The People's Perspective on Medicine

Gabapentin for Hot Flashes

Q. I swear by gabapentin for hot flashes. Effexor gave me dry mouth, constipation, dizziness, inability to concentrate and a general feeling of being spaced out. Gabapentin gives me great relief.

A. Although doctors prescribe the anticonvulsant gabapentin (Neurontin) to control hot flashes, this is not an FDA-approved use. The drug can increase the risk for suicidal thoughts as well as dizziness, fatigue, unsteadiness and edema.

There are other medications that are approved for menopausal “power surges.” Women who are really struggling with this problem can get relief from hormone replacement therapy–estrogen plus progesterone (for example, Prempro) or estrogen alone for those who have had hysterectomies. The usual recommendation is to take the lowest dose that controls symptoms for the shortest amount of time. This isn’t always easy to judge, since many women find that hot flashes recur when the HRT is discontinued, even if they have been on it for years.

There is more on how to manage hot flashes, including other prescription drugs that are sometimes used for this purpose, in our Guide to Menopause. It makes sense to know about the potential side effects of any medication and how easy or difficult it may be to discontinue before starting it.

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    About the Author
    Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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    I had a total hysterectomy when I was 31. Was prescribed estrace. Worked like a champ and took it for 30 yrs. Then my Dr. Said I better start tapering off since I was approaching 65 and would be going on Medicare and he would no longer be able to prescribe it after that. So I started weening off estrace, hot flashes started right away and got worse as the weening process progressed. Eventually, after 4 yrs of being estrace free, the hot flashes were horrific. 20-30 a day and every 30 min, like clock work at night. Most of them were flashes from hell, first the tingling in the arms, chest, face and head, then the flash, which felt like I was going to spontaneously combust. I was still working full time in a management position. I just thought I was going to commit suicide. No sleep, sweating like a pig at work, couldn’t think, sleep, talk, nothing. Going off hormones ruined my life. Then I developed neuropathy, Dr. Recommended gabapentin. 300mg at night. Helped the neuropathy. Hot flashes remained the same. Then I ran across several articles, blogs, etc. about gabapentin and hot flashes and increased to 300mg in am and 300mg in pm. This helped, but was still suffering with the bad flashes 3-4 times a night. Increased to 600mg in am and pm and like magic, all but two mild ones during the day and 1 medium one at might. Not perfect, but what a game changer. I forgot what it was like to be normal. But I have a question. Could these horrible hot flashes, meaning the amount and severity of them be because I was on estrace for so long?

    Any new thoughts about Gabapentin?

    My dr just rx’d it for my bad hot flashes & not sleeping.
    I had been on Estro patch & Progest pills for a couple years, but dr kept wanting to up the dosage, and I wanted to know where the end point was…
    So she suggested the Gaba…..
    After reading all that’s here, I am unsure.
    I seriously cannot gain any weight! That is out of the question.
    Dizziness? No thanks. Had vertigo for 3 years, don’t wanna deal with that again.
    Spaciness, tingling? No way.

    Maybe I just made up my mind now.
    Hoping for any other “new” news.

    I had a spinal tumor and Drs put me on Gabapentin, 1800 mg/day post surgery. At first it was ok, then started having problems: I couldn’t urinate, felt fuzzy and sleepy and started feeling like everyone hated me (literature lists as common effects: mood changes, sleepiness and the peeing thing). I asked dr. To take me off, he just added tramadol and told me to take it all. To heck with that! I researched tapering on Internet, now I’m Gabapentin free and use topical stuff like aspercreme with lidocaine for leg and back problems. Doesn’t help all that much, but at least I can pee a little better.

    Neurontin seems to be a life saver for hot flashes for me, started working almost immediately! I’m 37, had a hysterectomy at 35 (but kept both ovaries only to lose 1 a few months later due to endometriosis). I’ve been having wicked night sweats for the fast few months that turned into around-the-clock sweats and my God they are unreal! Anyway, I’m not going through menopause yet according to my blood work and ultra sound showed I’m still releasing eggs (matter of fact, the one ovary compensates for the one removed) so we still don’t know what is causing this but I have an appointment with my doctor tomorrow morning and hopefully we’ll get to the bottom of it! I’m just grateful for a little peace, even just for right now!

    I posted previously about my use with neurontin and effexor; I am now 60 and out 13 years from my estrogen positive breast cancer. I couldn’t take either of those med’s or the progesterone…it never made any difference in either the cream or pill form. I have had horrible headaches and the only thing that helped break that cycle was Topamax. It also helped me sleep which is a blessing as someone previously mentioned. I took it for about 2 months until the cycle of headaches stopped and then discontinued. The other thing that helps me sleep at night is Benedryl.
    I tried Ambien but read too many disturbing things and I felt I was getting hooked on it because I would worry all evening about whether or not I would get drowsy or sleep without it so I just gave that up too. I am wondering if anyone has heard from their doctor that some women who were pushed into menopause early due to chemo often never get over the hot flashes and night sweats? That is a hard pill to swallow. I awake every morning to a hot flash and still have several during the day and many at night.
    I limit my caffeine and alcohol because they make it worse. Even chocolate gives me a hot flash. I always sleep with a small fan in my face and never travel without it!! I now take a probiotic daily and take a high quality fish oil capsule. These two things have helped with my mood and my sleep yahoo!!! I too keep looking for new research on hot flashes and night sweats.

    Just started two days ago to use the gabapentin 600mg. So far the usual symptoms, the dizziness and light headed, the tingling in my fingers. I’m using it for my hot flashes, since chemo for breast cancer kicked me into menopause. It’s been difficult I was getting at least 10 flashes thru out the day. Today I onle have 4 so far, and is 11 pm. I will try for a couple of wks and see how I do. My Dr. Said I need to take a couple dosage before it gets better. But so far I’m enjoying having fewer hot flashes. Hope this helps you.

    I was diagnosed with neuropathy in my legs and was having my legs get numb and tingling and sometimes they just ache. Since my doctor put me on gabapentin it seemed to help me immediately. I called it a miracle drug.

    Yes I also tried this but I did not have any success in reducing the amount or severity of my hot flashes and night sweats.

    Hi, have you tired prometrium. I found out about it in 2010 while I was visiting in Australia. It worked for me.
    PEOPLE’S PHARMACY RESPONSE: This is a prescription progesterone, for those who are interested.

    I began taking Gabapentin for migraines after a lot of failed treatments. I am unable to take any Estrogen replacement due to my ongoing breast cancer treatments, which led to the removal of my ovaries (among other things). I suffered from hot flashes (mainly at night) and a happy co-occurence with the Gabapentin not only helping my migraines, but it has relieved my nightly hot flashes as well. And I sleep like a baby and awake refreshed and relaxed. I am a new me.

    Reading these comments is so scary to me. I do take Gabapentin for severe Neuropathy in my feet and hands. That’s all that the doctors have ever recommended. I have gained a tremendous amount of weight (about 40 pounds) and have to take 4800 mg a day to keep the pain in check. I rarely suffer from hot flashes (3 or 4 a week) because I think the meds I take are keeping them at bay. I do have many of the side affects from the Gabapentin. Is there anyone who takes something else for the relief of Neuropathy that doesn’t have the side affects of Gabapentin? It would be great to know.

    Wow your story mimics mine except for one factor. My horrible hot flashes started even before my hormone positive breast cancer and that post treatment drug we are taking. Also my hot flashes last from an hour after I get up in the morning to about 5 p.m., with a small break at lunch time if I am lucky. I am going on 6 years now, 5 pre breast cancer and 1 post breast cancer. I am taking gabapentin, believe it is helping somewhat but think I want to take higher dose, have to talk to doc soon about that. Good luck to all of us!!

    I would like to comment to the person who said age has nothing to do with medications working or not. That’s funny because I have read countless articles that say you need to be more careful. Many senior citizens are over-prescribed and it can hurt (or kill) if they are not careful. I do not consider myself old at 61 but I know to be very careful about what is prescribed and read up on it before I ever take it.
    I did not like: numbness in my feet, instability, psoriasis gone crazy (excuse me, but some people with this skin disease should not take certain prescriptions), loss of hair, constipation, and weight gain (while carefully watching caloric intake and eating healthily). Each of us are different and need to weigh the pros and cons. I choose to be more careful now.

    I do believe we all have choices as far as HRT. I am the one who had a terrible reaction to Gabapentin which some women seem to love for their hot flashes. As far as regular HRT, I have chosen not to take it. My Mom started on Premarin back in the 60’s I think, full dosage, and years later had breast tumors. At first all they did was lumpectomies, then later a radical mastectomy. She told my sister and me that when she took the Premarin she felt great and it helped her through our teenage years!
    She felt and looked good. But after what happened later, she advised us to try and get through menopause without it or search for alternatives. Interestingly, Mom and one of her four sisters took the Premarin and both had breast cancer whereas the two sisters who took nothing lived a lot longer (into their late 80’s). Mom died at 67 and her sister was 71. Actually, my Mom may not have died from breast cancer (that metastisized? to her liver) because her radical mastectomy was botched and she ended up with massive blood transfusions which led to hepatitis and liver tumors.
    I would love to find some magic elixir since I have this neuropathy and my lower back area has deteriorated some but I will soldier on.


    That People’s Pharmacy is still recommending prempro- the cruel extraction of hormones from mares’s (female horses) urine- is truly reprehensible. This pharmaceutical product is harmful to women and causes indescribable life-long suffering to animals.
    PEOPLE’S PHARMACY RESPONSE: The People’s Pharmacy has never “recommended” Prempro. But we do discuss it, since it is the most commonly prescribed drug for hot flashes, and women should have information about what their doctors have prescribed.

    I was put on Gabapentin by my arthritis doctor, which I could not understand because I mentioned that ‘I was not sleeping well, but! I’ve always been that way, even as a child!’. However, he decided that it meant that I had ‘restless leg syndrome’ and I needed Gabapentin! Since I didn’t know any better I started taking it! I only scanned the warning on the page given by the pharmacist & put it away.
    As time went by I gained 20 pounds, I thought I was just overeating, &/or eating the wrong things. I was taking 2 pills a day, 600Mg each. At first I slept wonderfully but as time went by it was not working as well & eventually stopped working. As I got older I told my regular doctor, an internist, that I wanted to start letting go of any medicine I could let go off. When we got to Gabapentin on my list, he said, you cannot let go of it ‘suddenly’. First let go off the morning pill, and let’s wait about 3-6 months and let go of the second pill. I researched it & he was right! It is very important not to let go of it all at once!
    Regardless, when I let go of the second pill, I started to loose weight! I thought, ‘How wonderful’, I figure I was just not eating as much! which encouraged me to eat better. But I kept loosing weight. After loosing 15 pounds I thought ‘Wait a minute’! Something is not right, because I’m eating pretty well the same things & same amounts. So as I started thinking about what have I changed in my diet/vitamins/meds -anything I ingest?! Gabapentin came to mind! I ran to look up the ‘warning pages’ that the pharmacist have given me, I have saved it! Sure enough, one of the ‘warnings was weight gaining’! AHA! I found the culprit!!
    That happened about about 6-8 years ago. Now, here I go again, I had a nerve pinched on my jaw, I was in excruciating pain & this doctor -different doctor, different state- recommends Gabapentin! but 300Mg, 2 a day. Well it worked! for the pain! But I’m only taking one a day -I did that on my own-. So far I have not gain weight, but I want to eventually let go of it all together. However! I noticed that now the ‘Warning pages’ does not ‘Warn’ that there is ‘Weight gaining’!!! I found that interesting! They know that ‘weight gaining’ is a big one for women, which is scary & amazing, because now it says ‘Suicidal thoughts’! So we don’t want to gain weight but is ok is we get drepressed & want to kill ourselves! What does that say about us women!! & some men too I’m sure!

    Wow. Estrogen is dangerous, but neurontin is OK? I’ve known chainsaw carvers who took neurontin for carpal tunnel, and stayed on it too long (face it, chainsaw carving and carpal tunnel are a combination that needs to be solved some other way) and the nerve damage they eventually suffered was NASTY.
    If I were talking rather than typing, I would be speechless. I don’t know an equivalent word for that feeling when it’s a keyboard…

    I have tried both gabapentin and effexor. I am a woman that had estrogen positive breast cancer at 47. I had surgery, chemo and radiation, my hot flashes have now lasted for 12 years…..they have decreased some but are the worst at night and used to be every 40 minutes. I have tried every prescription and non prescription med…..effexor was immediate in stopping my flashes but by about 2 weeks I had horrible nightmares that wouldn’t stop until I discontinued the med’s. Gabapentin worked also but I had to continually increase the dosage about every two to three weeks….this made me very uneasy and after about 6 months I decided to discontinue this too. There has been nothing that has helped me without unwanted side effects attached. Every year I ask my physician if there is anything on the market that is new that I might try. I can not take estrogen due to my history with breast cancer. I know that would help my mood, my skin, my hot flashes and everything else associated with menopause. I am hoping that after 12 years I will soon no longer have any hot flashes….it has been terribly debilitating and difficult to manage all these years….it is embarrassing, causes lack of sleep, depressing and overwhelming at times…..

    Once again I will repeat myself. Gabapentin may help some for hot flashes but at 59 (I am now 61) I was given it for extreme foot pain. The results were terrible for me–permanent neuropathy in my feet while the other side effects subsided some after discontinuance: unsteadiness, edema, major psoriasis outbreak, hair loss, constipation etc. At first when I reported numbness they told me to take more!
    After going to the ER in absolute misery they told me to take the Gabapentin I was prescribed and see a dermatologist for my psoriasis! I stopped the drug but was diagnosed with neuropathy–and unfortunately cost me in that I was working as a waitress and could no longer do that job. I have trouble with any long-time sitting or standing because of my feet. It was a costly choice of drugs for me. dj

    I’m glad gabapentin (Neurontin) worked for this reader. When I tried Neurontin for nerve pain I experienced the same side effects she had with Effexor: dry mouth, constipation, dizziness, inability to concentrate and a general feeling of being spaced out. I guess everyone is different.

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