Content area
Full Text
Key words: breast cancer, gabapentin, hot flashes, tamoxifen
Summary
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.
Introduction
Hot flashes are distressing symptoms experienced by over half (57%) of women taking tamoxifen for breast cancer [1] and cause considerable decline in patients' quality of life. Controversy surrounds the use of hormones in patients with breast cancer. Some nonhormonal agents, for example, anti-depressants, may be effective against hot flashes but are associated with side effects, while others, for example, black cohosh and Vitamin E, are no better or only slightly better than placebo. A need exists to study newer and more potent agents to treat hot flashes.
A report in the journal Neurology [2] showed a dramatic (86%) reduction in the frequency of hot flashes in six patients taking gabapentin for other reasons. Gabapentin was effective within 1-3 days of treatment followed by recurrence of hot flashes when discontinued. Building upon this, we conducted an open-labeled pilot study to assess the effects of gabapentin for tamoxifen-induced hot flashes in women with breast cancer.
Patients and methods
Postmenopausal women receiving tamoxifen therapy for breast cancer (adjuvant or metastatic) for at least 1 month with more than two hot flashes a...