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Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), clonidine (Catapres), and gabapentin (Neurontin) are effective nonhormonal medications for Vasomotor Symptoms. Although the optimum dosage remains to be established, a gabapentin dosage of 300 mg 3 times daily (as conventional [immediate-release] preparations) has been effective in reducing both the severity and frequency of vasomotor symptoms † in women with breast cancer [30] and in postmenopausal women. [31] Abstract. Vasomotor symptoms (VMS), including hot flashes and night sweats, occur in as many as 68.5% of women as a result of menopause. While the median duration of these symptoms is 4 years, approximately 10% of women continue to experience VMS as many as 12 years after their final menstrual period. 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 Emerging evidence suggests that treatment with SSRIs, SNRIs, and gabapentin is effective for many women who want to avoid hormone therapy. A shared decision approach to treatment decisions involves consideration of risks with treatment options and discussion of patient priorities. Gabapentin was found to be superior vs placebo for the relief of vasomotor symptoms, although less effective than estrogen; Evidence for pregabalin “was limited yet promising” Learn More – Primary Sources: Efficacy and safety of gabapentin and pregabalin in patients with vasomotor symptoms: a systematic review and meta-analysis Objective: Gabapentin is used to treat vasomotor symptoms (VMS) in postmenopausal women with contraindications to hormonal therapy or who prefer alternatives. We investigated the efficacy and tolerability of gabapentin for treating menopausal hot flushes via a meta-analysis. Clinical trials investigating the use of gabapentin at a dose of 900 mg per day (300 mg three times daily) for managing vasomotor symptoms associated with menopause have reported promising results. These trials have consistently demonstrated improvements in both the frequency and severity of VMS among menopausal women [95–97] . Nonhormone pharmacologic agents including some selec-tive serotonin reuptake inhibitors and serotonin and norepi-nephrine reuptake inhibitors, gabapentin, and oxybutynin are commonly used and effective for VMS treatment. In a 2016 overview, authors stated that doses of gabapentin for hot flashes range between 900–2,400 milligrams (mg) per day. Other studies have used doses as low as 100 mg and 300 mg which is theory based can have an impact on both vasomotor symptom perception and control and reduction in stress and wellbeing, sleep problems and vasomotor symptomatology. There are two-way interactions between mood and vasomotor symptoms with 10% of women more likely to have depressed mood during menopause. Nonhormone pharmacologic agents including some selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors, gabapentin, and oxybutynin are commonly used and effective for VMS treatment. Gabapentin may be a beneficial therapeutic option for managing vasomotor symptoms in postmenopausal women. “Future studies should investigate the lowest effective dose of gabapentin to Alternatively, an 8-week, randomized, double-blind, placebo-controlled trial compared the efficacy and tolerability of oral 17-beta-estradiol (0.5 mg/day) with low dose extended release venlafaxine (75 mg/day) in 339 perimenopausal and postmenopausal women with greater than 2 bothersome vasomotor symptoms per day. 25 The frequency of vasomotor HT is the most effective treatment for VMS. 19–21 HT use not only reduces symptom frequency but also intensity by nearly 90%, usually within one month of initiation. 21,27 Generally well tolerated, the most common acute adverse effects of HT, particularly estrogen therapy, are breast pain and uterine bleeding. 28. 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 comparable with low dose oestrogen in reducing the frequency and severity of hot flushes.3 What is the usual dosage? Soy has been linked to reduced vasomotor symptoms in Asian women who consume a soy-rich diet. 35, 36 It contains large quantities of phytoestrogens and is one of the richest sources of isoflavones Adverse effects of gabapentin include dizziness, somnolence, and peripheral edema. Brand Generic Route Effective dosage Approved for vasomotor symptoms? Approved for vaginal Gabapentin’s role in improving vasomotor symptoms was shown in the BREEZE 1, 2, and 3 trials, 12 – 18 which looked at the efficacy of gabapentin ER (Serada®; Depomed, Inc, Newark, CA, USA), an investigational drug in treating menopausal hot flashes. All three trials were prospective, Phase III, randomized, placebo-controlled, multicenter North American Menopause Society. Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause. 2015. 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.
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