Gabapentin for hot flashes in prostate cancer.
OBJECTIVE
To report a case of successful treatment of refractory hot flashes with gabapentin in a patient with prostate cancer who was receiving combination antiandrogen and gonadotropin hormone-releasing hormone (GnRH) analog therapy.


METHODS
A 70-year-old white man with a history of advancing prostate cancer experienced disabling hot flashes from combination therapy with the antiandrogen bicalutamide and the GnRH analog goserelin acetate. He failed to respond to clonidine 0.1 mg twice daily, megestrol acetate 40 mg/d, diethylstilbestrol 1 mg/d, and venlafaxine 25 mg twice daily. The patient was then treated with gabapentin 600 mg once daily, at which time he experienced near-complete resolution of his symptoms.


CONCLUSIONS
This case supports a previous report of the marked improvement in severity and duration of hot flashes associated with antiandrogen or GnRH analog therapy in prostate cancer. The mechanism by which gabapentin reduces hot flashes is unknown.


CONCLUSIONS
Hot flashes resulting from antiandrogen or GnRH analog therapy are often difficult to treat and leave many patients disabled. Gabapentin has been shown to markedly reduce the severity, frequency, and duration of these hot flashes. Controlled trials are necessary to evaluate gabapentin against other therapeutic modalities.
Jeffery
Sean M
SM
School of Pharmacy, University of Connecticut, West Haven 06156-2770, USA. Sean.Jeffery@med.va.gov
Pepe
Jeffrey J
JJ
Popovich
Lisa M
LM
Vitagliano
Gail
G
D000085:Acetates / Q000627:therapeutic use*; D000368:Aged; D000588:Amines; D000726:Androgen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D000077206:Gabapentin; D007987:Gonadotropin-Releasing Hormone / Q000009:adverse effects* / Q000627:therapeutic use; D019584:Hot Flashes / Q000139:chemically induced / Q000188:drug therapy*; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000726:Androgen Antagonists; D003509:Cyclohexanecarboxylic Acids; D018691:Excitatory Amino Acid Antagonists; D007987:Gonadotropin-Releasing Hormone; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin