Gabapentin for the management of hot flushes: a case series.
OBJECTIVE
To audit the effectiveness of the anticonvulsant gabapentin on hot flushes in postmenopausal women.


METHODS
This was an open case series involving 11 postmenopausal women who were willing to take gabapentin for the relief of their hot flushes and were willing to keep a diary recording the number and intensity of their hot flushes, both before and during treatment. Gabapentin was started at a dose of 300 mg, to be taken at night, and the women were instructed to increase the dose up to 1,200 mg, according to symptom behavior.


RESULTS
Eleven women agreed to participate for on average 53.22 days (range, 2-79 days), but two discontinued participation-one before starting treatment and one after 2 days-so there are complete data sets for nine women. Gabapentin was found to be extremely effective in reducing hot flush activity (P < 0.001; Fig. 1). A significant reduction in symptoms was observed with a dose of 300 mg/day (P < 0.001). Scores on the Green Climacteric Scale were significantly improved from a mean of 25.72 (range, 12-42) to 19.25 (range, 13-31; P < 0.001). Palpitations (P = 0.001), panic attacks (P = 0.0001), mood (P = 0.023), muscle and joint pains (P = 0.021), and paresthesias and loss of sensation in the extremities (P = 0.001) were also shown to improve with treatment.


CONCLUSIONS
In the present case series, gabapentin was well tolerated and could be a valuable alternative for the treatment of hot flushes in women with contraindications to hormonal replacement therapy. It would be particularly beneficial for women in whom aches and pains and paresthesias are also a significant feature of the climacteric syndrome.
Albertazzi
Paola
P
Centre for Metabolic Bone Disease, Hull Royal Infirmary, England. p.albertazzi@hull.ac.uk
Bottazzi
Mirella
M
Purdie
David W
DW
D000085:Acetates / Q000627:therapeutic use*; D000588:Amines; D000927:Anticonvulsants / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy; D003509:Cyclohexanecarboxylic Acids; D005260:Female; D000077206:Gabapentin; D006305:Health Status Indicators; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D007592:Joint Diseases / Q000150:complications / Q000188:drug therapy; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy; D009135:Muscular Diseases / Q000150:complications / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D016584:Panic Disorder / Q000188:drug therapy; D010292:Paresthesia / Q000188:drug therapy; D017698:Postmenopause; D012678:Sensation Disorders / Q000188:drug therapy; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin