Mao, J.J., Bowman, M.A., Xie, S.X., Bruner, D., DeMichele, A., & Farrar, J.T. (2015). Electroacupuncture versus gabapentin for hot flashes among breast cancer survivors: A randomized placebo-controlled trial. Journal of Clinical Oncology, 33, 3615–3620.
To evaluate the effects of electroacupuncture (EA) versus gabapentin (GP) for hot flashes among survivors of breast cancer, with a specific focus on the placebo, using sham acupuncture (SA) and placebo pills (PP), and monitoring nocebo effects.
By week eight, SA produced significantly greater reduction in HFCS than did PP (-2.39; 95% CI [-4.6, -0.17]). Among all treatment groups, the mean reduction of HFCS was greater in the EA group, followed by SA, GP, and PP (-7.4 vs -5.9 vs -5.2 vs -3.4; p = < 0.001). The pill groups had more treatment-related adverse effects than did the acupuncture groups; GP (39.3%), PP (20%), EA (16.7%), and SA (3.1 %), with p = 0.005. By week 24, HFCS reduction was greatest in the EA group, followed by SA, PP, and GP (-8.5 vs -6 vs -4.6 vs -2.8; p = 0.002).
EA resulted in the greatest reduction in hot flashes both at the end of the treatment and four months after the treatment. GP had similar effects while women received treatment, but not off treatment. Acupuncture (both SA and EA) elicited greater placebo and smaller nocebo effects than did GP or PPs for the management of hot flashes.
The EA group was found to have enhanced effects of reducing hot flashes in breast cancer survivors; however, SA also had better effects in reducing hot flashes than either GP or PPs. GP was associated with the most adverse effects, and the PP group reported more nocebo effects than did SA. This might be important information for nurses to be aware of as they provide education to patients.