Gabapentin gaat opvliegers net zo goed tegen als oestrogeen blijkt uit dubbelblind gerandomiseerde studie. Artikel geplaatst 12 juli 2006

11 juli 2006: Bron: Obstet Gynecol. 2006;108:41-48
,br> Gabapentin gaat opvliegers net zo goed tegen als oestrogeen blijkt uit gerandomiseerde studie. Gabapentin is een gamma-aminobutyric acid (sorry kan hiervoor niet echt een goede Nederlandse vertaling voor geven) dat al in 1994 officeel als goed werkend middel werd erkend in het beter doen opnemen van calcium. In een ongecontroleerde studie bleek Gabapentin ook toen al effectief tegen opvliegers en nu worden deze resultaten dus bevestigd in een gerandomiseerde dubbelblind gecontroleerde studie. Overigens ook < a href="bewezen-middelenmedicijnen.html">genisteine werkt uitstekend tegen opvliegers.

July 10, 2006 — Gabapentin is as good as estrogen for hot flushes, according to the results of a randomized study reported in the July issue of Obstetrics & Gynecology. "Gabapentin does appear to be as effective as estrogen," lead author Sireesha Y. Reddy, MD, from the University of Rochester Medical Center, said in a news release. "Until now, its efficacy relative to estrogen was unknown." Primary and secondary prevention trials have shown that estrogen is ineffective in preventing heart disease among older menopausal women and may even increase the risk for coronary and thromboembolic events during the first year of treatment. Evidence from the Women's Health Initiative points to an increased risk for breast cancer associated with estrogen use and possibly an increased risk of Alzheimer disease. Gabapentin, a gamma-aminobutyric acid analogue approved in 1994 for the treatment of seizures, is thought to have nociceptive properties due to high affinity binding sites located on calcium channels, resulting in alteration of calcium currents. In an uncontrolled case series, gabapentin appeared to be effective in treating hot flushes in postmenopausal women. In this double-blind trial, 60 postmenopausal women with moderate-to-severe hot flushes were randomized to receive either 0.625 mg/day of conjugated estrogens (n = 20), placebo (n = 20), or gabapentin titrated to 2400 mg (n = 20) for 12 weeks. Using a diary, these women recorded frequency and severity of baseline hot flushes for 2 weeks before randomization and for 12 weeks after randomization. The primary outcome measure was the weekly hot flush composite score, which incorporates both severity and frequency of hot flushes. Secondary endpoints were differences in pretreatment and posttreatment scores pertaining to depression (Zung Depression Scale) and other climacteric symptoms (Greene Climacteric Scale). Based on intent-to-treat analysis, the reduction in the hot flush composite score for both estrogen (72%; P = .016) and gabapentin (71%; P = .004) was greater than the reduction associated with placebo (54%) at the end of the 11th week. However, the extent of reduction in hot flush composite score was not significantly different between estrogen and gabapentin (P = .63). There were no differences noted between groups in the Zung Depression Scale or in any of the Greene Climacteric subscales except for the Somatic Symptom cluster, which was significantly greater in the gabapentin group than in the placebo group. Although overall adverse events were similar in frequency in both groups, the gabapentin group had the Headache, Dizziness, and Disorientation cluster with greater frequency. Estimation of the number needed to harm in this cluster suggests that these symptoms may occur in 1 of 4 patients treated with gabapentin. Study limitations include a large placebo effect and sample size insufficient to confirm a difference between gabapentin, estrogen, and placebo in somatic symptoms. "Despite the small scale of this study, gabapentin appears to be as effective as estrogen in the treatment of postmenopausal hot flushes," the authors write. "Although adverse events were similar in all groups, it remains to be seen whether this will be true in a larger study." The National Institutes of Health/NICHD supported this study in part. Pfizer supplied gabapentin but had no other role in the study. One of the authors has disclosed having a patent for the use of gabapentin in the treatment of hot flushes. Obstet Gynecol. 2006;108:41-48

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