Seizure Drug Cools Tamoxifen-Induced Hot Flashes

From the WebMD Archives

May 29, 2002 -- A drug commonly used to calm seizures may also provide relief from tamoxifen-induced hot flashes in women with breast cancer. A small study shows the drug Neurontin can reduce or even eliminate hot flashes in postmenopausal women who take tamoxifen to treat breast cancer.

Researchers say that more than half of women who take tamoxifen suffer from hot flashes as a result of the drug's anti-estrogen effects, which can create menopausal symptoms such as night sweats and hot flashes. Easing these symptoms is especially difficult for women being treated for breast cancer because they cannot take the hormone replacement therapy (HRT) normally prescribed for menopausal women because the estrogen they contain may interfere with their treatment.

"There is a big search for alternative treatments that may have some effect in these women," study author Kishan J. Pandya, MD, professor of hematology/oncology at the University of Rochester Medical Center, tells WebMD. "At least we have identified another drug that seems to be effective."

Neurontin is approved for the treatment of epileptic seizures, but it is also commonly used to treat migraine headaches and some anxiety disorders.

Researchers studied the effects of the drug in 16 women who were on tamoxifen therapy and were having at least one hot flash a day. After four weeks of treatment with Neurontin, the women reported, on average, a 74% reduction in hot flash duration, 44% decrease in the frequency of hot flashes, and 53% drop in the severity of hot flashes when they happened. Half of the women reported a complete elimination of hot flashes and continued on the drug after the study ended.

Other non-estrogen drugs that have been shown to help reduce menopausal symptoms in these women include antidepressants such as Effexor, SSRI's (a class of antidepressants that includes Paxil, Prozac, and others), and sedatives (Ambien).

Results of an earlier study of six patients in the August 2000 issue of Neurology suggested that Neurontin may fight hot flashes in menopausal women and prompted this pilot study in women using tamoxifen. The results of Pandya's study were presented this month at the American Society of Clinical Oncologists annual meeting in Orlando, Fla.

A nationwide follow-up study of Neurontin is now underway that will compare the effectiveness of two different dosage levels of the drug with a placebo.

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