET
Antidepressant Might Help Ease Hot Flashes
Lexapro could prove an alternative for women who can't use hormone therapy, study suggestsBy Serena Gordon
HealthDay Reporter

TUESDAY, Jan. 18 (HealthDay News) -- The antidepressant medication escitalopram (brand name Lexapro) reduced the frequency and severity of hot flashes in older women, according to new research.

Women in the study experienced nearly 10 hot flashes a day at the start of the study, but those were cut to an average of just over five hot flashes a day in women receiving the antidepressant compared to about 6.5 per day in women receiving a placebo.

"Although hormone treatment is the usual treatment for hot flashes, and it is effective, for women who don't want to assume the potential risks of hormone therapy, this is another option," said the study's lead author, Ellen Freeman, a research professor in the department of obstetrics and gynecology at the University of Pennsylvania School of Medicine.

"We found that after eight weeks of treatment with escitalopram, women had many fewer hot flashes a day compared to those on placebo," she added.

Results of the study, funded by the U.S. National Institutes of Health, are published in the Jan. 19 issue of the Journal of the American Medical Association.

Hormone therapy has traditionally been the most common treatment offered to women experiencing hot flashes as part of the menopausal transition. However, when the Women's Health Initiative study reported in 2002 that hormonal therapy had potentially serious risks, many women decided the benefits didn't outweigh the potential hazards. Since that finding, experts have been able to better identify which women might have a greater risk from hormone therapy, and those for whom hormones are a possible option.

"For some appropriate women -- meaning those without contraindications -- the short-term use of estrogen or hormone therapy may still be a viable option. And [for these women] we use the lowest dose for the shortest time possible," explained Dr. Judi Chervenak, a reproductive endocrinologist at Montefiore Medical Center in New York City.

"But, for women for whom hormones aren't an option, or those who don't want to take hormones, SSRIs [antidepressants] and SSRI-like medication are another option," Chervenak said.

Selective serotonin reuptake inhibitors (SSRIs) are approved by the U.S. Food and Drug Administration for the treatment of depression, but doctors sometimes prescribe them for "off-label" (non FDA-approved) uses, such as for treating pain or -- as in the study -- for the relief of hot flashes. SSRIs include drugs such as Celexa, Lexapro, Paxil, Prozac and Zoloft.

A generic version of Lexapro isn't yet available in the United States, according to the FDA. The cost of a month's supply of the drug varies, but a 20-milligram per day dose is approximately $110 for 30 days.

The current trial included 205 women between the ages of 40 and 62 who were either beginning menopause or who had finished the menopause transition in the past year. To be included in the study, the women had to experience at least 28 hot flashes per week that they would classify as bothersome or severe; most women had more than that.

The women were randomly assigned to receive escitalopram (between 10 and 20 milligrams per day) or a placebo for eight weeks.

The researchers found that 55 percent of the women in the escitalopram group reported at least a 50 percent reduction in the frequency of their hot flashes, compared to 36 percent of those in the placebo group. The escitalopram group also reported a decrease in hot flash severity.

Within three weeks of stopping the medication, women in the escitalopram group had an increase of about 1.5 more hot flashes a day than those in the placebo group, the investigators noted.

Side effects were minimal, said Freeman. Just 4 percent of the escitalopram group dropped out due to adverse side effects.

Exactly how escitalopram helps relieve hot flashes isn't known, according to Freeman. And, she noted, the exact cause of hot flashes still isn't clear.

"Hot flashes are so distressing to so many women that to have any potential new option is appreciated. This isn't the be-all, end-all treatment, but it's another option that we have to offer patients with hot flashes," said Chervenak.

She added that for women who don't wish to take medication, one of the best ways to reduce hot flashes is to keep a symptom diary to see if you can figure out what might be causing your hot flashes so you can avoid it. For example, she said, many women experience a hot flash after drinking red wine. Other potential triggers include caffeine, chocolate, spicy foods and stressful situations.

 Lexepro for Hot Flashes is merely another example of the medical victimization of women.  SSRI antidepressants were shown to be no better than placebo for depression (JAMA2010;303(1):47-53).  This new JAMA study shows that Lexepro is "marginally" more effective than placebo for Hot Flashes.  This is laughable.  Surely you must be joking? SSRI drugs are addictive drugs with adverse side effects including loss of sexual function, akasthesis, agitation, movement disorders and violence and suicide.  The proper, correct and effective treatment for hot flashes and all other menopausal symptoms is a biodentical hormone program which is safe and not associated with the increased cancer and heart disease risk found with synthetic hormones. for more information see my blog at jeffreydach (dot) com.
Lexapro Warnings & Precautions

Escitalopram discontinuation, particularly abruptly may cause certain withdrawal symptoms such as "electric shock" sensations (also known as "brain shivers" or "brain zaps"), dizziness, acute depressions and irritability, as well as heightened senses of akathisia.[34]

Jeffrey Dach MD
7450 Griffin Road
Davie, Fl 33314

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