Antiseizure Drug May Treat Hot Flashes
June 12, 2000 -- Either before or during menopause, three of every four
women will experience hot flashes -- the sudden bursts of skin-searing heat
that can quickly leave the sufferer glistening with sweat. But no one knows
what causes this alarming symptom.
The best known treatment for hot flashes is estrogen, but many women are
afraid to take the hormone for fear that it may increase their risk of breast
cancer. Women's health experts have long been eager to find an alternative, and
now a new report suggests that a drug used to treat epilepsy may be the best
Neurologist Thomas J. Guttoso Jr., MD, noticed that a woman who was taking
the drug for treatment of migraine headaches reported that after just two days
on the drug "her hot flashes were gone," he tells WebMD, adding that it
didn't help her migraines.
The drug is called gabapentin and, in addition to its FDA-approved use to
control seizures associated with epilepsy, it is now used to treat bipolar
disorder as well as some social phobia disorders, he says.
Published side effects of the drug include convulsions that occur after
suddenly stopping the drug, hypertension, fatigue, dizziness, and a variety of
other symptoms. The way in which the drug works is unknown, according to the
authors, and they note the need for further studies to determine how it works
and whether it can be used to treat hot flashes.
There have been other drugs that work on the brain and central nervous
system that appear to reduce hot flashes, but more research is needed before
they can be approved or prescribed for that use. It is important that you only
take medication prescribed for you and for your specific conditions.
Guttoso, who is an instructor of neurology at the University of Rochester
School of Medicine, says he thinks the drug affects an area of the brain called
the hypothalamus, which he thinks has a role in regulating the body's
temperature. Specifically, he suggests the drug works on the levels of
substances called tachykinins, which regulate the contraction and dilation of
smooth muscles. The drug appears to affect the flow of these tachykinins, he
He describes his theory and the effect of gabapentin on a handful of
patients in the June 13 issue of the journal Neurology. Guttoso says
that the drug "reduced the frequency of hot flashes by about 87%" in
the six patients he describes in the article. A seventh patient who suffered
from hypothermia -- a condition of low body temperature -- had a 100-fold
increase in these episodes, with temperatures as low as 95? F.
He is so impressed by these early results that he says he will study the
drug by measuring blood levels of tachykinins in women taking it to see if
their levels decrease. "If the levels drop, that would support my
theory," says Guttoso.