First of all, anti-depressants are not really the medicine for hot flashes but they do help some women. I take Prozac and that helped alot with my hot flashes but when they come, they just come. I think what the anti-depressant does in actuality is when you are having a hot flash, you do not necessarily go bazurko! when it happens. You kind of just float thru them, at least this is how I perceive it. And because of this, it keeps us from having anxiety attacks making are hot flashes worse, but you will still get them. The only think I know that can really stop hot flashes is Estrogen. Maybe even progesterone will help control hot flashes.