Which of the following is a nonhormonal prescription option for vasomotor symptoms (example: SNRI)?

• A. Paroxetine
• B. Venlafaxine
• C. Estradiol
• D. Progesterone

Answer: (B)

Nonhormonal pharmacologic options for vasomotor symptoms include antidepressants in the SSRI and SNRI classes. Venlafaxine is an SNRI, and it has evidence showing a modest yet meaningful reduction in hot flashes without using hormones. The way it helps is by boosting serotonin and norepinephrine in brain pathways that regulate body temperature, which can stabilize the thermoregulatory center and lessen the frequency and intensity of vasomotor episodes. This makes it a useful choice for patients who cannot or prefer not to use hormone therapy. Estradiol and progesterone are hormonal therapies, so they aren’t nonhormonal options. Paroxetine is also a nonhormonal option, but it’s an SSRI, not an SNRI—the question’s example points to an SNRI, which is venlafaxine.