Managing Menopause with Antidepressants

Antidepressants are drugs that can reduce the symptoms of mental health conditions known as depression.

What do you mean by Antidepressants?

People use antidepressants for treating a variety of conditions such as migraines, chronic pain, insomnia or difficulty in sleeping, eating disorders, anxiety, and panic disorders before using these medications for treating depression.

Antidepressants can also ease the symptoms of menopause. This article will help you to understand how antidepressants can reduce the symptoms of menopause.

Antidepressant types:

Selective serotonin reuptake inhibitors (SSRIs), Serotonin-norepinephrine reuptake inhibitors (SNRIs), Tricyclic Antidepressants (TCAs), and Monoamine oxidase inhibitors (MAOIs) are the four main types of antidepressants. Let’s discuss these in detail

• SSRIs (Selective serotonin reuptake inhibitors): SSRIs are the doctor’s first choice of medications as these drugs cause few side effects when compared to other drugs. These medications work by increasing the levels of serotonin in your brain. SSRIs can treat obsessive-compulsive disorder, anxiety, panic disorder, hot flashes caused by menopause, bulimia, premenstrual dysphoric disorder (PMDD), and post-traumatic stress disorder (PTSD). If you think you want to use SSRIs for treating your menopause problems, we would advise you to have a word with your physician and he will help you to make a sound decision.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): SNRIs are also a good choice for the people and doctors prescribe these medications only after trying selective serotonin reuptake inhibitors (SSRIs). If SSRIs are not showing any results then your physician would suggest you use SNRIs. SNRIs work by raising the levels of neurotransmitters in your brain such as serotonin and norepinephrine. Atomoxetine, desvenlafaxine, duloxetine, levomilnacipran, milnacipran, tramadol, and Effexor XR are the seven SNRIs are available in health stores.
• Tricyclic Antidepressants (TCAs): These are also called as cyclic antidepressants. Physicians prescribe these cyclic antidepressants to patients only when other antidepressant medications have failed to show positive results. These are the least choice drugs for doctors to prescribe for their patients. Trimipramine, amitriptyline, protriptyline, amoxapine, nortriptyline, desipramine, maprotiline, doxepin, and imipramine are the different types of cyclic antidepressants available in the health stores. These antidepressants work by keeping more serotonin and norepinephrine available in your brain.

• Monoamine oxidase inhibitors (MAOIs): Dopamine, serotonin, and norepinephrine are all certain examples of monoamines. It is also a kind of neurotransmitter. An enzyme known as monoamine oxidase is naturally secreted by your body which sabotages them. Monoamine oxidase inhibitors function by hampering this enzyme from acting on the monoamines in your brain. Whereas, Monoamine oxidase inhibitors are not suggested for the usage any longer, because they can lead to severe after-effects.

Advantages of using antidepressants during menopause:

Antidepressants can relieve you from the vasomotor symptoms of menopause. Blood vessels are included in the vasomotor symptoms. The symptoms might involve conditions like skin flushing, hot flashes, and night sweats.

There are certain prevalent symptoms of menopause. Based on research conducted in 2014, eighty percent of women go through these symptoms during their menopause.

Minimal dosage of SNRIs or SSRIs might assist in decreasing the vasomotor symptoms particularly night sweats and hot flashes indicated by certain analyses. For instance, the minimal dosage of SNRI venlafaxine (Effexor) can ease the symptoms of menopause such as skin flushing, and hot flashes based on a study conducted in the year 2014.

In women, who are experiencing menopause symptoms are advised to take a decreased SSRI paroxetine (Paxil) dose can increase the quality of sleep as per a clinical trial conducted in 2015. Researchers also found out that the reason behind the participant’s improved sleep is because of the drug known as paroxetine can ease the symptoms of vasomotor.

There is no clinical evidence that SSRIs and SNRIs can actually treat vasomotor symptoms but the clinical trials showed that it can, but the experts are not sure about this. SSRIs and SNRIs have the ability to stabilize the levels of neurotransmitter levels of the brain, researchers thought that maybe that was the reason behind SSRIs and SNRIs can ease the symptoms of vasomotor. Norepinephrine and serotonin levels can balance the body’s temperature.

Also, please bear in mind that these antidepressant medications cannot ease all the symptoms of menopause except night sweats and hot flashes. If you are experiencing severe menopause symptoms other than hot flashes and night sweats, choosing hormone therapy is the best treatment option for you.

Antidepressant side effects

There are lots of side effects associated with antidepressants. Among all the antidepressants, SSRIs are the best medications as they tend to cause fewer side effects. SSRIs are considered as the physician’s first choice of medications.

Sexual dysfunction, nausea, nervousness, dry mouth, rash, headache, increased sweating, trouble sleeping, weight gain, tiredness, and diarrhea are the possible side effects associated with Selective serotonin reuptake inhibitors (SSRIs).

Agitation, difficulty in sleeping or insomnia, fluid retention, nausea, constipation, changes in appetite, excessive sweating, muscle weakness, dry mouth, tremor, sleepiness, heart palpitations, dizziness, increased blood pressure, rapid heart rate, facing difficulties while urinating, headache, and an inability to maintain an erection or have an orgasm is considered as the possible side effects of serotonin-norepinephrine reuptake inhibitors (SNRIs).

Nausea, dry mouth, weight gain, dry eyes, low blood pressure, blurred vision, unable to maintain an erection in men or sexual dysfunction, dizziness, urinary retention, fatigue, constipation, headache, drowsiness, disorientation, and seizures are the common side effects associated with tricyclic antidepressants (TCAs).

Tingling of the skin, fatigue, weight gain, muscle aches, difficulty urinating, nervousness, high blood pressure, difficulty in sleeping, dry mouth, reduced libido, diarrhea, erectile dysfunction (ED), and lightheadedness are the side effects of Monoamine oxidase inhibitors (MAOIs).

Dry mouth, insomnia, nausea, restlessness, nervousness, and sexual problems such as erectile dysfunction are the common side effects of different types of antidepressant medications.

Every antidepressant medication comes with various side effects. That is why we would advise you to talk with your healthcare provider before choosing an antidepressant for your condition. Your physician will help you to choose the best suitable antidepressant medication for you.

Are antidepressants safe?

Antidepressant medications are considered as the safest medications. Nevertheless, people who are using antidepressant medications for treating the symptoms of menopause are considered off-label use. It means the manufacturers who are producing these antidepressant medications are not conducting any clinical trials in order to evaluate the effectiveness of these drugs when it comes to using these drugs for treating the symptoms of menopause such as night sweats and hot flashes.

Food and drug administration (FDA) have conducted rigorous trials on a medication called Brisdelle whether it is capable to treat the symptoms of vasomotor. It has been observed in this study that taking Brisdelle can ease the symptoms of menopause such as night sweats and hot flashes.

Keep in mind that, there are chances of antidepressants that might interact with other medications, so we would advise you to tell your physician regarding the previous medications you took and also tell them if you are currently under any medication.

You should also discuss with your physician if you are suffering from medical conditions such as an enlarged prostate, high cholesterol, glaucoma, a history of heart disease, and an increased risk of heart attack or stroke.

After knowing about all your medical history, your physician will calculate the risks and benefits of using antidepressants for menopause symptoms.

Serotonin Syndrome

If there is a sudden rise of serotonin levels in your body or having too much serotonin levels will lead to a rare condition known as serotonin syndrome. You will experience this syndrome due to the heavy dosage of antidepressants or the interaction of other medications. There are many drugs that can increase your serotonin levels such as

• Illicit drugs
• Supplements

Dextromethorphan, triptans, herbal supplements such as ginseng and St. john’s wort, illicit drugs include cocaine, amphetamines, and ecstasy, and other antidepressants that can seriously interact with antidepressants and will give rise to serotonin levels in your body.

Confusion, unresponsiveness, muscle rigidity, seizures, sweating, dilated pupils, overactive reflexes, rapid heartbeat, muscle spasms, and tremors are the side effects while taking antidepressants and call 911 or consult your physician immediately if you are experiencing any of these symptoms.

Conclusion

One of the most common off-label uses of certain antidepressant medications in treating night sweats and hot flashes. In recent times, the Food and Drug Administration certified the use of Brisdelle to ease the symptoms.

Minimal dosage of certain antidepressant medications will result in fewer after-effects and can decrease the risk of hormone therapy. Whereas, antidepressants can only treat some of the menopause symptoms such as night sweats and hot flashes. It’s always better to consult your healthcare provider or physician before choosing the alternative treatment for your symptoms and he will help you in opting for the best treatment procedure.