Treatments: Seizure Drug Cools Hot Flashes

By JOHN O'NEIL,  NY Times

 February 4, 2003

An antiseizure drug appears to help postmenopausal women control hot flashes, but the help comes with a high rate of mild side effects, a new study has found.

Researchers said the drug, gabapentin, might be an alternative for women who would rather not use hormone replacement therapy to reduce menopause symptoms.

The study, which is in The Journal of Obstetrics and Gynecology this month, was planned after a patient taking gabapentin for headaches told Dr. Thomas Guttuso Jr., a neurologist at the University of Rochester, that the intensity of her hot flashes had diminished.

In his study, 59 postmenopausal women were given 900 milligrams a day of gabapentin or a placebo. The intensity and frequency of hot flashes fell by half in the gabapentin group and by a third in the placebo group. In a second phase, women were offered the chance to take up to 2,700 milligrams a day. Almost all of the women did, and reported that the higher doses diminished the intensity of their hot flashes by two-thirds.

The medication's drawback was its high rate of side effects. Four of the 30 patients in the original gabapentin group dropped out, and half the women who remained reported symptoms like sleepiness, rashes or swelling of the hands or feet. Reports of side effects were lower, however, among the women who moved to the higher doses in the second phase.

Dr. Guttuso said that gabapentin's side effects had been shown in other uses to be transitory — usually lasting only a week or two — and that they could be minimized by building up doses slowly and taking the drug with food.