SSRIs for Hot Flashes
vs
Stellate Ganglion Block

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
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.
Stellate Ganglion Block

Stellate Ganglion Block

An injection of local anesthetic into a nerve bundle in the neck that may interrupt hot flash signals for several months.
EfficacyRecommended see details

Recommended by the Menopause Society for symptom relief.

Recommended (limited evidence) see details

Recommended with limited evidence by the Menopause Society.

Cost$0–$200 /monthly

Insurance: Usually

$500–$1,500

Insurance: No

DurationDaily pill (ongoing)Up to 6 months per injection (based on the Walega 2014 trial endpoint)
ReversibilityReversibleReversible
STI ProtectionNoNo
How it works

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

A clinician injects local anesthetic into the stellate ganglion, a nerve bundle in the neck that is part of the sympathetic nervous system. This may interrupt the temperature-regulation signals that trigger hot flashes.

PrescriptionRequired Prescription requiredRequired Prescription required
Available Products1 productNo branded products yet
Side effects
  • Nausea
  • Headache
  • Fatigue or malaise
  • Temporary hoarseness
  • Drooping eyelid (Horner's syndrome, temporary)
  • Nasal congestion
  • Arm weakness (temporary)
  • Rare serious complications (seizure, cardiac arrest if injected into blood vessel)
Who shouldn't use this
  • Current or recent MAOI use (within 14 days)
  • Concomitant thioridazine or pimozide
  • Pregnancy
  • Hypersensitivity to paroxetine or any ingredient
  • Active anticoagulation therapy
  • Local infection at injection site
  • Severe bleeding disorder
  • Allergy to local anesthetic