Verbatim response from Perplexity
The best non-hormonal treatment for hot flashes is usually fezolinetant (Veozah), because it is a newer, FDA-approved, hormone-free medication specifically for menopausal hot flashes and is listed by Mayo Clinic as a daily pill that treats them without hormones.[8] If you mean the most established non-hormonal option, low-dose paroxetine (Brisdelle) is the only non-hormonal medication Mayo Clinic identifies as FDA-approved for hot flashes.[8]
What counts as the “best” depends on what you mean:
- Most targeted newer option: Fezolinetant (Veozah), a non-hormonal pill for hot flashes.[8]
- Only FDA-approved non-hormonal hot flash drug noted in the older Mayo Clinic guidance: Paroxetine (Brisdelle).[8]
- Other effective prescription options: Gabapentin, venlafaxine/other SSRIs-SNRIs, clonidine, and oxybutynin have evidence of benefit, with gabapentin reducing hot flash frequency by 54% in multiple randomized trials and oxybutynin reducing frequency by up to 70% to 86% in some studies.[6][1][10]
If you want the most evidence-based practical answer, many clinicians now consider fezolinetant a strong first choice for women who want a non-hormonal prescription specifically for vasomotor symptoms, while paroxetine remains the classic FDA-approved alternative.[8][10]
If you want, I can also give you a ranked comparison of non-hormonal options by effectiveness, side effects, and who they’re best for.