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Hot Flash Pills
vs
SSRIs for Hot Flashes

A side-by-side comparison of two menopause relief methods — efficacy, cost, how they work, and who shouldn't use them.

Side-by-side comparison

Method
Hot Flash Pills

Hot Flash Pills

A daily prescription pill (neurokinin receptor antagonist) that blocks NK3 receptors in the brain to reduce hot flashes and night sweats.

SSRIs for Hot Flashes

SSRIs for Hot Flashes

A low-dose SSRI (paroxetine 7.5 mg) approved by the FDA for moderate-to-severe hot flashes.

EfficacyRecommended see details

Recommended by the Menopause Society for symptom relief.

Recommended see details

Recommended by the Menopause Society for symptom relief.

Cost$0–$780 /monthly

Insurance: Usually

$0–$200 /monthly

Insurance: Usually

DurationDaily pill (ongoing)Daily pill (ongoing)
ReversibilityReversibleReversible
STI ProtectionNoNo
How it works

Blocks neurokinin-3 (NK3) and/or neurokinin-1 (NK1) receptors in the hypothalamus to interrupt the temperature-regulation pathway that triggers hot flashes and night sweats.

Low-dose paroxetine affects serotonin and other neurotransmitters involved in temperature regulation, which can reduce hot flash frequency and severity.

PrescriptionRequired Prescription requiredRequired Prescription required
Available Products2 products1 product
Side effects
  • Elevated liver enzymes (requires monitoring)
  • Abdominal pain
  • Diarrhea
  • Insomnia
  • Back pain
  • Hot flush
  • Headache
  • Somnolence, dizziness, and fatigue (more common with dual NK1/NK3 antagonists)
  • Nausea
  • Headache
  • Fatigue or malaise
Who shouldn't use this
  • Cirrhosis or severe liver disease (NK3 antagonists such as fezolinetant)
  • Severe renal impairment or end-stage renal disease (NK3 antagonists such as fezolinetant)
  • Concomitant use of CYP1A2 inhibitors such as fluvoxamine or ciprofloxacin (NK3 antagonists such as fezolinetant)
  • Pregnancy (dual NK1/NK3 antagonists such as elinzanetant)
  • Current or recent MAOI use (within 14 days)
  • Concomitant thioridazine or pimozide
  • Pregnancy
  • Hypersensitivity to paroxetine or any ingredient