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The anticonvulsant gabapentin has been studied for hot flash management. A 2005 study by Pandya et al. randomized 420 women with breast cancer and experiencing at least 2 hot flashes in 24 hours to one of three groups: gabapentin 300 mg daily, gabapentin 900 mg daily, or placebo 23. After 8 weeks, the 300 mg dose group showed a modest 20% Pandya KJ, Morrow GR, Roscoe JA, et al. Gabapentin for hot flashes in 420 women with breast cancer: a randomized double blind placebo-controlled trial. Lancet 2005; 366:818–24. DOI 10.1016/S0140-6736(05)67215-7 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. Gabapentin is effective in the control of hot flashes at a dose of 900 mg/day, but not at a dose of 300 mg/day. This drug should be considered for treatment of hot flashes in women with breast cancer. "Gabapentin is effective in the control of hot flashes at a dose of 900 mg/day, but not at a dose of 300 mg/day," the authors write. "This drug should be considered for treatment of hot flashes in women with breast cancer." The authors report no conflict of interest. Lancet. 2005;366:818-824 Clinical Context Hot flashes happen in about 80% of menopausal women and on average, last for more than seven years. Though some women continue to experience them longer than 10 years. Dr. Kling says that treating hot flashes and having another option to help women during these years creates a ripple effect. Gabapentinoids (gabapentin and pregabalin) Multiple randomized controlled trials have shown that when compared with placebo, gabapentin is effective at reducing hot flash frequency by 54% and hot flash composite score (combined hot flash frequency and severity score) by 31% to 51%. earched the PubMed, MEDLINE, EMBASE, and CENTRAL databases for English-language articles published until June, 2018. The following search terms were used: “menopause,” “hot flushes,” “vasomotor symptoms,” “gabapentin,” and “non-hormonal therapy.” Primary outcomes were frequency, duration, and composite score of hot flushes. Secondary outcomes were adverse effects and Randomised controlled trials (RCTs) that compared the efficacy and tolerability of gabapentin with placebo for treating hot flashes (or hot flushes) in women with either natural or tamoxifen-induced menopause were eligible for inclusion. Gabapentin (Neurontin, Gralise, others). This antiseizure medicine helps ease hot flashes. Side effects can include being drowsy, dizzy or tired and swelling in the arms and legs, called edema. Pregabalin (Lyrica). This is another anti-seizure medicine that can help ease hot flashes. According to Table 2, after 12 weeks, gabapentin 300 mg/day reduced 62.2% in severity and 64.7% in frequency of hot flashes, which is similar to estrogen results with 67.3% reduction in severity and 62.4% in frequency; but those who received gabapentin 100 mg/day had only 23.9% reduction in severity and 38.5% reduction in frequency of hot flashes. 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).[] At doses used to control hot flashes, gabapentin was well tolerated, with drowsiness as its most reported adverse effect. Gabapentin can be considered effective in the treatment of hot flashes and should be considered a reasonable alternative when estrogen therapy is not desired. Gabapentin presents a promising option for managing hot flashes, particularly for those who haven’t found relief through other treatments. By understanding its benefits, potential side effects, and proper administration, you can make informed decisions about its use. Gabapentin is a drug that doctors sometimes prescribe off-label to reduce hot flashes during menopause. Instead of affecting hormones, experts think it may act on the hypothalamus, the part 45 percent decrease in hot flashes with gabapentin versus 29 percent with La VB, Loprinzi C, Novotny P, Wilwerding MB, Sloan J. Venlafaxine for the control of hot flashes: results of a
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