Low-dose paroxetine (Brisdelle)
The only SSRI approved specifically for hot flashes, at a low nightly dose.
VIDEO LESSON
How it's taken
• 7.5 mg once daily at bedtime
Side effects at a glance
• Nausea, fatigue, dizziness
• Headache
Rare but serious
• Suicidal thoughts (class boxed warning)
• Serotonin syndrome with other serotonergic drugs
• Bleeding risk with blood thinners or NSAIDs
Good to know
Not for women taking tamoxifen. Venlafaxine or an NK receptor blocker are alternatives.
AT A GLANCE
Class
Non-hormonal
Brand names
Brisdelle
Status
FDA-approved
Reviewed by
Farhan Tahir, MD
Is this medicine right for you?
Prescription medicines need individual medical advice. Dr. Tahir’s team offers consults through Youthful Medicine.
MECHANISM
How it works
Paroxetine blocks serotonin reuptake, which modulates the brain circuits that regulate body temperature. At 7.5 mg the dose is lower than doses used for depression.
THE EVIDENCE
What the research actually shows.
EVIDENCE SUMMARY
Two phase 3 trials (12 and 24 weeks) showed reductions in hot flash frequency and severity compared with placebo.
KEY TRIALS
Simon JA, et al. Menopause. 2013 (two phase 3 RCTs)
TYPICAL RESULT
A modest, meaningful reduction in hot flashes within weeks.
SAFETY
Risks, side effects and who should avoid it
Carries the antidepressant class boxed warning for suicidal thoughts. Avoid with tamoxifen (CYP2D6 inhibition) and MAO inhibitors. Nausea, fatigue and dizziness can occur.
This summary is not a complete list of risks. Read the official prescribing information and discuss your own history with your clinician.
KEY REFERENCE
Simon JA, et al. Low-dose paroxetine 7.5 mg for menopausal vasomotor symptoms: two randomized controlled trials. Menopause. 2013
Educational content only, reviewed by Farhan Tahir, MD. Not individual medical advice. Medicines named here require a prescription and medical supervision.