10/15/2012 02:09 pm ET Updated Dec 06, 2017

Gabapentin-ER: A New Non-Estrogen for Hot Flashes

I've just come back from the North American Menopause Society (NAMS) meeting and there were a lot of interesting presentations. This one is about a new treatment for women with hot flashes: Gabapentin-ER, which stands for "extended release."

Hot flashes affect about 75 percent of women in menopause. It's one of the most troublesome side effects. Not only does it interrupt concentration and make comfort a challenge, it's one of the most common reasons women in menopause don't sleep well.

The best treatment for hot flashes is estrogen, also called estrogen therapy (ET), hormone therapy (HT) or, in the past, hormone replacement therapy (HRT). But some women either can't or won't take estrogen due to potential side effects, risks or simply choosing not to. Women who have had breast cancer are a special group that are unable to take hormone therapy, and as a result, many struggle with hot flashes.

So there are literally millions of women looking for another treatment option for their hot flashes besides lifestyle changes and over-the-counter remedies.

This study was conducted by Dr. JoAnn Pinkerton, a past president of NAMS and a professor at the University of Virginia. She and her colleagues gave either Gabapentin-ER or a placebo to half of approximately 600 women (~300 in each group) who were having on average 11 hot flashes daily.

The medicine dosage was increased slowly over one week, and they continued the treatment for a total of six months. Women receiving Gabapentin-ER had fewer hot flashes, found their hot flashes to be less bothersome, and slept better significantly more than the placebo group. The more women taking the medication also reported that they were either much improved or very much improved over those taking a placebo.

The short-acting form of Gabapentin is currently available on the market today, and although it is sometimes used for hot flashes, it is not approved for hot flashes. It must be given three times daily, and about 20 percent of the women taking it will have dizziness and/or sleepiness the next day.

The women taking this extended-release form took the medication twice daily and only 12 percent of women had dizziness or sleepiness. By the end of one week, only 3 percent of women had side effects, which was the same as placebo.

This drug is at the FDA and will potentially be available for use by the end of 2013. It would then be available as an FDA-approved drug for menopausal women with hot flashes who either cannot or won't take estrogen.

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