Monday, April 10, 2017

How Efficient is Gabapentin (Neurontin) for Menopausal Symptoms: Insomnia and Hot Flashes?

Gabapentin is approved to treat seizures, but it has also been shown to help reduce hot flashes. This drug is useful in women who can't use estrogen therapy and in those who also have migraines.


Extended-release (ER) gabapentin (Serada, Depomed), an investigational nonhormonal drug, improved substantially sleep for menopausal women and reduces hot flashes, according to the phase 3 clinical trial BREEZE 3, completed in 2012.

"Right now, if women don't want to take hormones, and if over-the-counter products, acupuncture, and lifestyle changes do not work, we don't have any FDA [US Food and Drug Administration] approved therapies," said lead researcher JoAnn Pinkerton, MD, who is professor of obstetrics and gynecology at the University of Virginia in Charlottesville and past president of NAMS.

A New Drug Application was submitted for gabapentin ER in July 2012. If approved, the drug will be the first nonhormonal, non-antidepressant treatment for the bothersome symptoms of menopause, Dr. Pinkerton explained.

In the older study of 2005, completed by the University of Rochester Cancer Center, involved 420 women with breast cancer who been suffering from hot flashes. The women were divided into two different groups. One group was given 300 mg of the medication per day while the other group was given 900 mg of gabapentin.

The subjects were asked to record the frequency and intensity of their hot flashes before the study and during weeks four and eight. The results of the study showed that 900 mg of gabapentin is effective for controlling hot flashes. The subjects who only took 300 mg of the medication did not notice a significant decrease in their hot flashes. The researchers concluded by saying that gabapentin should be used to treat hot flashes.

Gabapentin is FDA-approved currently for seizures and postherpetic neuralgia (shingles). The drug also has been used off label to treat diabetic neuropathy, chronic pain, and restless leg syndrome. However, the drug has not been officially approved by FDA for treatment of the menopausal symptoms as hot flashes and insomnia after the drug developer, Depomed, application has been reviewed in 2013.

Still, many women consider the drug as effective, though the extend of the possible effects may vary.

Before you take Gabapentin

Tell your doctor if you are taking other medications including:
* Treatment for stomach or duodenal ulcers such as cimetidine
* Antacids or other medications to treat heart burn or reflux

Consumption and Dosage

Swallow whole with a full glass of water. It does not matter if you take Gabapentin before or after food. Initially take 300mg at night, increase the dose by 300mg every two to three days (add morning dose then midday dose if no side effects) until taking 300mg three times a day. It is advisable to take Gabapentin at the same time each day. If you miss a dose take it as soon as you remember, however if it is almost time for your next dose, take only your usual dose at that time.

Side Effects

side effects of gabapentin are somnolence, drowsiness, dizziness, and a "spacey" feeling. These effects tend to subside after a month of treatment. Gabapentin has a half-life of 5 to 7 hours, which means that a single dose taken prior to bedtime will have an effect throughout the night.

People are less likely to experience side effects if they take it at bedtime or with a meal. They are also less likely to experience side effects if the dosage is gradually increased.

Like many other anti-seizure medications, Gabapentin may increase the risk of suicide. That is why people who take these medications should be watched closely for signs of suicidal behavior. Women who are worried about this possible side effect should make sure that they discuss it with their doctor.

Is Gabapentin Addictive?

Many women who take Neurontin for hot flashes are concerned about whether the drug is addictive. The good news is that Neurontin is not considered an addictive drug. However, it is important to note that it is possible for one to develop a physical dependence on the drug. Some people may experience withdrawal symptoms for up to 45 days after they stop taking the drug. Insomnia, anxiety, pain, sweating and nausea are some of the most common withdrawal symptoms.

Sources and Additional Information:

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