Roger McIntyre and associates1 discuss reciprocal relationships between hormone replacement therapy (HRT) and antidepressant treatment. Although some women experience significant mood changes related to changes in estrogen levels at menopause, I believe there is another obvious explanation for the increase in prescriptions for selective serotonin reuptake inhibitors (SSRIs) after publication of the Women's Health Initiative (WHT) trial.2 As demonstrated by Loprinzi and colleagues,7 breast cancer patients with depression reported a reduction in hot flashes when taking SSRIs. Subsequently, other SSRIs were shown to have similar beneficial effects. However, SSRIs are much less effective in this regard than HRT (which is more than 85% effective).3 1. McIntyre RS, Konarski JZ, Grigoriadis S, Fan NC, Mancini DA, Fulton KA, et al. Hormone replacement therapy and antidepressant prescription patterns: a reciprocal relationship [editorial]. CMAJ 2005;172(1):57-9.