Gabapentin May Ease Symptom of Menopause

According to some estimates, hot flashes affect approximately 32 million women in the United States and may be the most common menopause-related discomfort. Although estrogen can effectively treat this symptom, concerns over estrogen’s safety have caused clinicians and patients alike to seek effective alternatives. One such option that has shown promise is gabapentin. To gain additional insights into this treatment option, Dr Laura P. Hayes from Auburn University’s Harrison School of Pharmacy in Tuscaloosa, AL, and colleagues reviewed the recent literature on gabapentin’s efficacy in treating menopause-related hot flashes.

Hayes and colleagues conducted a literature review using PubMed, MEDLINE, and International Pharmaceutical Abstracts; they looked at studies published between 1948 and November 2010. The researchers included human studies that were published in English with data describing gabapentin for hot flash management for natural or surgically induced menopause. The researchers excluded studies that included women who had a history of breast cancer. A total of 4 studies were identified that met the inclusion criteria for the review.

Based on the data found in these studies, gabapentin significantly decreased hot flash frequency and hot flash composite scores by at least 45% from baseline. In two of the studies, the authors noted that gabapentin improved hot flash composite scores as much as 71% from baseline scores and was comparable to hormone replacement therapy improvement at the end of 12 weeks of treatment (72%; p = 0.63). In the same two studies, gabapentin decreased hot flash frequency at the end of 8 weeks and was comparable to hormone replacement therapy (58.9% vs 70.1%, p > 0.05).

Overall, gabapentin was well-tolerated, although some adverse effects were noted. Somnolence/drowsiness, unsteadiness, and dizziness were the most common adverse effects reported. Such adverse events were most common in the first couple of weeks of treatment; they resolved and were similar to the adverse events associated with the placebo by the fourth week.

“These trials were short (< 12 weeks) and had small sample sizes; however, their results appear to show that gabapentin is safe and effective for short-term treatment of hot flashes in women who have entered menopause either naturally or surgically,” noted Hayes and colleagues. “Gabapentin 600-2400 mg/day in divided doses may be a viable option for treating hot flashes in menopausal women who do not want to use hormone replacement therapy.”

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Reference

Hayes LP, Carroll DG, Kelley KW. Use of gabapentin for the management of natural or surgical menopausal hot flashes.  Ann Pharmacother. 2011;45(3):388-394.