A 54-year-old woman has severe vasomotor symptoms but declines hormone therapy because of breast cancer fear. Which non-hormonal drug is specifically approved at a low dose for the treatment of moderate to severe hot flushes?

• A Fluoxetine 20 mg daily
• B Paroxetine 7.5 mg daily ✓
• C Venlafaxine 150 mg daily
• D Clonidine 0.1 mg twice daily

Explanation

Low-dose paroxetine mesylate 7.5 mg daily is the only non-hormonal agent formally approved by the US FDA for moderate to severe vasomotor symptoms associated with menopause. Other SSRIs and SNRIs such as venlafaxine and fluoxetine reduce flush frequency in trials but lack this specific approval, and clonidine offers modest benefit with limiting side effects. Paroxetine should be avoided with tamoxifen because it inhibits CYP2D6 and reduces tamoxifen activation.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.