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.
