To the Editor In a recent issue of JAMA Internal Medicine, Joffe et al1 report the results of a 3-arm, double-blind trial randomizing healthy perimenopausal and postmenopausal women with bothersome vasomotor symptoms (VMS) to low-dose estradiol and venlafaxine. Their findings contribute to a better understanding of the differences between estrogen therapy and venlafaxine therapy. However, there is a concern about the use of venlafaxine to treat VMS. It is well known that menopause is a risk factor for cardiovascular disease, the leading cause of death in women in the United States.2 Thus, the blood pressure–increasing effect of venlafaxine, observed by Joffe et al1 and others,3 may potentiate the menopausal risk for cardiovascular disease. Unfortunately, the authors did not address this potential concern.
Zhou S, Lun Y, Li D. Concern About the Use of Venlafaxine to Treat Vasomotor Symptoms. JAMA Intern Med. 2015;175(4):657-658. doi:10.1001/jamainternmed.2014.7988