By vgreene, 17 December, 2014 If SSRI/SNRI contraindicated: Consider gabapentin, pregabalin, clonidine6
By vgreene, 17 December, 2014 If SSRI/SNRI not contraindicated: Consider low-dose paroxetine (7.5 mg/day) or other well-studied SSRI/SNRI (venlafaxine, escitalopram, others).5 If sx control not adequate: Adjust dose/consider gabapentin, pregabalin, clonidine6
By vgreene, 17 December, 2014 Nonhormonal tx for menopausal1 pts ≥45 yo1 w/ mod-to-severe2 vasomotor sx inadequately responsive to behavior mod2 who have HT contraindications3,4 or no interest in HT
By vgreene, 17 December, 2014 If severe/resistant sx, other less well-established tx (eg, stellate ganglion block) may be options
By vgreene, 17 December, 2014 If pt has GSM sx, may be candidate for low-dose vaginal estrogen or other tx
By vgreene, 17 December, 2014 Other SSRI/SNRIs<sup>11</sup> as well as gabapentin, pregabalin, clonidine can be considered<sup>12</sup>
By vgreene, 17 December, 2014 If HT not OK by 10-yr CVD risk,3 menopause duration, breast CA/other risks:7,8
By vgreene, 16 December, 2014 Decision about HT duration:<sup>4</sup> continued mod-to-severe sx, pt preference, risks for breast CA/CVD/osteoporosis, etc<sup>3,7,10</sup>
By vgreene, 16 December, 2014 If uterus intact:<sup>9</sup> E+P options (CE+bazedoxifene may also be an option)