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CBT for Hot Flashes vs Gabapentin for Hot Flashes
A side-by-side comparison of two menopause relief methods — efficacy, cost, how they work, and who shouldn't use them.
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Side-by-side comparison
- CBT for Hot Flashes A structured, evidence-based talk therapy that teaches skills to manage the impact of hot flashes and night sweats.
- Gabapentin for Hot Flashes An off-label gabapentin prescription that may reduce hot flashes. Pregabalin is a related gabapentinoid but is not recommended for hot flashes.
| Method | CBT for Hot Flashes A structured, evidence-based talk therapy that teaches skills to manage the impact of hot flashes and night sweats. | Gabapentin for Hot Flashes An off-label gabapentin prescription that may reduce hot flashes. Pregabalin is a related gabapentinoid but is not recommended for hot flashes. |
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| Efficacy | CBT for Hot Flashes Recommended Recommended by the Menopause Society for symptom relief. | Gabapentin for Hot Flashes Recommended Recommended by the Menopause Society for symptom relief. Trial average: 45% reduction in hot flash frequency, across the whole group (not a share of people). |
| Cost | CBT for Hot Flashes $122–$227 per unit Insurance: Varies | Gabapentin for Hot Flashes $9+ monthly Insurance: Varies |
| Duration | CBT for Hot Flashes 4 weekly sessions | Gabapentin for Hot Flashes Daily pill (ongoing) |
| Reversibility | CBT for Hot Flashes Reversible | Gabapentin for Hot Flashes Reversible |
| STI protection | CBT for Hot Flashes No | Gabapentin for Hot Flashes No |
| How it works | CBT for Hot Flashes CBT teaches skills to manage the physical and emotional impact of hot flashes, including relaxation and paced breathing, spotting and managing triggers, and cognitive strategies for unhelpful thoughts about hot flashes. It has been shown to reduce how much hot flashes bother you and interfere with daily life. | Gabapentin for Hot Flashes Gabapentin binds to the alpha-2-delta subunit of voltage-activated calcium channels; how this reduces hot flashes is not known. Pregabalin is structurally related to gabapentin, but NAMS 2023 does not recommend it for hot flashes. |
| Prescription | CBT for Hot Flashes Not required Professional Service | Gabapentin for Hot Flashes Required Telehealth Prescription |
| Side effects | CBT for Hot Flashes None reported | Gabapentin for Hot Flashes
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| Who shouldn't use this | CBT for Hot Flashes None reported | Gabapentin for Hot Flashes
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Key differences
The Menopause Society rates both recommended. How long it lasts: CBT for Hot Flashes, 4 weekly sessions; Gabapentin for Hot Flashes, daily pill (ongoing). A prescription is needed for Gabapentin for Hot Flashes, not for CBT for Hot Flashes. CBT for Hot Flashes: costs $122–$227 per unit. Gabapentin for Hot Flashes: costs $9+ monthly.