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Hypnosis, venlafaxine equally reduce hot flashes; combination not superior to either approach

20 Mar 2017

Hypnosis may produce reductions in hot flashes similar to that achieved with venlafaxine, according to a study, although the combination of these two treatment approaches is not superior to either treatment alone.

The pilot study randomized 71 postmenopausal women to one of four treatment groups: venlafaxine 75 mg plus hypnosis (VH; n=15; mean age 56 years), venlafaxine 75 mg plus sham hypnosis (VSH; n=19; mean age 54 years), placebo pill plus hypnosis (PH; n=22; mean age 54 years) and placebo pill plus sham hypnosis (PSH; n=15; mean age 56 years). Treatment lasted 8 weeks.

All women kept a daily diary in which hot flash severity and frequency were recorded in real time. A General Estimating Equation model facilitated analysis of intrapatient difference in hot flash score (frequency x severity) at 8 weeks—the primary endpoint—using VSH as the referent arm and controlling for baseline hot flashes.

The primary endpoint did not statistically differ in the active treatment arms, PH and VH, when compared with the referent arm VSH (p=0.34 and p=0.05, respectively). Hot flashes decreased by about 50 percent in the PH and VH arms vs 25 percent in the PSH arm. Women in the PSH arm also reported statistically smaller reductions in hot flash score compared with those in the referent VSH arm (p=0.001).

No significant negative side effects were reported during the course of the study.

Hot flashes occur commonly in menopause, affecting up to 75 percent of women including those with a history of cancer. The symptom can be a significant source of bother and distress, negatively affecting quality of life and possibly leading to a loss of productivity. [Lancet 2002;360:1851-1861; Clin Obstet Gynaecol 2007;21:261-274; Climacteric 2015;18:456-469]

Aside from hormonal therapy and nonhormonal alternatives such as serotonergic antidepressants and the anticonvulsant gabapentin, behavioural therapy also shows potential in the management of hot flashes. [N Engl J Med 2016;374:803-806; J Clin Oncol 2002;20:1578-1583; Oncol 2009;27:2831-2837]

The current data provide evidence of the efficacy of hypnosis in the treatment of hot flashes, although more studies are needed to elucidate whether the intervention could be combined with a different low-dose pharmacologic intervention “to provide optimal relief of hot flashes synergistically without ceiling effects and without side effects, or to identify a population who could benefit more from such a combination,” researchers said.

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Most Read Articles
4 days ago
Greater exposure to total volatile organic compounds (TVOCs) appears to have an adverse effect on early postnatal growth, according to a study.
6 days ago
Functional capacity (FC) in active postmenopausal women depends more on lower limb muscle strength than on abdominal obesity, suggesting that those with abdominal obesity may not necessarily have a reduced FC as long as lower limb muscle strength is preserved, according to a study.
Robert Chin, 5 days ago
This review article outlines the prevalence of nausea and vomiting of pregnancy (NVP) and hyperemesis gravidarum (HG), definition of NVP and HG, aetiology, risk factors, complications of HG, recommended investigations, primary care management, hospital and ambulatory daycare, therapeutic management of HG supported by good clinical evidence, discharge planning, and importance of the multidisciplinary team to provide high quality care in patients with NVP and HG.
16 Oct 2014

Korean red ginseng (KRG), which is processed from raw ginseng, improves the quality of life of women by ameliorating oxidative stress induced by exposure to endocrine-disrupting bisphenol A (BPA), according to a recent study.