Venlafaxine is not FDA approved to treat hot flashes. However, it has been studied for the treatment of hot flashes, and it is recommended by the North American Menopause Society (NAMS) to treat hot flashes in doses ranging from 37.5 mg to 150 mg per day. In one study, venlafaxine 75 mg/day was as effective as 0.5 mg of estradiol/day at reducing hot flash frequency at 8 weeks (47.6% in the venlafaxine group vs 52.9% in the estradiol group). It is thought to work by increasing serotonin levels and restoring the ability of the hypothalamus to regulate body temperature.
The use of venlafaxine for the treatment of hot flashes is an off-label use. Rory-affiliated providers have the discretion to prescribe venlafaxine off-label if they believe it is an appropriate course of treatment based on a patient’s unique medical history, symptoms, and preferences. To learn more about off-label prescribing, see the related Rory FAQ.