Gabapentin helpful for hot flushes in postmenopausal women
The Journal of Family Practice. 2003 July;52(7):512-525
July 1, 2003|The Journal of Family Practice
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- BACKGROUND: Although HRT is effective in reducing hot flushes, recent data from the Women’s Health Initiative and other concerns about estrogen use have limited its use in postmenopausal women. Safe, effective, and well-tolerated therapies for hot flushes would be welcomed.
- POPULATION STUDIED: The investigators enrolled 59 postmenopausal women who reported a daily average of 7 or more hot flushes. Study participants were recruited by advertisements and from a local news program about complementary hot flush therapies.
- STUDY DESIGN AND VALIDITY: In this randomized, double-blind trial, subjects were assigned to receive 12 weeks of therapy with gabapentin 300 mg capsules 3 times daily (900 mg/d), or matching placebo.
- OUTCOMES MEASURED: The primary outcome measure for the double-blinded portion of the study was the percentage change in hot flush frequency from baseline to treatment week 12. Secondary outcome measures included changes in the hot flush composite scores from baseline to week 12.
- RESULTS: The gabapentin group experienced a 45% decrease in mean hot flush frequency, compared with a 29% decrease in the placebo group (from 10.8 to 5.9 per day in the gabapentin group and from 10.3 to 7.3 per day in the placebo group; P=.02). The gabapentin group experienced a 54% decrease in the mean hot flush composite score, compared with a 31% decrease in the placebo group (44.9 to 20.5 vs. 39.5 to 27.3; P=.01). This is a significant change, but certainly less than the 90% efficacy that has been observed with HRT.
PRACTICE RECOMMENDATIONS
Gabapentin effectively decreases both the frequency and severity of hot flushes in postmenopausal women who report 7 or more hot flushes per day. Gabapentin, an anticonvulsant, is indicated by the US Food and Drug Administration as adjunct therapy in the treatment of partial seizures in epilepsy.
Although somnolence, dizziness, and peripheral edema are commonly experienced by patients taking this medication, gabapentin provides an effective treatment for reducing the number of hot flushes in women for whom hormone replacement therapy (HRT) is not recommended or desired.
