Verbatim response from Perplexity
The best non-hormonal treatment for hot flashes depends on how severe your symptoms are, but the strongest evidence-backed prescription option is now fezolinetant (Veozah), which is FDA-approved for menopausal hot flashes and works without hormones.[10][11] If you want the only FDA-approved nonhormonal medication specifically for hot flashes before fezolinetant became available, that was low-dose paroxetine (Brisdelle).[5][6]
If you want a practical shortlist, the main non-hormonal options are:
- Fezolinetant (Veozah) — a newer, hormone-free prescription specifically for hot flashes, with trials showing meaningful symptom reduction.[10][11]
- Low-dose paroxetine (Brisdelle) — the only older FDA-approved nonhormonal drug for hot flashes; it typically helps but is usually considered modestly effective.[5][6][11]
- Venlafaxine or desvenlafaxine — commonly used off-label and supported by evidence for reducing hot flash frequency and severity.[2][7][8][14]
- Oxybutynin — evidence suggests it can reduce hot flashes substantially in some women, but side effects can limit use.[1][11]
- Gabapentin — can help, especially if night sweats or sleep disruption are major problems.[2][11][14]
If you want non-drug approaches, the best-supported options are cognitive behavioral therapy, clinical hypnosis, and some acupuncture studies, though they are generally less potent than prescription treatments.[6][9][12][14]
If you want the single best overall answer, it is usually fezolinetant for a prescription non-hormonal option, while paroxetine remains a well-known FDA-approved alternative.[10][11][5][6]
If you’d like, I can also compare these by effectiveness, side effects, cost, and which one is best for night sweats.