title: Efficacy of a biobehavioral intervention for hot flashes: a randomized controlled pilot study.
abstract: OBJECTIVE
  The need for effective nonhormonal treatments for hot flash management without unwanted side effects continues. The primary aim of this pilot study was to evaluate the effect of combining a nonhormonal pharmacologic agent with a behavioral treatment for hot flash reduction.
  
  
  METHODS
  Seventy-one postmenopausal women were randomized to one of four groups: venlafaxine 75 mg + hypnosis (VH) versus venlafaxine 75 mg + sham hypnosis (VSH) versus a placebo pill + hypnosis (PH) versus placebo pill + sham hypnosis (PSH). Women recorded hot flash severity and frequency in a daily diary, in real time. The intrapatient difference in hot flash score (frequency × severity) at 8 weeks was analyzed using a General Estimating Equation model, using VSH as the referent arm, controlling for baseline hot flashes.
  
  
  RESULTS
  The active arms including PH or VH were not statistically significantly different than VSH (P = 0.34, P = 0.05, respectively). Women in each active arm reported hot flash reductions of about 50%, with the PSH group reporting a 25% reduction. Women receiving the PSH reported statistically significantly smaller reductions in hot flash score than women in the referent VSH arm (P = 0.001). There were no significant negative side effects during the course of the study.
  
  
  CONCLUSIONS
  Hypnosis alone reduced hot flashes equal to venlafaxine alone, but the combination of hypnosis and venlafaxine did not reduce hot flashes more than either treatment alone. More research is needed to clarify whether combining hypnosis with a different antidepressant would provide synergistic benefits.
authors.affiliation: 1University of Michigan, School of Nursing, Ann Arbor, MI 2Mayo Clinic, Rochester, MN 3University of Texas, Austin, TX 4Baylor University, Waco, TX.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Barton
authors.forename: Kelliann C Fee
authors.initials: KCF
authors.lastname: Schroeder
authors.forename: Tanima
authors.initials: T
authors.lastname: Banerjee
authors.forename: Sherry
authors.initials: S
authors.lastname: Wolf
authors.forename: Timothy Z
authors.initials: TZ
authors.lastname: Keith
authors.forename: Gary
authors.initials: G
authors.lastname: Elkins
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D000066949:Biobehavioral Sciences; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D019584:Hot Flashes / Q000523:psychology / Q000628:therapy*; D006801:Humans; D006990:Hypnosis / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride / Q000627:therapeutic use*
chemical_list: D018687:Antidepressive Agents, Second-Generation; D000069470:Venlafaxine Hydrochloride