Short report Evaluation of gabapentin in management of hot flushes in postmenopausal women Nutan Agarwal, Smita Singh, Alka Kriplani, Neerja Bhatla and Nilanchali Singh Abstract This study was conducted to assess the efficacy of gabapentin in controlling hot flushes in postmenopausal women. Fifty postmenopausal patients with hot flushes were randomized in two groups, one receiving gabapentin 900 mg daily along with calcium and another group receiving calcium alone. Frequency, duration and severity of hot flushes were noted and a composite score was calculated. There was around an 80% reduction in composite score in the gabapentin group at 3 and 6 months; significantly more than the placebo group. Gabapentin has a two-fold better response than placebo in reducing hot flushes with the relief starting from the first month and maximum effect at 3 months. Keywords Hot flushes, gabapentin, postmenopausal Introduction Fifty per cent of postmenopausal women experience vasomotor symptoms. 1 Though hormone replacement therapy is effective in reducing hot flushes, due to potential adverse effects an interest in safer non-hormo- nal therapies has increased. Recent reviews evaluating alternative therapies conclude that there is insufficient evidence regarding their effectiveness. 2 Gabapentin has been shown to reduce hot flushes in women with breast cancer, chemical or surgical menopause and in a small sample of women with natural menopause. 3–5 There is little emerging evidence about its efficacy but its use in this application is still evolving. No study to date has assessed the efficacy of gabapentin for treatment of hot flushes in Indian women. Methods This was a pilot study conducted at AIIMS, New Delhi. Ethical clearance was taken from the institutional eth- ical committee. Fifty women with a natural menopause were recruited after informed consent. Inclusion criteria were women of 45–55 years age, non-menstruating for 1 year, FSH greater than 40 mIU/ml, no pelvic path- ology, normal Pap smear and presence of hot flushes. Exclusion criteria were asymptomatic women, abnor- mal cervical screening results, hormonal treatment within the last six months and renal or liver disorders. A detailed history was taken regarding symptoms of hot flushes: frequency, severity and duration. Severity of each episode was graded as 1 – mild, 2 – moderate, 3 – severe. Daily hot flushes severity assessment was per- formed using two parameters: integrated hot flush dur- ation score (frequency  duration of each hot flush) and hot flush composite score (frequency  severity  dur- ation of each hot flush). Patients were randomized into two groups using a computerized method. Group I received gabapentin 900 mg/day (300 mg thrice daily) along with calcium 500 mg while Group II received placebo three times a day with calcium. The participants and interviewer were blinded to the intervention. All women main- tained a hot flush diary. They were asked to complete the diary daily for the initial four weeks and thereafter, last week of each month for next five months. A total record for nine weeks was obtained over six months. Follow-ups were performed after one, three and six months of therapy. Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi Corresponding author: Nutan Agarwal, 55 New Campus, IIT Hauz Khas, New Delhi 110 016, India. Emails: nutan.agarwal1@gmail.com; nutan_agarwal@yahoo.com Post Reproductive Health, formerly Menopause International 2014, Vol. 20(1) 36–38 ! The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1754045313518527 prh.sagepub.com by guest on February 29, 2016 min.sagepub.com Downloaded from