June 2007: Black Cohosh vs. Prozac for Menopausal Symptoms
The process of menopause causes a host of symptoms, some immediate and the others long-term. Two of the most problematic immediate side effects are hot flashes and mood alterations. While hormone replacement therapy can ameliorate these problems, the results of the Women’s Health Initiative study have cast doubt on the wisdom of taking estrogen during and after menopause.
The herb ]]>black cohosh]]> is one of the prime candidates for a safe alternative treatment. Some, though not all, studies have found it helpful for a variety of menopausal symptoms. The strongest evidence regards hot flashes, but black cohosh has also shown some promise for stabilizing mood.
On the pharmaceutical side, the antidepressant drug fluoxetine (Prozac) has known antidepressant properties that are thought to help calm down menopausal mood disorders. Despite fears raised when it was first released, Prozac has a good track record of safety, and therefore is also recommended as an alternative to hormone replacement therapy.
Based on the above, researchers recently conducted a ]]>double-blind study]]> comparing black cohosh and fluoxetine for the treatment of menopausal symptoms.
A total of 120 women with menopausal symptoms were enrolled in this double-blind study. Half received fluoxetine, the other half black cohosh. Participants kept symptom diaries. In addition, they were examined at the end of the first, second, third, and sixth months of the study.
The results were, perhaps, predictable. Black cohosh proved more effective than Prozac for reducing hot flashes; conversely, Prozac was a better mood stabilizer.
What about using them both together? That may be the next study.
Oktem M, Eroglu D, Karahan HB, et al. Black cohosh and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized trial. Adv Ther . 2007;24:448-61.
Last reviewed by ]]>Steven Bratman, MD]]>
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