Beyond the Antidepressant Action, Paroxetine in Managing the Hot Flashes in Women with Menopause: A Systematic Review

Abstract

Background: Women in the menopausal phase of their lives often experience the vasomotor symptoms of menopause, namely, hot flushes or flashes and disturbances of sleep. About 75–85% of menopausal women tend to experience one or more vasomotor symptoms of menopause. Menopausal hormone therapy (MHT) is considered to be the mainstay treatment in treating vasomotor symptoms of menopause. However, MHT tends to be accompanied by adverse outcomes and there exist contraindications to it. Hence, an alternative treatment strategy is required in view of contraindications, intolerance, or side effects of MHT. Recently, paroxetine is the first and only selective serotonin reuptake inhibitor antidepressant which is United States Food and Drug Administration approved as a non-hormonal management method of vasomotor/climacteric symptoms in menopausal women. Objective: In the present study, we systematically reviewed paroxetine’s role in the management of hot flashes in menopausal women. Material and Methods: For the review purpose, we included the previously published relevant original, review, meta-analysis, and randomized controlled trial articles that were published in the English language using a 4-phase process of the preferred reporting items for systematic reviews and meta-analyses statement. Results: The severity and frequency of hot flashes were significantly reduced among menopausal women who received paroxetine compared to placebo. Five studies also showed improvement in the night-time sleep duration among menopausal women who received paroxetine in low doses. Conclusion: Thus, this study shows that low-dose paroxetine can be a beneficial and effective non-hormonal management option in managing hot flashes among menopausal women.