Pilot study using gabapentin for tamoxifen-induced hot flashes in women with breast cancer.
ABSTRACT In this pilot study, 22 women with breast cancer on tamoxifen therapy with at least two hot flashes a day took oral gabapentin at 300 mg three times a day for 4 weeks. The 16 women who completed the study had a mean decrease in hot flash duration of 73.6% (P = 0.027), frequency of 44.2% (P < 0.001), and severity of 52.6% (P < 0.001), with a complete response in 8/16 women. Side effects reported by four women who did not complete 4 weeks of the study were nausea (1/4), rash (1/4) and excessive sleepiness (3/4). Two additional patients did not provide complete data. Gabapentin is a promising new agent in the treatment of tamoxifen induced hot flashes, and should be studied further.
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ABSTRACT: The cardinal climacteric symptoms of hot flushes and night sweats affect 24-93% of all women during the physiological transition from reproductive to post-reproductive life. Though efficacious, hormonal therapy and partial oestrogenic compounds are linked to a significant increase in breast cancer. Non-hormonal treatments are thus greatly appreciated. This systematic review of published hormonal and non-hormonal treatments for climacteric, and breast and prostate cancer-associated hot flushes, examines clinical efficacy and therapy-related cancer risk modulation. A PubMed search included literature up to June 19, 2014 without limits for initial dates or language, with the search terms, (hot flush* OR hot flash*) AND (clinical trial* OR clinical stud*) AND (randomi* OR observational) NOT review). Retrieved references identified further papers. The focus was on hot flushes; other symptoms (night sweats, irritability, etc.) were not specifically screened. Included were some 610 clinical studies where a measured effect of the intervention, intensity and severity were documented, and where patients received treatment of pharmaceutical quality. Only 147 of these references described studies with alternative non-hormonal treatments in post-menopausal women and in breast and prostate cancer survivors; these results are presented in Additional file 1. The most effective hot flush treatment is oestrogenic hormones, or a combination of oestrogen and progestins, though benefits are partially outweighed by a significantly increased risk for breast cancer development. This review illustrates that certain non-hormonal treatments, including selective serotonin reuptake inhibitors, gabapentin/pregabalin, and Cimicifuga racemosa extracts, show a positive risk-benefit ratio. Key pointsSeveral non-hormonal alternatives to hormonal therapy have been established and registered for the treatment of vasomotor climacteric symptoms in peri- and post-menopausal women.There are indications that non-hormonal treatments are useful alternatives in patients with a history of breast and prostate cancer. However, confirmation by larger clinical trials is required.SpringerPlus 12/2015; 4(1). DOI:10.1186/s40064-015-0808-y
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ABSTRACT: While most women will suffer from hot flashes at some point over their lifetime, most symptoms resolve with time. However, some women may experience severe and/or long-lasting hot flashes. Estrogen, the most effective treatment for hot flashes, is not generally recommended for women with a history of breast cancer or women at high risk of developing breast cancer. Moreover, long-term administration of estrogen to healthy women is associated with increased risks of cardiovascular disease, stroke, and breast cancer. Newer antidepressants from the selective serotonin or noradrenergic reuptake inhibitor family, such as venlafaxine and paroxetine, appear to be among the most effective nonhormonal agents for the treatment of hot flashes. New information demonstrates that gabapentin also is an effective nonhormonal therapy for hot flashes. In this review, we will discuss current knowledge of the epidemiology and pathophysiology of hot flashes, along with treatment options. We will focus on nonhormonal treatments that have been studied in prospective randomized clinical trials, and will present an algorithm for the treatment of symptomatic patients.The journal of supportive oncology 1(1):11-21; discussion 14-5, 19-21.