Gabapentin useful as alternative treatment for vasomotor symptoms

Gabapentin is beneficial in the treatment of vasomotor symptoms in postmenopausal women with contraindications to hormonal therapy or who prefer alternatives, according to the results of a systematic review and meta-analysis.

Researchers searched multiple online databases for relevant studies evaluating the efficacy of gabapentin in terms of the following: frequency, duration and composite score of hot flushes (primary outcomes), and adverse effects and dropout rate (secondary outcomes).

Standardized mean difference (SMD) and combined odds ratio (OR) were estimated using fixed or random-effects models, depending on study heterogeneity. Additional subgroup and meta-regression analyses of gabapentin dosage were carried out.

The meta-analysis included seven randomized controlled trials that assessed single-agent gabapentin vs placebo in postmenopausal women with hot flushes. Pooled data showed that the active drug conferred superior improvements in terms of the frequency (SMD, 2.99, 95 percent confidence interval [CI], 2.01–3.98; p<0.001), duration (SMD, 0.89, 95 percent CI, 0.49–1.30; p<0.001) and composite score (SMD, 2.31, 95 percent CI, 1.50–3.11; p<0.001) of hot flushes.

Adverse events occurred with greater frequency among gabapentin-treated women than among those taking placebo, specifically dizziness (OR, 1.58, 95 percent CI, 0.98–2.18; p<0.001) and unsteadiness (OR, 1.19, 95 percent CI, 0.43–1.95; p=0.002).

The present data show that gabapentin may be used to treat vasomotor symptoms, although additional investigation is required to identify the lowest effective dose of the drug to minimize adverse effects.