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Men with bothersome hot flashes (at least 14/week) related to androgen deprivation therapy were randomized to receive either a placebo or gabapentin doses of 300 mg qd, 300 mg bid or 300 mg tid These results support that gabapentin decreases hot flashes, to a moderate degree, in men with androgen ablation-related vasomotor dysfunction. Hot flashes are a complication of androgen deprivation therapy given to men with prostate cancer. A previous clinical study indicated that use of low dose gabapentin (900mg/day) was well-tolerated and decreased hot flash frequency to a moderate degree for 4 weeks. Results showed that Gabapentin at a dose of 300 mg 3 times daily reduced the frequency of hot flashes by approximately 50%. This study was a very small one which included only 214 men with prostate cancer enrolled from 45 centers. Gabapentin, a GABA analogue, is useful for treating vasomotor symptoms in women, although the specific mechanism of action is not understood. Gabapentin was evaluated in a randomized, It also noted that the anticonvulsant gabapentin is the best studied and potentially most effective of the nonhormonal treatment options. It’s important to know that testosterone replacement creasing the dose of gabapentin to 900 mg at night and 1500 mg a day in total. After more in the management of hot flashes in men (N00CB). Ann Oncol 20: ; 2090 . 9 - 245 2. Loprinzi CL A phase III randomized, double-blind, placebo-controlled trial of gabapentin in the management of hot flashes in men (N00CB). Ann Oncol 20 (3): 542-9, 2009. [PUBMED Abstract] Mao JJ, Bowman MA, Xie SX, et al.: Electroacupuncture Versus Gabapentin for Hot Flashes Among Breast Cancer Survivors: A Randomized Placebo-Controlled Trial. Men with bothersome hot flashes (at least 14/week) related to androgen deprivation therapy were randomized to receive either a placebo or gabapentin doses of 300 mg qd, 300 mg bid or 300 mg tid; men were treated for 4 weeks. In a recently published clinical trial in men with prostate cancer who were treated with GnRH analogues and antiandrogens, the disabling hot flashes were successfully treated with gabapentin. 32 Unfortunately, gabapentin has been associated with anorgasmy in both men and women. 33 Nonetheless, a thorough study of gabapentin in rigorous clinical Megestrol acetate is commonly utilized for the treatment of hot flashes in men receiving ADT and has been reported to reduce hot flashes by up to 85% . A few case reports describe progression of prostate cancer with megestrol acetate; therefore, monitoring of disease is important [ 51 , 52 ]. 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. Conclusions: Gabapentin appears to provide moderate efficacy as a nonhormonal option for longer-term treatment of hot flashes in men undergoing androgen ablation for prostate cancer and seems to be well tolerated. Experts are not certain how gabapentin helps with hot flashes, but they believe it may act on the hypothalamus. This part of the brain controls temperature regulation. Because of this, A 65-year-old physician had a PSA-only recurrence of prostate cancer, detected after radical prostatectomy. He had been taking gabapentin (300 mg three times a day) for neuropathic pain, which he Facts that support that gabapentin moderately decreases hot flashes in men include a statistically significant comparison of hot flash frequencies and a trend for improvement in hot flash scores between the 900 mg/day and placebo arms; statistically significant improvements of hot flash frequencies and scores between the 900 mg/day and 300 mg There is a positive correlation between hot flushes and LH surges. Hot flushes have been reported to worsen with longer ADT treatment durations and are also worse in younger men with lower BMI. 3 In the next part of his talk, Dr. Frydenberg discussed the various treatment options of hot flushes. Megace 20 mg/d has been helpful for some of my patients with severe hot flashes. This is supported by a SWOG randomized trial to reduce hot flashes in women treated for breast cancer (at 3 months, 65% of women had a 75+% reduction in hot flashes, compared to only 14% who had placebo). Given this promising evidence and the similar treatment benefits of some drugs for hot flashes in men and women, it was hypothesized that gabapentin would be effective against hot flashes in men receiving androgen ablation therapy. 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
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