Sang-Hee Yoon, MD, PhD; Ji Young Lee, MD, PhD; Chulmin Lee, MD, PhD; Hyojin Lee, MD; Soo-Nyung Kim, MD, PhD
Objective: Gabapentin is used to treat vasomotor symptoms (VMS) in postmenopausal women with contraindications to hormonal therapy or who prefer alternatives. We investigated the efficacy and tolerability of gabapentin for treating menopausal hot flushes via a meta-analysis.
Methods: We searched the PubMed, MEDLINE, EMBASE, and CENTRAL databases for English-language articles published until June, 2018. The following search terms were used: «menopause,» «hot flushes,» «vasomotor symptoms,» «gabapentin,» and «non-hormonal therapy.» Primary outcomes were frequency, duration, and composite score of hot flushes. Secondary outcomes were adverse effects and dropout rate. We estimated the standardized mean difference (SMD) and combined odds ratio (OR) using fixed or random-effects models, depending on study heterogeneity. Subgroup and meta-regression analyses of gabapentin dosage were performed.
Results: We included seven randomized controlled trials that compared single-agent gabapentin with placebo for treating hot flushes in the meta-analysis. Women who received gabapentin reported a significantly greater reduction in the frequency (SMD 2.99 [95% confidence interval 2.01–3.98], P < 0.001), duration (0.89 [0.49–1.30], P < 0.001), and composite score (2.31 [1.50–3.11], P < 0.001) of hot flushes. Adverse events were significantly more frequent among those taking gabapentin than among those taking the placebo (OR 1.58 [0.98–2.18], P < 0.001; and 1.19 [0.43–1.95], P = 0.002 for dizziness and unsteadiness, respectively).
Conclusions: Gabapentin could be used to treat VMS in postmenopausal women with contraindications to hormonal therapy. Future studies should investigate the lowest effective dose of gabapentin to minimize adverse effects.