Objective: Various non‑hormonal agents have been used for the treatment of hot flashes 
in women with menopause. Some studies have reported that gabapentin appears to be an 
effective and well‑tolerated treatment modality. The aim of this study was to evaluate whether 
the treatment with gabapentin is effective in reducing hot flash frequency and severity and 
also to compare gabapentin 100 mg/day, 300 mg/day and conjugated estrogen in this regards.
Methods: In this comparative clinical trial, 100 post‑menopausal women attending outpatient 
clinics of Isfahan University hospitals were included from April 2008 to February 2009. 
Participants randomly received gabapentin 300 mg/day, gabapentin 100 mg/day, or conjugated 
estrogen 0.625 mg/day for 12 weeks. Frequency and severity of hot flashes and adverse 
effects were compared among the three groups.
Findings: From all, 16 participants dropped out. There were no significant differences among 
the groups before intervention in terms of age, body mass index and baseline hot flash 
frequency and severity. Hot flash diaries were used to record the frequency and severity of 
hot flashes. After the treatment period, there was a significant decrease in both severity and 
frequency of hot flashes in all three groups. Post‑hoc analyses showed that the frequency and 
severity of hot flashes were significantly lower in those who received gabapentin 300 mg/day 
or estrogen 0.625 mg/day compared to those who received gabapentin 100 mg/day. There 
was not statistically significant difference between those who received gabapentin 300 mg/day 
and those who received estrogen. Very few adverse effects, mostly gastrointestinal discomfort 
were observed in both gabapentin groups (8%).
Conclusion: Gabapentin 300 mg/day could be useful to relieve hot flashes in women 
for whom hormone therapy is not suitable or when hot flashes do not respond to other 
therapies. Further researches are needed to determine the efficacy of gabapentin use for 
longer periods or at higher doses.