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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.

Last verified October 11, 2026Updated October 11, 2026

Side-by-side comparison

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

Method	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 An injection of local anesthetic into a nerve bundle in the neck that may interrupt hot flash signals for several months.
Efficacy	SSRIs for Hot Flashes Recommended Recommended by the Menopause Society for symptom relief.	Stellate Ganglion Block Recommended (limited evidence) Recommended with limited evidence by the Menopause Society.
Cost	SSRIs for Hot Flashes $69–$200 monthly Insurance: Varies	Stellate Ganglion Block Contact provider Insurance: Varies
Duration	SSRIs for Hot Flashes Daily pill (ongoing)	Stellate Ganglion Block One injection; effects followed for 6 months in the main trial
Reversibility	SSRIs for Hot Flashes Reversible	Stellate Ganglion Block Reversible
STI protection	SSRIs for Hot Flashes No	Stellate Ganglion Block No
How it works	SSRIs for Hot Flashes Low-dose paroxetine is a selective serotonin reuptake inhibitor (SSRI) that blocks the reuptake of serotonin. How it reduces hot flash frequency and severity is not known.	Stellate Ganglion Block 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.
Prescription	SSRIs for Hot Flashes Required Telehealth Prescription	Stellate Ganglion Block Required In-Person Procedure
Side effects	SSRIs for Hot Flashes Nausea Headache Fatigue or malaise	Stellate Ganglion Block Drooping eyelid (Horner's syndrome, temporary) Temporary hoarseness Dizziness Rare serious complications (seizure if injected into a blood vessel, bleeding)
Who shouldn't use this	SSRIs for Hot Flashes Current or recent MAOI use (within 14 days) Concomitant thioridazine or pimozide Pregnancy Hypersensitivity to paroxetine or any ingredient	Stellate Ganglion Block Active local or systemic infection Bleeding disorder Allergy to local anesthetic

Key differences

Menopause Society rating: SSRIs for Hot Flashes, recommended; Stellate Ganglion Block, recommended (limited evidence). How long it lasts: SSRIs for Hot Flashes, daily pill (ongoing); Stellate Ganglion Block, one injection; effects followed for 6 months in the main trial. SSRIs for Hot Flashes: costs $69–$200 monthly. Stellate Ganglion Block: Contact provider.