The use of pregabalin in the treatment of hot flashes.

Abstract

Perimenopausal women often consult health care professionals for help in managing vasomotor symptoms such as hot flashes and night sweats. Similar symptoms are also associated with the use of certain drugs such as tamoxifen and leuprolide.1,2 Various therapies have been studied for the treatment of these symptoms, the most predominant being hormonal therapy (HT). Because of the risks and contraindications associated with HT, however, nonhormonal pharmacologic therapy has been explored for the treatment of hot flashes. Antidepressants (e.g., venlafaxine, paroxetine and fluoxetine), as well as clonidine, Bellergal (belladonna, ergotamine and phenobarbital) and gabapentin are medications that can be prescribed as alternatives to HT, as suggested by the Society of Obstetricians and Gynaecologists of Canada (SOGC).3 While antidepressants affect the release and reuptake of serotonin and/or norepinephrine,4-6 gabapentin and pregabalin are gamma-aminobutyric acid analogues,7,8 and their mechanism of action related to the reduction of hot flashes is currently unclear. Patients using gabapentin for neurologic conditions have been described in the literature as having a reduction in hot flashes.9 Although pregabalin is not listed by the SOGC as one of the options for treating hot flashes, preliminary data supporting its use for this indication are available.10,11 This investigational use of pregabalin stems from past evidence that shows the benefit of gabapentin,12,13 an agent of the same class, for the treatment of hot flashes.