Gabapentin
"I am in my 6th year of severe hot flashes.  I had a least 20 during the day and one every 15 minutes at night.  I couldn't take estrogen because the risk of stroke.  I tried herbal remedies, Paxil and lexapro.  While on lexapro I had anxiety stacks and severe depression for 3 months being on lexapro for 2 weeks.  It messed with my brain.  I regret taking that and was very frustrated nothing could help hot flashes.  I did some searching on goggle and found gabapentin.  This is a Godsend!  My first night taking it my hot flashes diminished totally.  I take 300mgx2.  One in the morning and one at night.  If I do get a hot flash it last about 10 seconds and very minimal.  I would recommend gabapentin in place of ERT.  "