Gabapentin may be a beneficial therapeutic option for managing vasomotor symptoms (VMS) in postmenopausal women who are unable to take hormonal therapy (HT) or prefer an alternative treatment, according to the findings of a recently published meta-analysis.
The study authors searched PubMed, MEDLINE, EMBASE, and CENTRAL databases for randomized controlled trials (RCTs) analyzing the efficacy and tolerability of gabapentin when used in the treatment of menopausal hot flushes. The primary outcomes of the analysis included the frequency and duration of hot flushes, as well as a composite score expressing severity.
Secondary outcomes of the study were adverse effects and dropout rate. Depending on the study’s heterogeneity, fixed or random-effects models were used to estimate standardized mean differences (SMD) and combined odds ratios (OR). Additionally, the study authors performed subgroup as well as meta-regression analyses of gabapentin dosage.
The analysis included a total of 7 RCTs (N=1446) that compared single-agent gabapentin to placebo for the treatment of hot flushes in postmenopausal women. Doses in these trials ranged from 300-2400mg, with follow-up periods ranging from 1-6 months. Data analysis revealed that gabapentin use was associated with a significant reduction in hot flush frequency (SMD, 2.99; 95% CI, 2.01-3.98; P <.001), duration (SMD, 0.89; 95% CI, 0.49-1.30; P <.001), and composite score (SMD, 2.31; 95% CI, 1.50-3.11; P <.001).
Results of the analysis also revealed that patients who received gabapentin reported experiencing dizziness (OR, 1.58; 95% CI, 0.98-2.18; P <.001) and unsteadiness (OR, 1.19; 95% CI, 0.43-1.95; P <.002) more frequently compared with patients who received placebo. It was noted, however, that no difference was observed in the dropout rate between the 2 groups, suggesting that the severity of adverse effects associated with gabapentin use did not lead to discontinuation of treatment.
“Gabapentin represents a potentially beneficial treatment for VMS in postmenopausal women who are contraindicated to HT or who prefer alternatives,” the authors concluded. They added, “Future studies should investigate the lowest effective dose of gabapentin to minimize adverse effects.”
Yoon SH, Lee JY, Lee C, Lee H, Hyojin MD, Kim SN. Gabapentin for the treatment of hot flushes in menopause. Menopause: April 2020. Volume 27. Issue 4. Pages 485-493.