Gabapentin for the management of hot flashes (hot flushes) in prostate cancer survivors

[JimJimJimJim]

Jim Marshall (not a doctor) said ...

Hot flashes (or hot flushes) can become such a nuisance to some men on hormone therapy (ADT) that your doctor may recommend drug treatment.

 

One drug sometimes prescribed is Gabapentin at a low dose. The study reported below was done to find the lowest dose that would be effective. This was necessary because the drug does slow nerve response while you take it, and at higher doses (used to treat epilepsy) it can have side effects which may effect daily life. The safe dose was found to be 300 mg per day.

 

The full article is to be found at:

full article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075822/

where it qualifies the 'suggest' in the abstract.

... end Jim

 

J Support Oncol. 2010 May-Jun;8(3):128-32.

Gabapentin for the management of hot flashes in prostate cancer survivors: a longitudinal continuation Study-NCCTG Trial N00CB.

Moraska AR, Atherton PJ, Szydlo DW, Barton DL, Stella PJ, Rowland KM Jr, Schaefer PL, Krook J, Bearden JD, Loprinzi CL.

Source

Mayo Clinic Rochester, Rochester, Minnesota 55905, USA.

Abstract

Hot flashes are a complication of androgen deprivation therapy for prostate cancer. A phase III study showed that use of low-dose gabapentin was well tolerated and moderately decreased the frequency of hot flashes due to androgen deprivation therapy when taken for 4 weeks.

 

The current study, an open-label continuation of the randomized study, examined the efficacy and toxicity of gabapentin when taken for (an additional) 8 weeks. Patients were allowed to start, or continue, gabapentin and to titrate the dose to maximum efficacy, up to 900 mg/d. They were asked to complete a hot flash diary daily and keep weekly logs of toxicity, satisfaction with hot flash control, and quality of life. The moderate reduction in hot flash frequency and severity in the randomized phase of the study appeared to be maintained during this continuation phase. Men originally receiving the placebo or lowest dose of gabapentin (300 mg/d) had improved hot flash control relative to that at the end of the randomized phase. Minimal adverse effects were reported.

 

These findings suggest that low-dose gabapentin is moderately efficacious for at least 12 weeks of hot flash treatment in men undergoing androgen deprivation therapy for prostate cancer and seems to be well tolerated. (NCT00028572)

PMID: 2055292

[alanbarlee]

Adding to Jim's post, Alan Barlee quotes Patrick Walsh and Stephen Strum, both recognised PCa experts in th USA. as recommending the use of a progesterone-active drug like Provera or Megace  to control hot flushes.

 

Another possibility is  an SSRI inhibitor like sertraline (Zoloft or generic).

 

These medical possibilities should be discussed with your medical team.

 

Useful avoidance measures might  include regular aerobic exercise, making the afternoon snack and evening meal early, light and low carb, keeping away from heaters and hot drinks before bedtime.

 

Coping strategies can include loose cotton clothing, especially around the neck, which facilitates evaporativ cooling of the skin, and sleeping in a cool rather than heated environment, with a ceiling fan running and / or a pedestal fan nearby for use as  necessary. Bio-feedback and meditation are also useful techniques, which may'train' the hypothalamus to get your body thermostat working a bit better.