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Gabapentin for Hot Flashes vs SSRIs 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

  • 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.
  • SSRIs for Hot Flashes A low-dose SSRI (paroxetine 7.5 mg) approved by the FDA for moderate-to-severe hot flashes.
Method
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.
SSRIs for Hot Flashes A low-dose SSRI (paroxetine 7.5 mg) approved by the FDA for moderate-to-severe hot flashes.
EfficacyGabapentin 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).

SSRIs for Hot Flashes Recommended

Recommended by the Menopause Society for symptom relief.

CostGabapentin for Hot Flashes $9+ monthly Insurance: VariesSSRIs for Hot Flashes $69–$200 monthly Insurance: Varies
DurationGabapentin for Hot Flashes Daily pill (ongoing)SSRIs for Hot Flashes Daily pill (ongoing)
ReversibilityGabapentin for Hot Flashes ReversibleSSRIs for Hot Flashes Reversible
STI protectionGabapentin for Hot Flashes NoSSRIs for Hot Flashes No
How it worksGabapentin 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.

SSRIs for Hot Flashes

Low-dose paroxetine is a selective serotonin reuptake inhibitor (SSRI) that blocks the reuptake of serotonin. How it reduces hot flash frequency and severity is not known.

PrescriptionGabapentin for Hot Flashes Required Telehealth PrescriptionSSRIs for Hot Flashes Required Telehealth Prescription
Side effectsGabapentin for Hot Flashes
  • Drowsiness
  • Dizziness
  • Fatigue
  • Headache
  • Weight gain
  • Peripheral edema
SSRIs for Hot Flashes
  • Nausea
  • Headache
  • Fatigue or malaise
Who shouldn't use thisGabapentin for Hot Flashes
  • Hypersensitivity to gabapentin or any ingredient
SSRIs for Hot Flashes
  • Current or recent MAOI use (within 14 days)
  • Concomitant thioridazine or pimozide
  • Pregnancy
  • Hypersensitivity to paroxetine or any ingredient

Key differences

The Menopause Society rates both recommended. Gabapentin for Hot Flashes: costs $9+ monthly. SSRIs for Hot Flashes: costs $69–$200 monthly.