100mg (MD=-0.40, 95% (4)Yes. Clinical CI -0.70 to -0.10); 150mg heterogeneity was (MD=-0.46, 95% CI -0.7 explored. to -0.22). Risk of bias: Low Night-time awakenings: EB risk of bias: Low 100mg (MD=-3.60, 95% CI -0.52 to -2.81); 150mg (MD=-0.56, 95% CI -0.80 to -0.32). Authors’ conclusion: meta-analysis suggests that treatment with desvenlafaxine 100 mg/day is associated with a significant reduction of “The moderate to severe hot flashes in postmenopausal women. Desvenlafaxine appears both safe and effective for treating hot flushes for up to 12 months.” Shams et al (2014)10, escitalopram 11 RCTs reported Healthy peri- and Escitalopram Placebo Hot flush Escitalopram vs (1)Yes. Five in 14 studies on postmenopausal daily for 8 frequency Placebo databases were SSRIs, women. weeks Frequency of hot searched with escitalopram flushes (mean effect appropriate search (N=2304) 95% CI -4.82 to trial. 0.62, 61% probability (2)Yes. Quality treatment is best). assessed by two SSRIs vs Placebo independent Hot flush frequency (MD assessors. -0.93; 95% CI -1.49 to (3)Yes. Results I2 = 21%), expressed as mean Significant. difference or Pooled effects for standardized mean adverse events on difference. sleep disturbance (RR (4)Yes. Clinical 1.32, CI 0.36 to 4.90) heterogeneity was and decreased libido explored. (RR 1.81, CI 0.21 to SR risk of bias: Low 15.48), Not significant. EB risk of bias: Moderate
100mg (MD=-0.40, 95% CI -0.70 to -0.10); 150mg (MD=-0.46, 95% CI -0.7 to -0.22). Night-time awakenings: 100mg (MD=-3.60, 95% CI -0.52 to -2.81); 150mg (MD=-0.56, 95% CI -0.80 to -0.32). (4)Yes. Clinical heterogeneity was explored. Risk of bias: Low EB risk of bias: Low Authors’ conclusion: “The meta-analysis suggests that treatment with desvenlafaxine 100 mg/day is associated with a significant reduction of moderate to severe hot flashes in postmenopausal women. Desvenlafaxine appears both safe and effective for treating hot flushes for up to 12 months.” Shams et al (2014)10, escitalopram 11 RCTs reported in 14 studies on SSRIs, escitalopram (N=2304) Healthy peri- and postmenopausal women. Escitalopram daily for 8 weeks Placebo Hot flush frequency Escitalopram vs Placebo Frequency of hot flushes (mean effect 95% CI -4.82 to 0.62, 61% probability treatment is best). SSRIs vs Placebo Hot flush frequency (MD -0.93; 95% CI -1.49 to I2 = 21%), Significant. Pooled effects for adverse events on sleep disturbance (RR 1.32, CI 0.36 to 4.90) and decreased libido (RR 1.81, CI 0.21 to 15.48), Not significant. (1)Yes. Five databases were searched with appropriate search (2)Yes. Quality assessed by two independent assessors. (3)Yes. Results expressed as mean difference or standardized mean difference. (4)Yes. Clinical heterogeneity was explored. SR risk of bias: Low EB risk of bias: Moderate trial.