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Gabapentin for the management of hot flushes: a case series

Albertazzi, Paola MD, MRCOG1; Bottazzi, Mirella MS2; Purdie, David W. MD, FRCOG, FRCP Edin1

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Objective To audit the effectiveness of the anticonvulsant gabapentin on hot flushes in postmenopausal women.

Design 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.

From the 1Centre for Metabolic Bone Disease, Hull Royal Infirmary, Hull, England, and the 2Department of Medical Statistics, University of Pavia, Pavia, Italy.

Received September 11, 2002; revised and accepted November 13, 2002.

Address reprint requests to Paola Albertazzi, Centre for Metabolic Bone Disease, H.S. Brocklehurst Building, Hull Royal Infirmary, 220-236 Anlaby Road, Hull HU3 2RW United Kingdom. E-mail: p.albertazzi@hull.ac.uk.

©2003The North American Menopause Society