selective serotonin and serotonin-norepinephrine inhibitors (ssris and snris) have been shown to be effective for the treatment of hot flashes. a recent study from ensrud and colleagues (including dr. hadine joffe of the cwmh) reports on the impact of escitalopram (lexapro) on sleep quality in a group of healthy postmenopausal women reporting significant vasomotor symptoms. insomnia was measured using the insomnia severity index (isi), and subjective sleep quality was assessed using the pittsburgh sleep quality index (psqi) at baseline and at weeks 4 and 8. at baseline, most of the participants experienced insomnia and poor sleep quality. based on scores on the isi, a total of 77 (37.6%) women were classified as having mild (subthreshold) insomnia (isi, 8-14); 55 (26.8%), with moderate clinical insomnia (isi, 15-21); and 12 (5.9%), with severe clinical insomnia (isi, 22-28). the authors reported that women treated with escitalopram had an improvement in insomnia symptoms and subjective sleep quality, with statistically significant improvements on their isi and psqi scores at week 8. clinical improvement in insomnia symptoms and subjective sleep quality (as defined as a?50% decrease in scores on the isi or psqi from baseline) were observed more frequently in the escitalopram group than in the placebo group (isi, 50.0% vs. 35.4%, p = 0.04; psqi, 29.6% vs. 19.2%, p = 0.09).
the authors make note of the fact that insomnia and poor subjective sleep quality were extremely common in this cohort at baseline, despite excluding women with a diagnosis of major depression or anxiety disorder. effect of escitalopram on insomnia symptoms and subjective sleep quality in healthy perimenopausal and postmenopausal women with hot flashes: a randomized controlled trial. 2012 aug;19(8):848-855. an snri reportedly does better for vasomotor symptoms because a tract to the hypothalamus keeps glucose transporters maintained; estrogen also stimulates production of these transporters; lack of estrogen, lack of glucose, the hot flashes is percieved hypoglycemia. those with anxiety have more difficult with menopause. the architecture may look different but at least it can be measured because they sleep. i haven’t read the study but thanks for your work.
they should be clear about the limits of the research around that medication and if there are any other options. it is important to discuss the risks and benefits of treatment with your doctor and caregivers. if you are pregnant, please discuss the risks and benefits of antidepressant use with your health care provider.
they may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication. depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. this information contains a summary of important points and is not an exhaustive review of information about the medication. always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions.
in healthy women with menopausal hot flashes, treatment with escitalopram at doses of 10 or 20 mg/d relative to placebo reduced insomnia symptoms and improved according to the fda, approximately 5% of people who use lexapro for anxiety or depression experience insomnia during the initial stage of the coadministration of eszopiclone and escitalopram was associated with rapid improvement in insomnia by week 1, demonstrated by changes in sleep onset,, .
insomnia as a side effect of using lexapro typically does not last long. you can expect to stop experiencing insomnia within the first two weeks of using the medication. if your insomnia persists after several weeks, talk to a doctor about other options. insomnia is a common side effect of many antidepressants, including lexapro. for example, it’s listed as one of the most common adverse reactions experienced by people prescribed lexapro in fda documentation. according to data from the fda, more than five percent of people who use lexapro experience insomnia. some antidepressants may cause insomnia, making it difficult to get to sleep or stay asleep, so you may be tired during the day. consider these strategies: take the authors reported that women treated with escitalopram had an improvement in insomnia symptoms and subjective sleep quality, headache, nausea, diarrhea, dry mouth, increased sweating, feeling nervous, restless, fatigue, or having trouble sleeping (insomnia). these will often improve, .
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