In Reply

Professor Revenstorf is right to point out the promising, but in some cases uncontrolled, studies of the efficacy of hypnotherapy and the recommendation of Germany’s Scientific Advisory Board on Psychotherapy.

The cited passage from the CME article entitled “Treatment of Tobacco Dependence” intentionally refers to current treatment guidelines. The therapeutic recommendations on tobacco dependence issued by the Drug Commission of the German Medical Association (Arzneimittelkommission der deutschen Ärzteschaft) in 2010 (1), as well as the US treatment guidelines (2) conclude that currently the evidence supporting hypnotherapy is insufficient. The most recent Cochrane meta-analysis of the efficacy of hypnotherapy (3) analyzed 11 studies and found inconsistent results for the efficacy of hypnotherapy compared with no intervention, simple recommendations to practice abstinence, or other psychological therapies.

Unfortunately the assessment of the inconsistent data on the efficacy of hypnosis or hypnotherapy on the basis of the evidence based criteria that are required for medical treatment guidelines at the S2 and S3 level prompted my conclusion, that data on hypnosis and hypnotherapy are so inconsistent that their use cannot be recommended. In spite of all that it deserves mention that numerous studies have shown positive results—but these studies did not meet the requirements of the guideline panel.

It remains to be hoped that in the near future, randomized controlled studies will provide proof of efficacy for hypnotherapy in treating tobacco dependence, such as is required and recognized by these panels. The author himself is currently conducting a two-center study of the efficacy of hypnotherapy compared with behavior therapy, which meets the requirements of a randomized controlled trial.

Once the results of further controlled studies are published, the upcoming new edition of the guidelines may necessitate a new assessment of the situation.

DOI: 10.3238/arztebl.2012.0265b

Prof. Dr. med. Anil Batra

Universitätsklinik für Psychiatrie und Psychotherapie

Sektion Suchtforschung und Suchtmedizin

anil.batra@med.uni-tuebingen.de

Conflict of Interest Statement
The author has received honoraria for expert opinions from Pfizer Consumer Health Care and honoraria into a third-party account from Pfizer, Sanofi, McNeil, and Pfizer Consumer Health Care.