SSRIs and SNRIs for hot flashes
This is not medical advice — it is general information based on what you searched for that may help.
General information based on published sources and the symptoms you searched for. This isn't medical or legal advice, a diagnosis or a treatment plan. Please consult a doctor about your own symptoms. If your symptoms are severe or sudden, seek urgent care.
Evidence:Strong evidence
This page may not apply to you if:
- If you take tamoxifen, certain SSRIs that inhibit CYP2D6 can interfere with how your body activates it — this must be checked with your prescriber and oncologist
Selected SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) are rated a Level I non-hormonal option for hot flashes and night sweats by The Menopause Society's 2023 Nonhormone Therapy Position Statement. They work independently of their effect on mood, which is why they're a reasonable option even if you aren't experiencing depression or anxiety.
The tamoxifen interaction that actually matters
This is the single most important safety detail for this drug class: certain SSRIs — specifically paroxetine and fluoxetine — inhibit the CYP2D6 enzyme that your body uses to activate tamoxifen into its effective form. If you take tamoxifen for breast cancer treatment or prevention, taking one of these specific SSRIs alongside it can blunt how well tamoxifen works.
This doesn't rule out the SSRI/SNRI class entirely — it means the specific choice within the class matters. Options that don't significantly inhibit CYP2D6 are generally preferred for people on tamoxifen, which is exactly the kind of decision to make with your prescribing clinician rather than alone.
Who else should be cautious
These medications can interact with other drugs and have their own side-effect profile, which is why starting or adjusting one should always go through a clinician rather than self-selecting. Compare this option against other Level I non-hormonal treatments, including gabapentin and CBT and clinical hypnosis, which don't carry the same drug-interaction profile.
If you're weighing this against unproven supplements, our Does It Work? evidence directory grades those honestly too.
Questions to take to your clinician
Organize these in our treatment conversation builder:
- If I take tamoxifen, which SSRI or SNRI options would avoid interfering with it?
- How soon should I expect to notice a difference in hot flash frequency, and what side effects should prompt a follow-up?
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Do antidepressants help hot flashes even if you're not depressed?
Yes. Certain SSRIs and SNRIs reduce hot flash frequency and severity through an effect on the brain's temperature-regulation center, separate from their effect on mood. The Menopause Society (2023) rates this a Level I non-hormonal option for vasomotor symptoms, usable whether or not you have depression.
Can I take any SSRI if I'm on tamoxifen?
Not automatically. Certain SSRIs, including paroxetine and fluoxetine, inhibit the enzyme (CYP2D6) that activates tamoxifen into its effective form, which can reduce how well tamoxifen works. If you take tamoxifen, your oncologist and prescriber need to choose an option that doesn't interfere with it.
Related pages
References
- Shufelt CL, Brown V, Carpenter JS et al.. The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause (The North American Menopause Society, now The Menopause Society), 2023.
Change log
- : Published evidence guide on SSRIs and SNRIs for hot flashes