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What is venlafaxine (Effexor)?

Venlafaxine is a medicine that is available by prescription for depression. Recent studies, conducted in part at the Mayo Clinic, have shown that low doses of this medicine are also helpful in reducing hot flashes. In these studies hot flashes decreased on average by 60%, with some patients having more hot flash reduction and others less.

How do I take this medicine for my hot flashes?

You will be given a prescription for 37.5 mg of venlafaxine. This is a long-acting medicine, so these pills cannot be crushed or broken. For the first week, you will take one tablet a day. It is important to take this medicine with food, because it may lessen any nausea the pill may cause. You may take it in the morning or evening. During the second week, if you are not happy with the decrease in your hot flashes, begin taking 75 mg per day (two 37.5 mg tablets) at the same time each day. You should know whether this medicine is helpful to you by the end of this second week. If it does not help, inform your health care provider.

What are the side effects of this medicine?

From studies of the low doses of venlafaxine used in the clinical trial, women had only three side effects: dry mouth, loss of appetite, and nausea. Nausea was the worst during the first week of taking the medicine and then got much better. You should not take venlafaxine if your blood pressure is high and not well controlled.

How much does this medicine cost?

A 37.5 mg tablet costs about $2.20 each, and a 75 mg tablet costs about $2.40 each. Thus, taking one 75 mg tablet is cheaper than two 37.5 mg tablets. You will receive prescriptions for both 37.5 and 75 mg tablets. Check your insurance policy to determine what your prescription benefits are.

What other things can I do for my hot flashes?

Some things in your daily routine may help decrease hot flashes. One of the most important is to dress in layers in loosely woven cotton clothing and use loosely woven bedding. This allows air to flow around your skin better than some tighter fabrics. Also, keep air circulating either with an open window or a fan. Sometimes foods or beverages can bring on hot flashes. Alcohol, caffeine, and spicy foods may cause a hot flash. Be aware if "trigger" foods exist for you -- things that you eat or drink that generally cause hot flashes. Sometimes sucking on ice cubes or sipping an iced fruit drink cools people.

Other medicines have been tested for relieving got flashes. Ask your doctor about these or any hot flash clinical trials that are currently available. If you have any questions, ask your doctor or nurse.

REFERENCE: Barton, D., LaVasseur, B., Loprinzi, C. L., Novotny, P., Wilweding, M.B., & Sloan, J.A. (2002). Venlafaxine for the control of hot flashes: Results of a longitudinal continuation study. Oncology Nursing Forum, 29, 33-39.