Antidepressants for Menopause: Do They Work?
Antidepressants are a range of medications used to treat clinical depression. They may also be used to treat other kinds of mental health issues including post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and generalized anxiety disorder. In recent years, the use of antidepressants for menopause symptoms has increased as an alternative treatment option, yielding positive results for some women.
In this article we briefly discuss the types of antidepressants and their side effects, and outline the benefits and risks of using antidepressants for the treatment of menopause.
Types of Antidepressants
There are various types of antidepressants that can be used to treat menopause. It is up to you and your doctor to find one that is the best for you.
Selective Serotonin Reuptake Inhibitors (SSRIs)
These are the most popular and most widely used antidepressants. SSRI’s are not as strong as other antidepressants and carry fewer side effects. Examples of SSRIs include the most popular one, fluoxetine, as well as paroxetine, sertraline and citalopram.
Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs)
The SNRIs are not too different from the SSRIs. Many comparisons have been made between the SSRIs and the SNRIs as to which is the more potent antidepressant, most of which have turned out inconclusive. They have recorded equal success rates in treating depression. Examples of SNRIs are venlafaxine and duloxetine.
Noradrenaline and Specific Serotogenic Antidepressants (NASSAs)
These antidepressants serve as an alternative for those who want to avoid taking SSRIs. NASSAs carry fewer side effects than SSRIs. A common example of an NASSA is mirtazapine.
Older Type Antidepressants
These kinds of antidepressants have somewhat taken the back seat in the treatment of depression and are only considered when more drastic measures are required. They include menoamine oxidase inhibitors (MAOIs), including tranylcypromine, phenelzine and isocarboxazid. They also include tricyclic antidepressants (TCAs), like amitriptyline, clomipramine and nortriptyline.
Side Effects of Antidepressants for Menopause
Over the years, the use of antidepressants has been observed to result in numerous side effects. As potent as the SSRIs have proven to be in the treatment of menopausal symptoms, like depression and anxiety, many women have complained of its negative sexual side effects. These side effects include diminished sexual appetite, failure to experience and maintain arousal, and difficulty in reaching an orgasm. Many patients who have been administered fluoxetine, sertraline, paroxetine and other SSRIs have complained of negative sexual performance.
Fortunately, some non-SSRI antidepressants have been found to be less likely to cause sexual dysfunction and, in fact, lead to an improvement in sexual urges. Examples of such non-SSRI drugs include duloxetine and bupropion.
Other side effects of antidepressants:
- Weight gain
- Excessive sweating
- Dry mouth
Antidepressants for the Treatment of Menopause
Menopausal symptoms including hot flashes, night sweats, insomnia, depression, anxiety and reduced libido, are caused by decreased estrogen levels and are referred to as vasomotor symptoms. These types of symptoms are the most common symptoms associated with menopause. Non-vasomotor symptoms include lighter or heavier periods and less frequent menstruation.
Antidepressants are currently being used to treatment these menopausal symptoms in some women. While the way in which antidepressants help to manage symptoms remains unknown, they have been shown to be effective at reducing certain characteristic menopausal symptoms, most notably, hot flashes. Antidepressants that have successfully helped to reduce hot flashes in menopausal women include paroxetine, citalopram, sertraline and fluoxetine.
Benefits of Treating Menopause with Antidepressants
Menopausal symptoms are typically treated with hormonal therapy, which are medications administered to influence the release of hormones that are responsible for menopausal symptoms. Unfortunately, these drugs are associated with numerous side effects.
Antidepressants offer an alternative treatment option, often with fewer side effects than hormonal therapy. Additionally, the use of hormonal therapy exposes women to the risks of developing breast cancer and stroke, which further strengthens the case for the use of antidepressants as an alternative treatment. Another benefit is that when antidepressants are used correctly, they have been observed to also lead to an improvement in sleeping habits without negatively impacting libido or causing weight gain.
The Risks of Treating Menopause with Antidepressants
There are several risks involved with using antidepressants for the treatment of menopause symptoms. However, it is important to note that these risks are predominantly caused by a withdrawal from the use of antidepressants. When patients who have used antidepressants for treating their menopause symptoms decide to stop using them, they tend to develop harmful symptoms as a result of the withdrawal.
Prominent on the list of these withdrawal symptoms include increase in depression and suicidal tendencies. The risk of suicide is usually highest during the first two months after stopping the medication. The quicker the withdrawal, the more prone the patient is to experiencing withdrawal symptoms. Experts have advised that withdrawal from antidepressants be done gradually, under the supervision of a qualified medical practitioner that can monitor and detect any abnormal symptoms or behaviors.
Other risks of using antidepressants for the treatment of menopause:
- Increased fall risk, resulting in an increased risk of fracture
- Increased anxiety
Effectiveness of Antidepressants for Menopause Treatment
Studies on the effectiveness of antidepressants in the treatment of menopause have yielded largely inconclusive results. It was discovered that antidepressants work well in treating menopause in some people but are unsuccessful and may even worsen symptoms in others.
The cause of these mixed results can be attributed to unexplained biological differences. Also, some individuals tend to develop resistance to antidepressants quite rapidly, thereby impeding the effectiveness of the drug. Since antidepressants produce varying results in the treatment of menopause, it is important that the benefits and risks are thoroughly discussed to determine if this is the right for of treatment.
Menopause can be an uncomfortable transitional period for many women. While antidepressants do carry an array of side effects, they may be a potential treatment option for menopausal women who have difficulty getting their symptoms under control.