Gabapentin (Neurontin) and estrogen have been found equally effective in reducing the frequency and severity of menopausal hot flushes.

Gynecologists at the University of Rochester in New York randomized 60 postmenopausal women to daily regimens of conjugated estrogens 0.625 mg, gabapentin 2,400 mg, or placebo. The women recorded the frequency and severity of their hot flushes in a diary. After 12 weeks, those who took gabapentin or estrogen reported a 71%-72% reduction in hot flushes; those taking placebo reported a 54% reduction. The pattern of adverse events was similar among all three groups. The authors conclude that gabapentin appears to be an “efficacious alternative to estrogen” (Obstet Gynecol. 2006;108:41-48).

Gabapentin, approved in 1994 to treat epileptic seizures, has been used off-label for years for headaches, shingles pain, and other problems. It is theorized that the drug reduces hot flushes by regulating the flow of calcium in and out of cells, a mechanism that helps regulate body temperature.

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