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This individual patient pooled analysis supports that newer antidepressants and gabapentin decrease hot flashes. With regard to the newer antidepressants, it seems that venlafaxine and paroxetine are more effective than the studied doses of sertraline and fluoxetine. The relative efficacy of gabapentin was found to be similar to the newer antidepressants, decreasing hot flashes by approximately 20% to 30% more than placebo, resulting in approximately 1 fewer hot flash per day compared with placebo (P = .009 and P = .007 for composite score of frequency and severity of hot flashes for the 2 dose of Nonhormonal treatment options have been investigated as treatments for hot flashes, a major clinical problem in many women. Starting in 2000, a series of 10 individual double-blind placebo-controlled studies has evaluated newer antidepressants and gabapentin for treating hot flashes. Based on the anecdotal information, the current phase 2 clinical trial was developed to more definitively evaluate gabapentin's efficacy against hot flashes and its associated toxicity. Nonhormonal treatment options have been investigated as treatments for hot flashes, a major clinical problem in many women. Starting in 2000, a series of 10 individual double-blind placebo-controlled studies has evaluated newer antidepressants and gabapentin for treating hot flashes. "What's important about this medication is that it's only our second FDA-approved nonhormonal medication available for people having hot flashes and night sweats that impact their quality of life," says Dr. Kling. Until now, the antidepressant paroxetine (Brisdelle) was the only FDA-approved medication to help with hot flashes due to menopause Gabapentin (Neurontin) has shown efficacy in relieving vasomotor symptoms and is used as off-label for this indication. A new extended-release formulation of gabapentin has also shown efficacy in treating hot flashes and improving sleep quality with possibly fewer side effects than regular gabapentin. The decrease in estrogen use has led many women to seek alternative treatments to alleviate hot flashes. One large study found that nearly 50% of women used complementary and alternative medications (CAMs) alone or in combination with conventional therapies, whereas one-third of women surveyed did not use any therapies related to menopause. 5 Given the large number of women seeking relief from Step-wise approach to management of menopausal hot flashes. M ANAGEMENT. The management of HFs is guided by their frequency and severity. The severity of HFs can be graded as (a) mild (no interference with usual daily activities), (b) moderate (interfere with usual daily activities to some extent), and (c) severe (when usual daily activities cannot be performed).[] Certain antidepressants can treat hot flashes caused by menopause. They may be helpful if you’re unable to take menopause hormone therapy or if you prefer a nonhormonal option. Brisdelle (paroxetine mesylate) is the only antidepressant that’s FDA approved for treating hot flashes. Other antidepressants are prescribed off-label for hot flashes. Gabapentin seems to decrease hot flashes by approximately 50% in women with inadequate hot flash control who were using an antidepressant. This study saw no significant additional hot flash reduction from continuation of the antidepressant. Gabapentin and pregabalin are other agents that have been shown to decrease hot flashes substantially more than placebos. 24,40,43 Cross-study comparisons of the benefit from gabapentin and pregabalin suggest that these drugs reduce hot flashes to a similar degree as seen with the most effective newer antidepressants. Antidepressants don't work as well as hormone therapy for strong hot flashes. But they can help people who can't use hormones. Possible side effects include nausea, trouble sleeping or feeling sleepy, weight gain, dry mouth or trouble having sex. Gabapentin Brand name: Neurontin® available as 100mg, 300mg, 400mg, 600mg and 800mg capsules. Also available in generic brands. Gabapentin is usually used to control epilepsy or chronic nerve (neuropathic) pain. It is also a non-hormonal medicine that has been shown to be effective in reducing menopausal hot flushes. Gabapentin appears to be Loprinzi CL, Sloan J, Stearns V, et al. Newer antidepressants and gabapentin for hot flashes: an individual patient pooled analysis. J Clin Oncol. 27(17):2831-7, 2009. Shams T, Firwana B, Habib F, et al. SSRIs for hot flashes: a systematic review and meta-analysis of randomized trials. J Gen Intern Med. 29(1):204-13, 2014. Changes in hot flash scores from newer antidepressants and gabapentin are apparent within 4 weeks of therapy. Available data indicate that hot flash treatment efficacy, compared with that of placebo, remains stable for up to 12 weeks of follow-up.
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