Are there non-hormonal prescription options for hot flushes?
Yes, several non-hormonal prescription medications, including SSRIs, SNRIs, gabapentin, clonidine, and the new drug fezolinetant, can reduce hot flushes in women unable to use HRT.
Detailed Medical Explanation
When HRT is unsuitable, NICE recommends selective serotonin reuptake inhibitors (SSRIs) such as citalopram, serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine, gabapentin, clonidine, and fezolinetant (pending UK approval). These options offer relief for many women, though individual responses and side effects vary. For more, see the BNF menopause summary.
Clinical Context
Non-hormonal medications are most appropriate for women with a history of hormone-sensitive cancers or contraindications to oestrogen. Regular follow-up is advised to assess benefit and side effects.
Evidence-Based Approaches
NICE guidelines detail the range of non-hormonal options and their evidence base. Women are encouraged to discuss individual risks and preferences with a menopause specialist. See NICE menopause guidance.