Epilepsy Drug May Ease Hot Flashes
Study: Hot Flashes Eased in Breast Cancer Patients Taking Neurontin
Sept. 1, 2005 -- An antiseizure drug called Neurontin may help ease hot flashes in women with breast cancer, researchers report in The Lancet.
Neurontin is approved to treat epilepsy. It has been studied before as an alternative to hormone replacement therapy for postmenopausal women who have hot flashes.
Hormone replacement therapy is indicated for treating menopausal symptoms like hot flashes, but for some women, such as those with breast cancer, HRT is not an option.
"We believe that [Neurontin] can be added to the list of non-hormonal agents for the control of hot flashes in women with breast cancer," write Kishan Pandya, MD, and colleagues. Pandya works at the University of Rochester Cancer Center.
Neurontin showed benefits against hot flashes in postmenopausal women in an earlier University of Rochester study.
In the new study, researchers gave Neurontin or a fake drug (placebo) to 420 women with breast cancer. The women were 55 years old, on average; most were white. They were having at least two hot flashes per day at the study's start.
The women were randomly given a placebo, 300 daily milligrams of Neurontin, or 900 daily milligrams of Neurontin for eight weeks. Higher doses (3,000-3,600 milligrams per day) are usually used to treat seizures.
No one knew which drug they were taking.
The women were asked to keep diaries detailing their hot flashes during the study. Nearly 350 did so throughout the study.
Fewer, Less Severe Hot Flashes
The women's diaries show a 44% drop in hot flash frequency and a 46% drop in hot flash severity scores after taking 900 milligrams of Neurontin for eight weeks.
The placebo and lower dose of Neurontin didn't significantly ease hot flashes. "The effects of doses higher than 900 mg/day merit further study," write the researchers.
It's not clear how Neurontin helped relieve hot flashes, they note. Seizures aren't a symptom of hot flashes.
The study was short, so the scientists can't comment on long-term Neurontin use for hot flashes.
However, they write that the drug "is used for long durations for various other symptoms and certainly could be considered for hot flashes also."
Neurontin's side effects can include fatigue or drowsiness, dizziness or lightheadedness (especially in the first few weeks), swelling of the hands or feet, and rash.
In Pandya's study, the drug's immediate side effects weren't noted, but women's reasons for quitting the study early were recorded.
Some women said they quit because whatever drug they were taking didn't help; others cited side effects. Withdrawal rates were similar for all three treatment groups, write the researchers.
Women experiencing bothersome effects of menopause, including hot flashes, should consult health care professionals about their options.
The North American Menopause society also makes the following suggestions about lifestyle:
- Less physical activity increases the risk of hot flashes while daily exercise has been associated with an overall decreased rate of hot flashes.
- Avoiding hot and spicy foods; these have been reported in some women to trigger hot flashes although studies have not supported this.
- Cigarette smoking also has been associated with increasing the risk of hot flashes because it increases the breakdown of the hormone estrogen.
- Slow, deep breathing.
- Relaxing activities.