Menopausal hot flashes, night sweats, and insomnia disappeared with lamotrigine: a case report

OBJECTIVE: Approximately 75% of women aged between 45 and 55 years suffer from symptoms of menopause. Hormone therapies used in breast cancer treatment can induce the same symptoms. Current medications for menopausal symptoms are not suitable for everyone. Here, we describe a case of a woman whose menopausal vasomotor symptoms decreased after starting lamotrigine.

METHODS: We report a case of a woman whose menopausal vasomotor symptoms disappeared with lamotrigine and returned after stopping the medication. We did not find any reports of lamotrigine in regards to menopausal symptoms.

RESULTS: A 53-year-old woman with menopausal symptoms and migraine had tried different medications for migraine. She could not use estradiol 1 mg p.o. regularly, because it worsened her headache. Then, lamotrigine was started for the migraine as a preventive medication. Lamotrigine's official indication is epilepsy and bipolar disorder. It is also used off-label, for example, for migraine. In a few days the nighttime hot flashes, night sweats and sleeping problems disappeared. Then she developed a rash. Because the rash induced by lamotrigine can be severe, the medication had to be stopped. In 2 weeks, the menopausal symptoms returned.

CONCLUSIONS: Menopausal vasomotor symptoms disappeared with lamotrigine and returned after stopping the medicine in this case. The precise action mechanism(s) of lamotrigine is unknown. Lamotrigine has interactions with estrogen and progesterone medicines. So, this effect we describe might not have been just a coincidence. Lamotrigine could be worth further research in regards to menopausal symptoms.