Verbatim response from Perplexity
The best non-hormonal treatment for hot flashes is usually a prescription medication, especially fezolinetant or, if that is not suitable, an SSRI/SNRI such as paroxetine or venlafaxine.[8][10][7] For mild hot flashes, the best non-drug approach is lifestyle cooling and trigger avoidance, but for moderate to severe symptoms, medication works better.[10][5]
What the evidence says:
- Fezolinetant (Veozah) is a newer non-hormonal option specifically approved for menopausal hot flashes and is described by Mayo Clinic as a daily pill that works by blocking a brain pathway involved in heat regulation.[8]
- Paroxetine (Brisdelle) is the only FDA-approved nonhormonal treatment listed by Mayo Clinic as approved for hot flashes, though other sources note that several other antidepressants are also effective off-label.[8][5][10]
- Venlafaxine and other SSRIs/SNRIs have repeatedly shown meaningful reductions in hot flashes and are commonly recommended when hormones are not desired or are unsafe.[1][3][5][7]
- Gabapentin is another well-supported option, with randomized trials showing substantial reductions in hot flash frequency.[7][10]
- Oxybutynin can also be highly effective, with some studies showing large reductions in frequency, but side effects can limit use.[7][4]
If you want the shortest practical answer:
- Most targeted newer option: fezolinetant[8]
- Most established prescription option: paroxetine or venlafaxine[8][5][7]
- Best non-drug help for mild symptoms: cooling, avoiding triggers, weight loss, and stress reduction.[10][3][5]
If you tell me your age, whether the hot flashes are due to menopause or another cause, and whether you want to avoid antidepressants, I can narrow this to the most appropriate option.