Hot flashes occur frequently in menopausal women and in women with
breast cancer, diminishing their quality of life. A report from the Women's Health Initiative published in 2002 raised concerns about the long-term safety of
estrogen therapy. As a result, nonhormonal alternatives have emerged as preferred treatments.
Gabapentin is an
anticonvulsant that the United States Food and Drug Administration approved as an adjunct
therapy for
partial seizures and
postherpetic neuralgia.
Somnolence,
dizziness,
ataxia,
fatigue, nystagmus, and peripheral
edema are adverse effects commonly associated with
gabapentin in the treatment of
epilepsy and
postherpetic neuralgia. The North American Menopause Society and the American College of Obstetricians and Gynecologists recommend the use of
gabapentin as an option for managing
hot flashes in women who are unwilling to take
estrogen-containing supplements. To evaluate the efficacy and safety of
gabapentin for the treatment of
hot flashes in women with menopause and/or
breast cancer, we performed a search of the MEDLINE database (1966-March 2008) and International
Pharmaceutical Abstracts, as well as manually searching reference articles for relevant articles and abstracts; 10 clinical studies were identified. Although the studies were few, all showed
gabapentin to be safe and effective in the treatment of
hot flashes. At doses used to control
hot flashes,
gabapentin was well tolerated, with drowsiness as its most reported adverse effect.
Gabapentin can be considered effective in the treatment of
hot flashes and should be considered a reasonable alternative when
estrogen therapy is not desired.