Gabapentin (Neurontin) Cools Hot Flashes As Well As Estrogen

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Gabapentin (Neurontin)Cools Hot Flashes As Well As Estrogen

http://www.medicalnewstoday.com/medicalnews.php?newsid=46450

University of Rochester researchers, who have been investigating new

therapies for hot flashes for several years, report in the July

Obstetrics and Gynecology journal that the seizure drug gabapentin is

as effective as estrogen, which used to be the gold standard

treatment for menopause symptoms.

Estrogen is no longer the preferred therapy because recent, large

studies have shown that the hormone increases the risk of heart

disease, stroke, breast cancer and Alzheimer's disease for some

women. Given that news, millions of women have abandoned hormone

replacement therapy (HRT) and are seeking other ways to ease

symptoms. So-called natural remedies such as soy, herbal products or

acupuncture have not proven safe or effective at this point.

The latest Rochester study is the first to compare gabapentin and

estrogen head-to-head against a placebo. Although it showed a

substantial placebo effect similar to other menopause studies - women

taking the sugar pill reported a 54-percent reduction in hot flashes -

the women taking gabapentin and estrogen reported even better

results, with a 71 percent to 72 percent decline in symptoms.

" Gabapentin does appear to be as effective as estrogen, " said lead

author Sireesha Y. Reddy, M.D., assistant professor of Obstetrics and

Gynecology at the University of Rochester Medical Center. " Until now

its efficacy relative to estrogen was unknown. "

Approximately 75 percent of postmenopausal women between the ages of

35 and 60 experience hot flashes. Gabapentin (sold under the trade

name Neurontin) was approved by the FDA in 1994 to treat epileptic

seizures but has been used off-label for years to treat headaches,

shingles pain and other ailments. Scientists hypothesize that

gabapentin may reduce hot flashes by regulating the flow of calcium

in and out of cells, which is one mechanism for controlling body

temperature.

An expert panel on menopause convened by the National Institutes of

Health last year cautioned against the tendency to use treatments

with scant safety data, and concluded that nothing to date was as

effective as estrogen therapy although more research was needed.

In the latest study, Reddy and colleagues enrolled 60 women in a

randomized, double-blind, placebo-controlled trial for 12 weeks.

Initially the researchers received more than 1,500 calls from women

who wanted to participate, but after screening the callers to meet

the study's protocol, the number was whittled to 60, with 53 women

complying with every step.

They were randomly divided into three groups: 20 women received

gabapentin at 2,400 mg per day and a daily placebo or fake estrogen

pill; 20 received estrogen in the form of Premarin at 0.625 mg per

day and a fake gabapentin pill; 20 received sugar pills resembling

gabapentin and estrogen. The women recorded the frequency and

severity of their hot flashes in diaries.

Results were tabulated using two statistical methods to compare the

women's hot flash reports throughout the 12-week period with their

baseline symptoms. Doctors did find that women who took gabapentin

complained more often of headaches, dizziness or disorientation.

Researchers believe that slowly ramping up the medication and taking

it with meals can alleviate the side effects.

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The NIH funded the study. Pfizer Inc. supplied gabapentin but had no

role in the research. A co-author on the paper, Guttuso Jr.,

M.D., has a patent for the use of gabapentin in the treatment of hot

flashes. Guttuso is a former neurologist at the University of

Rochester who is now on the faculty at the University of Buffalo.