How does Venlafaxine help with hot flushes?

Q. I have GAD, can I switch from Zoloft to Venlafaxine to help my hot flushes?

Answered by
Dr. Ashok Kumar
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jun 23, 2020 and last reviewed on: Jul 21, 2020

Hello doctor,

I am a 51-year-old female in the menopausal stage. I have GAD and on Zoloft 100 mg for almost two years, and I heard that if I switch to Venlafaxine it will help the hot flushes that I am suffering from. So my question is, can I make an instant switch? If so, to what mg of Venlafaxine?



Welcome to

I read your query and understand your concerns.

First of all, I like to inform you that Venlafaxine is definitely a better option when we need to deal with GAD (generalized anxiety disorder) as well as hot flushes. However, the research has shown that Prestiq (Desvenlafaxine) have an upper hand in the treatment of hot flushes in comparision to Venlafaxine and other similar medications. So in my opinion, you can discuss the option of Prestiq with your psychiatrist for the purpose.

In regard to your question, I feel cross tapering will be better than the instant switch. Cross tapering means the existing medicine is slowly reduced in dosage while the new medication (Venlafaxine or Desvenlafaxine in your case) is slowly increased. Over a period of four weeks, the switch can be completed.

Cross tapering is better because it avoids withdrawal symptoms. In addition, it also maintains the person asymptomatic because it allows them time for a new medication to act. Similarly, the cross tapering carries the risk of more side effects although this is uncommon in my personal experience.

I hope this helps.

Thank you doctor,

How about the mg of Venlafaxine? How much should it be in your opinion? I take 100 mg of Zoloft daily.



Welcome back to

Theoretically speaking the dose of Venlafaxine is 150 to 300 mg for most individuals. However, you are on 100 mg of Sertraline and I feel that about 150 mg of Venlafaxine may be an initial target dose for your case. As stated above the dose need to be started slowly so you need to start with 37.5 initially followed by 37.5 mg twice a day after four days. The further dose increase may be made in increments of 37.5 mg every four days so it can be stated that the final dose will take around 12 days to build on. The Zoloft can be reduced from day 8 (when you reach 112.5 mg per day of Venlafaxine) in a gradual manner, say 25 mg every week.

I hope this helps.

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