Complementary and alternative medicine in the treatment of anxiety and depression

School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia.
Current Opinion in Psychiatry (Impact Factor: 3.94). 02/2008; 21(1):37-42. DOI: 10.1097/YCO.0b013e3282f2d814
Source: PubMed


There is well documented evidence for the increasing widespread use of complementary and alternative medicine in the treatment of physical and psychiatric symptoms and disorders within Western populations. Here we provide a review of the recent literature on evidence for using such interventions in the treatment of anxiety and depression.
With regard to herbal treatments, kava is effective in reducing anxiety symptoms and St John's wort in treating mild to moderate depression. The association of kava with hepatotoxicity, however, is a significant concern. Promising data continue to emerge for the use of omega-3 fatty acids in managing depression. Evidence for the use of acupuncture in treating anxiety disorders is becoming stronger, although there is currently minimal empirical evidence for the use of aromatherapy or mindfulness-based meditation.
The evidence base for the efficacy of the majority of complementary and alternative interventions used to treat anxiety and depression remains poor. Recent systematic reviews all point to a significant lack of methodologically rigorous studies within the field. This lack of evidence does not diminish the popularity of such interventions within the general Western population.

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    • "Use of traditional medicine including medicinal plants remains widespread in developing countries, whereas complementary and alternative medicine use continue to thrive in developed countries [1]. Investigations support complementary and alternative medicine for physical and psychiatric disorders [2]. Thus, medicinal plants are still being widely studied in contemporary pharmaceutical sciences. "
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    ABSTRACT: Hypericum perforatum L. (Hypericaceae) has been widely prescribed for mild to moderate depression following the release of promising results in clinical trials. However, it is known that its constituents may be affected by milieu. The stability complexities of the constituents of H. perforatum have gained interest in recent years. The aim of the present study was to examine the impact of storage conditions on H. perforatum total extract simultaneously under different storage conditions. Temperature, humidity, and light conditions were evaluated. Comparative analyses of methanol extracts were conducted using high performance liquid chromatography-diode array detection for chlorogenic acid, rutin, hyperoside, isoquercitrin, quercitrin, quercetin, amentoflavone, pseudohypericin, hyperforin, and hypericin. Analysis and extraction were performed using a validated method. The fluctuation of the constituents of the plant extract has been demonstrated. Among these components, chlorogenic acid was the most stable. Hyperforin, hypericin, and pseudohypericin were more stable than the flavonoids at −20°C, in the 6th month. As estimated, decay was lowest at −20°C and highest at 40°C–75% relative humidity for the analyzed constituents. Except for hyperforin, light protection decreased the breakdown of components within 4 months. However, at the 6th month, equivalent changes were seen for all constituents. Degradation of the constituents at −20°C indicates the importance of stability tests in analysis studies covering time and storage conditions.
    Journal of Food and Drug Analysis 05/2015; DOI:10.1016/j.jfda.2015.04.002 · 0.62 Impact Factor
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    • "Ayurveda is among the oldest Indian indigenous systems of medicine with documented history of about 5000 years and 80% of the population still depends upon Ayurveda for their health concerns (Goyal et al., 2011). Although, evidence base for the efficacy of the majority of CAM interventions used to treat depression remains poor (Van der Watt et al., 2008), Ayurveda and its therapeutic strategies have promising potential especially in management of MDD (Conboy et al., 2009). But efficacy, safety and neurobiology of mechanism of action of these treatments still remain to be evaluated due to lack of systematic research in this area (Qureshi and Al-Bedah, 2013; Ravindran and da Silva, 2013). "
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    ABSTRACT: Introduction Ayurveda (Indian- complimentary and alternative medicine) is still most sought after in India and has promising potential in management of Vishada [Major depressive disorder (MDD)]. But, systematic research is lacking. In this study we evaluated of influence of Ayurvedic treatment (Panchakarma and Ayushman-15) on psychopathology, heart rate variability (HRV) and endocrinal parameters in patients with major depression. Methods 81 drug naive patients diagnosed as Vishada by Ayurvedic physician and MDD according to DSM IV-TR were given Ayurvedic Virechana module (therapeutic purgation) and were randomized into two groups. Patients in Group A (n = 41) received Ayushman-15 A while group B (n = 40) received Ayushman-15 B for two months and Shirodhara (forehead -oil pouring therapy). Patients were assessed with Hamilton Depression Rating Scale (HDRS), Montgomery Asberg Depression Rating scale (MADRS), Heart Rate variability (HRV). Cortisol and Adrenocorticotropic hormone (ACTH) were estimated at baseline and after ayurvedic therapy. HRV and endocrinal parameters were compared with age and gender matched healthy volunteers. Results HRV parameters showed significant sympathetic dominance in patients compared to healthy volunteers. Two months of Ayurvedic treatment significantly decreased psychopathology, showed increase in vagal tone, decrease in sympathetic tone and reduced cortisol levels. However, there was no significant difference between groups receiving Ayushman A and B. Conclusion This study provides evidence for antidepressant, cardiac (HRV) and beneficial neuroendocrine modulatory influence of Ayurveda therapy in patients of Vishada (MDD). Further studies are needed to confirm these findings. Greater insight into the neurobiology behind this therapy might provide valuable information about newer drug target.
    Asian Journal of Psychiatry 08/2014; 12(1). DOI:10.1016/j.ajp.2014.07.002
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    • "Findings from a number of reviews suggest that the use of CAM products and services is associated with improvements in mental health. For example, one systematic review found strong evidence for the effectiveness of St. John's wort for the treatment of depression and for kava in the treatment of anxiety, and emerging evidence for the use of omega-3 fatty acids and acupuncture in treating depression and anxiety, respectively [14]. Another review examined the use of yoga in the treatment of mood and anxiety disorders. "
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    ABSTRACT: Objectives. To examine: (i) the extent to which victims of intimate partner abuse (IPA) use complementary and alternative medicine (CAM) and (ii) the effects of CAM on their mental health. Methods. Medline, Scopus, and Web of Science were searched for studies measuring the extent of CAM use amongst victims of IPA and trials assessing the impact of CAM on mental health amongst this population. Risk of bias was assessed using the Cochrane collaboration tool. Results. No studies measuring the level of CAM use amongst IPA victims, and only three studies assessing the effect of CAM on the mental health of this population were identified. Two studies looked at yogic breathing, while one assessed the effect of music therapy. All three studies showed some beneficial effects; however, each had a small sample, brief intervention period, and no follow-up measurement and were considered to be at high risk of bias. Conclusions. The review found little evidence for the benefits of CAM for IPA victims. Findings suggest positive effects of music therapy and yogic breathing; however, methodological limitations mean that these results should be interpreted with caution. It is important that more research into the use and effects of CAM amongst this population are undertaken.
    Evidence-based Complementary and Alternative Medicine 05/2014; 2014:963967. DOI:10.1155/2014/963967 · 1.88 Impact Factor
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