Journal of Family Practice - High-dose gabapentin = estrogen for hot flashes
* Clinical Question
Is high-dose gabapentin as effective as usual-dose estrogen for the treatment of postmenopausal hot flashes?
* Bottom Line
In this small study, high-dose gabapentin (Neurontin) was as effective as the usual dose of conjugated equine estrogens (Premarin) for the treatment of menopausal vasomotor symptoms. Larger studies are needed to confirm this result. (LOE=1b)
Study Design
Randomized controlled trial (double-blinded)
Funding
Government
Allocation
Concealed
Setting
Outpatient (primary care)
Synopsis
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These authors recruited menopausal women aged 35 to 60 years with at least 50 moderate to severe hot flashes weekly for at least 2 months. Any treatments for hot flashes, including hormones, were discontinued for at least 1 month prior to enrollment. Sixty women were randomized to either gabapentin at a dose of 2400 mg daily, conjugated equine estrogens 0.625 mg daily, or placebo. The gabapentin was titrated up over a 12-day period to a total of two 400-mg capsules 3 times daily.
Women recorded their hot flashes in a diary and indicated the severity of each hot flash on a visual analog scale (1 = mild, 4 = severe). The number of hot flashes was multiplied by the severity of each over the course of a week to obtain a composite hot flash score. The hot flash composite scores at 12 weeks were compared with baseline.
The gabapentin group had a mean reduction of 71%, the estrogen group had a mean reduction of 72%, and the placebo group’s score dropped 54% (P
