depressants that are prescribed to reduce hot flashes in women entering menopause, he says. "But we dont understand exactly how any of these drugs work to reduce hot flashes," says Dr. Loprinzi.
Gabapentin was approved by the Food and Drug Administration to treat epileptic seizures in 1994, and pain from shingles in 2002. The ability of gabapentin to reduce hot flashes was first detected when it was being used for other reasons. Since then, several clinical trials testing gabapentin in women found that a dose of about 900 milligrams a day decreased hot flashes by about half -- the same dose and a similar degree of effectiveness discovered in Dr. Loprinzis clinical trial.
Men participating in this study had a mean age of 70, and suffered with hot flashes occurring at least 14 times a week. They were randomized into four groups. Over 28 days, one group was given placebo pills, another received a 300 mg/d (milligrams a day) tablet of gabapentin, a third group received an escalating dose of gabapentin that reached 600 mg/d, and the fourth groups dose reached 900 mg/d. The study was blinded: physicians and patients did not know which pills contained the active agent.
Using a scale from 1 to 4, patients recorded the daily number of mild, moderate, severe, and very severe hot flashes. Researchers found that median hot flash frequency and score decreased between 22 percent to 27 percent in the placebo group, 23 percent to 30 percent in the 300 mg/d group, 32 percent to 34 percent in the 600 mg/d group, and 44 percent to 46 percent in the 900 mg/d gabapentin arm.
The highest dose used in the study was less than one-third of the dose that can be used to treat epileptic seizures, Dr. Loprinzi says, leaving room for possible improvements in effect against hot flashes with an increase in dosage. His research team may explore that idea in the future.
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