There are two basic reasons why your doctor might prescribe anti-depressants for you during your menopause years. The most common reason is that some particular types of anti-depressants have been shown to alleviate menopause symptoms such as hot flashes and night sweats. Because these anti-depressants also help to regulate the changes of mood associated with menopause, it can be difficult to distinguish between the first reason for prescribing them, and the second reason, which is to treat depression brought on by menopause.
Off Label Usage
The United States Food and Drug Administration (FDA) has not officially approved anti-depressants as a treatment for menopause symptoms, but it doesn't object to doctors prescribing the drugs "off-label" for this purpose.
Many doctors offer the drugs to women who, for health reasons or due to personal choice, don't want to receive HRT (hormone replacement therapy). HRT is not recommended for women who're considered to have a higher than average chance of developing female cancers.
Nevertheless, in terms of treating physical menopausal symptoms or menopause-related depression, these drugs should be prescribed only as a last resort, i.e. when other, non-medical forms of treatment have been tried to no avail.
SSRIs and SNRIs
There are four different types of anti-depressants, but only two of these have been found by clinical trials to be effective against menopause problems (hot flashes, night sweats, insomnia, mood swings). These anti-depressants are SSRIs (serotonin reuptake inhibitors) and SNRIs (norepinephrine reuptake inhibitors).
SSRIs include the well known anti-depressant Prozac (its generic name is fluoxetine) as well as other brand names such as Paxil, Celexa and Zoloft.
The SNRI used to treat menopause symptoms is called Effexor (its generic name is venlafaxine).
It should be emphasized HRT is a more effective menopause treatment than any of these drugs. Anti-depressants work best against mild to moderate hot flashes, therefore women suffering from severe hot flashes or other symptoms may find the treatment insufficient. However, the advantage of anti-depressants for menopause is that when they do work, they work quickly. It usually takes a couple of weeks to determine whether or not an anti-depressant medication is going to be effective.
Anti-depressants have a number of side effects which affect patients to varying degrees. These include: nausea, dizziness, dryness of the mouth, feelings of anxiety and problems sleeping. If you feel anxious or can't sleep when taking anti-depressants, this is likely to exacerbate the negative emotions and insomnia you were already experiencing due to menopause. Another anti-depressant side effect is loss of sex drive. Given that the loss of libido and vaginal dryness or irritation are also menopause symptoms - you may find that taking anti-depressants makes things worse, not better.
Some medical practitioners and feminist thinkers argue that anti-depressants are an inappropriate treatment for menopause because menopause is not a mental health condition. They say that prescribing these drugs to menopausal women is harking back to the 1950s, when women at this stage of life were given valium, basically to keep them quiet and amenable. While they do stress that menopausal women are entitled to seek treatment and relief from their symptoms, anti-depressants should not be marketed to them as a "quick fix." Menopausal women have a right to their feelings and emotions, and should not be put into a state of artificial numbness, just so life will be easier for the people around them.