Comparison of Gabapentin with Estrogen for treatment of hot flashes in post-menopausal women Original paper

What was studied?

This study aimed to compare the effectiveness of gabapentin and estrogen in reducing the frequency and severity of hot flashes in post-menopausal women. The research included a clinical trial that randomized 100 post-menopausal women to receive either 100 mg/day or 300 mg/day of gabapentin, or 0.625 mg/day of conjugated estrogen for 12 weeks. The study measured the frequency and severity of hot flashes at baseline, 4 weeks, and 12 weeks of treatment to determine which treatment provided the greatest reduction in symptoms. The trial also assessed the side effects associated with each treatment, including gastrointestinal discomfort and other adverse effects.

Who was studied?

The study included 100 post-menopausal women between the ages of 45 and 65, all of whom had experienced moderate to severe hot flashes for at least 2 months. The women were recruited from outpatient clinics at Isfahan University Hospitals between April 2008 and February 2009. Exclusion criteria included a history of cardiovascular, neurological, liver, gallbladder, or chronic renal diseases, as well as those who had been on estrogen or gabapentin therapy in the previous 3 months. The study population was homogenous, consisting of white, married, non-smoking women with no concurrent non-hormonal treatments for hot flashes.

Most important findings

The study found that both gabapentin 300 mg/day and conjugated estrogen 0.625 mg/day were equally effective in significantly reducing both the frequency and severity of hot flashes. After 12 weeks of treatment, the group receiving gabapentin 300 mg/day showed a 64.7% reduction in hot flash frequency and a 62.2% reduction in severity, while the estrogen group showed a 62.4% reduction in frequency and a 67.3% reduction in severity. In contrast, the group receiving gabapentin 100 mg/day showed only a 38.5% reduction in frequency and a 23.9% reduction in severity, which was significantly lower than both the higher dose of gabapentin and estrogen. The side effects were minimal in both gabapentin groups, with only mild gastrointestinal discomfort reported in 8% of patients in each gabapentin group.

Key implications

The findings suggest that gabapentin 300 mg/day is an effective alternative to estrogen for managing hot flashes in post-menopausal women, particularly for those who cannot take hormone therapy due to contraindications or preference. While estrogen remains the most commonly used and effective treatment for hot flashes, gabapentin offers a non-hormonal alternative with fewer severe side effects. The study supports the use of gabapentin for those who do not respond to other non-hormonal treatments or prefer to avoid estrogen, but it also highlights the need for further research to determine the long-term efficacy and safety of gabapentin at different dosages. Clinicians should consider starting with a low dose of gabapentin (300 mg/day) and carefully monitor for adverse effects, particularly in patients with a history of dizziness or other neurological symptoms.