I suffered with significant hot flashes when I was on androgen deprivation therapy (ADT). I experienced between seven to 15 flashes in a twenty-four hour period. Often the flashes were accompanied with breathing difficulties and fatigue. My quality of life was significantly negatively affected. The flashes were significant enough to require that I occasionally change my shirt (the manufactures of tide were thrilled by my family’s increased consumption). My doctors suggested and I tried a number of different ways of controlling the flashes, one of the drugs I took was gabapentin.

Since hot flashes represent a significant problem in men, undergoing ADT, there has been sporadic research to evaluate methods to control the flashes. In the Ann Oncol. 2009 Jan 6, Loprinzi CL etal published some research evaluating gabapentin as a drug to moderate hot flashes. Their research consisted of a 214 patient sample, prospective, double-blind, placebo-controlled clinical trial of men who had hot flashes while on ADT for prostate cancer. Subjects received either a placebo or gabapentin at target doses of 300, 600, or 900 mg/day. Hot flash frequencies and severities were recorded daily during a baseline week and for 4 weeks while the patients took the gabapentin.

Comparing the fourth treatment week to the baseline week, mean hot flash scores decreased in the placebo group by 4.1 units and in the three increasing dose gabapentin groups by, 3.2, 4.6, and 7.0 units. However when comparing the three combined gabapentin treatment arms to the placebo arm there was no significant hot flash differences. Gabapentin was well tolerated in this trial.

The researchers did concluded that the results support that gabapentin decreases hot flashes, but only to a moderate degree. Clearly, the higher dose of 900 mg/day provided a larger benefit. When I took gabapentin I took only 300 mg/day and felt that I had no benefit from the drug. If I go back and try gabagentin again I will insist that I receive the higher dosage, 900 mg/day.

This research was conducted by:
Loprinzi CL, Dueck AC, Khoyratty BS, Barton DL, Jafar S, Rowland KM Jr, Atherton PJ, Marsa GW, Knutson WH, Bearden JD 3rd, Kottschade L, Fitch TR.

Ann Oncol. 2009 Jan 6. Epub ahead of print.
PubMed Abstract

Joel T Nowak MA, MSW