From the Research
Treatment options for hot flashes in scleroderma patients should prioritize non-hormonal approaches, such as gabapentin (300-900 mg daily in divided doses), due to the increased cardiovascular risks associated with hormonal therapy in these patients. The most recent and highest quality study 1 supports the use of nonhormonal medications, including selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and gabapentin, for hot flash reduction.
Some key points to consider when treating hot flashes in scleroderma patients include:
- Non-hormonal medications, such as venlafaxine (37.5-75 mg daily), paroxetine (7.5-20 mg daily), or clonidine (0.1-0.2 mg daily), may be effective alternatives to hormonal therapy
- Lifestyle modifications, such as wearing layered clothing, avoiding triggers like spicy foods, caffeine, and alcohol, maintaining cool ambient temperatures, practicing relaxation techniques, and regular exercise, can also help alleviate hot flashes
- Treatment selection should consider the patient's specific scleroderma manifestations, as some medications may worsen symptoms like Raynaud's phenomenon or interact with other scleroderma medications, as noted in 2
- The use of complementary and alternative therapies, such as isoflavone supplementation or mindfulness-based stress reduction therapy, may also be considered, although the evidence for these approaches is limited, as discussed in 1
It is essential to weigh the potential benefits and harms of each treatment option and consider the individual patient's needs and preferences when developing a treatment plan for hot flashes in scleroderma patients, as emphasized in 1.