Some non-hormonal therapies may help treat hot flashes, but probably not as much as estrogen, doctors report in The Journal of the American Medical Association.Those findings come from a review of 43 previously published studies. The reviewers included Heidi Nelson, MD, MPH, of Oregon Health & Science University.Menopause isn't a disease. But hot flashes are common and may be severe in menopausal women. The studies in Nelson's review tested these therapies to treat hot flashes:Antidepressants. Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) such as Paxil, Prozac, Effexor, and Celexa. Clonidine (Catapres). A blood pressure medication made in pill or patch form Gabapentin (Neurontin). An anti-seizure medication Red clover isoflavone extracts Soy isoflavone extracts Each treatment was separately compared with a sham treatment (placebo). The women didn't know whether they received the real treatment or placebo. They kept diaries of their hot flashes before and during treatment, which ranged in length from a few weeks to a year.Estrogen has long been used to treat menopausal symptoms. "However, recent studies reporting adverse effects of estrogen, such as cardiovascular events and breast cancer, raise important concerns about its use," write Nelson and colleagues. Those concerns have spurred interest in alternative treatments for menopausal symptoms.Estrogen may still be used to treat menopausal symptoms. The FDA advises doctors to prescribe "the smallest effective dose for the shortest duration possible," write Nelson and colleagues.Nelson's study uses the term "non-hormonal therapies" for treatments that weren't based on the hormones estrogen, progestin, progesterone, or androgen.