What are antidepressants?

Antidepressants are medications that help treat symptoms of depression. Most impact a type of chemical called a neurotransmitter. Neurotransmitters carry messages between the cells in your brain.

Despite their name, antidepressants can treat a variety of conditions besides depression. These include:

  • anxiety and panic disorders
  • eating disorders
  • insomnia
  • chronic pain
  • migraines

Antidepressants may also help treat menopause symptoms. Read on to learn more about the benefits of antidepressants for menopause.

There are four main types of antidepressants:

  • Selective serotonin reuptake inhibitors (SSRIs). SSRIs increase the amount of the neurotransmitter serotonin in your brain. Doctors often prescribe these first because they cause the fewest side effects.
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs). SNRIs increase the amount of serotonin and norepinephrine in your brain.
  • Tricyclic antidepressants. These keep more serotonin and norepinephrine available in your brain.
  • Monoamine oxidase inhibitors (MAOIs). Serotonin, norepinephrine, and dopamine are all monoamines. A monoamine is a type of neurotransmitter. Your body naturally creates an enzyme called monoamine oxidase that destroys them. MAOIs work by blocking this enzyme from acting on the monoamines in your brain. However, MAOIs are rarely prescribed anymore, as they can cause more serious side effects.

Antidepressants may provide relief from vasomotor symptoms of menopause. Vasomotor symptoms involve the blood vessels. They include things like:

  • hot flashes
  • night sweats
  • skin flushing

These are also some of the most common menopause symptoms. Almost 80 percent of menopausal women experience these symptoms, notes a 2014 study.

Studies suggest that low doses of SSRIs or SNRIs may help reduce vasomotor symptoms, especially hot flashes and night sweats. For example, a 2014 clinical trial found that a low dose of the SNRI venlafaxine (Effexor) worked almost as well as traditional hormone therapy for reducing hot flashes.

Another clinical trial from 2015 found that a low dose of the SSRI paroxetine (Paxil) improved sleep quality in women going through menopause. The participants’ improved sleep was due to fewer vasomotor symptoms during the night while taking paroxetine.

The results of these trials are promising, but experts still aren’t sure why SSRIs and SNRIs reduce vasomotor symptoms. It may be related to their ability to balance norepinephrine and serotonin levels. Both of these neurotransmitters help stabilize the body’s temperature.

Keep in mind that antidepressants are only known to help with hot flashes and night sweats. If you’re looking to treat other menopause symptoms, hormone therapy may be a more effective option.

Antidepressants can cause a range of side effects. SSRIs generally cause the fewest side effects. Your doctor might suggest trying this type first.

Common side effects across different types of antidepressants include:

  • dry mouth
  • nausea
  • nervousness
  • restlessness
  • insomnia
  • sexual problems, such as erectile dysfunction

Tricyclic antidepressants, including amitriptyline, can cause additional side effects, such as:

  • blurred vision
  • constipation
  • drops in blood pressure when standing
  • urinary retention
  • drowsiness

Antidepressant side effects also vary between medications, even within the same type of antidepressant. Work with your doctor to choose an antidepressant that provides the most benefit with the fewest side effects. You might have to try a few before you find one that works.

Antidepressants are generally safe. However, most antidepressants used for menopause symptoms are considered off-label use. This means that antidepressant manufacturers haven’t conducted the same rigorous trials to ensure safety and effectiveness when it comes to treating hot flashes and night sweats.

There’s one medication called Brisdelle that’s been studied by the U.S. Food and Drug Administration (FDA) specifically to treat vasomotor symptoms. It’s been shown effective in reducing hot flashes and night sweats during menopause.

Antidepressants can also interact with other medications, so make sure to tell your doctor about all over-the-counter and prescription medication you take. This includes vitamins and supplements as well.

You should also tell your doctor if you have:

  • high cholesterol
  • a history of heart disease
  • an increased risk of heart attack or stroke
  • glaucoma
  • an enlarged prostate

Your doctor can help you weigh the benefits and risks of using antidepressants for menopause symptoms.

Serotonin syndrome

Serotonin syndrome is a rare but serious condition that happens when your serotonin levels are too high. It tends to happen when you use antidepressants, especially MAOIs, with other medications, supplements, or illicit drugs that increase your serotonin levels.

Things that can interact with antidepressants and cause serotonin syndrome include:

  • Dextromethorphan. This is a common ingredient in over-the-counter cold and cough medications.
  • Triptans. These are a type of antimigraine medication.
  • Herbal supplements. These include ginseng and St. John’s wort.
  • Illicit drugs. These include LSD, ecstasy, cocaine, and amphetamines.
  • Other antidepressants.

Seek emergency medical treatment if you experience any of these side effects while taking antidepressants:

Treating hot flashes and night sweats is one of the more popular off-label uses of some antidepressants. Recently, the FDA approved the use of Brisdelle for these symptoms.

Low doses of antidepressants often cause fewer side effects and reduce certain risks of hormone therapy. However, antidepressants only help with certain menopause symptoms. Work with your doctor to figure out the most effective treatment option for your symptoms.