Effect of escitalopram on hot flash interference: a randomized, controlled trial

Fertil Steril. 2012 Jun;97(6):1399-404.e1. doi: 10.1016/j.fertnstert.2012.03.001. Epub 2012 Apr 3.


Objective: To estimate the effect of escitalopram (10-20 mg/d) versus placebo for reducing hot flash interference in daily life and understand correlates and predictors of reductions in hot flash interference, a key measure of quality of life.

Design: Multisite, randomized, double-blind, placebo-controlled clinical trial.

Setting: MsFLASH clinical sites in Boston, Indianapolis, Oakland, and Philadelphia.

Patient(s): A total of 205 midlife women (46% African-American) who met criteria participated.

Intervention(s): After baseline, women were randomized to one pill of escitalopram 10 mg/d (n = 104) or placebo (n = 101) with follow-up at 4 and 8 weeks. At week 4, those not achieving 50% fewer hot flashes were increased to two pills daily (20 mg/d or 2 placebo pills).

Main outcome measure(s): The Hot Flash Related Daily Interference Scale; correlates were variables from hot flash diaries; predictors were baseline demographics, clinical variables, depression, anxiety, sleep quality, and hot flashes.

Result(s): Compared to placebo, escitalopram significantly reduced hot flash interference by 6.0 points at week 4 and 3.4 points at week 8 more than placebo. Reductions in hot flash interference correlated with changes in hot flash diary variables. However, baseline variables did not significantly predict reductions in hot flash interference.

Conclusion(s): Escitalopram (10-20 mg/d) for 8 weeks improves women's quality of life and this benefit did not vary by demographic, clinical, mood, sleep, or hot flash variables.

Clinical trial registration number: NCT00894543.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Affect / drug effects
  • Circadian Rhythm / drug effects
  • Citalopram / administration & dosage*
  • Female
  • Follow-Up Studies
  • Hot Flashes / drug therapy*
  • Humans
  • Menopause / drug effects*
  • Middle Aged
  • Placebos
  • Quality of Life
  • Selective Serotonin Reuptake Inhibitors / administration & dosage*
  • Sweating / drug effects


  • Placebos
  • Serotonin Uptake Inhibitors
  • Citalopram

Associated data

  • ClinicalTrials.gov/NCT00894543