CRD Summary: This review investigated the efficacy and tolerability of gabapentin for the treatment of hot flashes in menopausal women. Gabapentin was associated with reductions in the severity and frequency of hot flashes in menopausal women, but there was substantial variation in the results across the included trials. The authors' conclusions appear to be reliable based on the evidence presented.

CRD Commentary: The review addressed a clear question and the criteria for including studies in the review were stipulated. The literature search was confined to English-language studies, so language bias cannot be ruled out. A number of sources were searched for relevant studies and efforts were made to retrieve unpublished studies. Steps were taken to minimise errors and bias in all aspects of the review process. There were some discrepancies in the inclusion criteria pertaining to eligible study designs and the studies actually included in the review. The authors' decision to pool some of the results in a meta-analysis may not have been justified, given the differences in participant groups (natural or tamoxifen-induced menopause) and the wide variations in dose regimen of gabapentin used in the trials. The authors' conclusions about the results and the heterogeneity of the included studies seem reliable based on the evidence presented.