Gabapentin for the Treatment of Hot Flashes in Menopausal Women

For women who fear developing breast cancer, those who have contraindications to hormone replacement therapy and those who prefer an alternative treatment, there is presently no standard treatment for hot flashes. Women and health care providers have few options other than hormone replacement therapy as evidenced-based trials of alternatives have not shown many effective options. Many non-hormonal agents have been studied including antidepressants, antihypertensives, vitamin E, soy products, black cohosh, acupuncture, and belladonna and ergotamine combinations. Preliminary studies using the antiseizure medication, gabapentin (Neurontin), has demonstrated a substantial reduction in hot flashes. This agent may provide an effective treatment for hot flashes in postmenopausal women.

Inclusion criteria

• Women with substantial hot flashes defined as reporting at least 14 hot flashes per week.
• Postmenopausal women as defined by the natural cessation of menses for 1 year.
• Aged 45 - 65 years.

Exclusion criteria

• Women on hormone replacement therapy.
• Women with a surgically induced menopause (oophorectomy).
• Women on tamoxifen or receiving chemotherapy/radiation therapy or planned antineoplastic chemotherapy/radiation therapy.
• Renal function impairment (serum creatinine greater than the laboratory normal range; or creatinine clearance <30ml/min).
• Use of antidepressants with serotonin reuptake mechanisms and antiseizure medications within the past month.
• Neurologic conditions: seizures, vertigo, and syncope.
• Known hypersensitivity to gabapentin and its components.
• Inability to complete questionnaires for any reason including psychiatric disorders.
• History of a hypothalamic dysfunction.
• Life expectancy less than 6 months.