ArticlePDF Available

Mood disorders and complementary and alternative medicine: A literature review

Taylor & Francis
Neuropsychiatric Disease and Treatment
Authors:
Naseem Akhtar Qureshi at Ministry of Health, Riyadh
Naseem Akhtar Qureshi
  • Ministry of Health, Riyadh
Abdullah Mohammed Al-Bedah
Abdullah Mohammed Al-Bedah
Abdullah Mohammed Al-Bedah
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Download full-text PDFDownload full-text PDF
Read full-text
Download citation

Abstract and Figures

Mood disorders are a major public health problem and are associated with considerable burden of disease, suicides, physical comorbidities, high economic costs, and poor quality of life. Approximately 30%-40% of patients with major depression have only a partial response to available pharmacological and psychotherapeutic interventions. Complementary and alternative medicine (CAM) has been used either alone or in combination with conventional therapies in patients with mood disorders. This review of the literature examines evidence-based data on the use of CAM in mood disorders. A search of the PubMed, Medline, Google Scholar, and Quertile databases using keywords was conducted, and relevant articles published in the English language in the peer-reviewed journals over the past two decades were retrieved. Evidence-based data suggest that light therapy, St John's wort, Rhodiola rosea, omega-3 fatty acids, yoga, acupuncture, mindfulness therapies, exercise, sleep deprivation, and S-adenosylmethionine are effective in the treatment of mood disorders. Clinical trials of vitamin B complex, vitamin D, and methylfolate found that, while these were useful in physical illness, results were equivocal in patients with mood disorders. Studies support the adjunctive role of omega-3 fatty acids, eicosapentaenoic acid, and docosahexaenoic acid in unipolar and bipolar depression, although manic symptoms are not affected and higher doses are required in patients with resistant bipolar depression and rapid cycling. Omega-3 fatty acids are useful in pregnant women with major depression, and have no adverse effects on the fetus. Choline, inositol, 5-hydroxy-L-tryptophan, and N-acetylcysteine are effective adjuncts in bipolar patients. Dehydroepiandrosterone is effective both in bipolar depression and depression in the setting of comorbid physical disease, although doses should be titrated to avoid adverse effects. Ayurvedic and homeopathic therapies have the potential to improve symptoms of depression, although larger controlled trials are needed. Mind-body-spirit and integrative medicine approaches can be used effectively in mild to moderate depression and in treatment-resistant depression. Currently, although CAM therapies are not the primary treatment of mood disorders, level 1 evidence could emerge in the future showing that such treatments are effective.
Figures - uploaded by Naseem Akhtar Qureshi
Author content
All figure content in this area was uploaded by Naseem Akhtar Qureshi
Content may be subject to copyright.
0046353205d8758c080000
00.pdf
Content uploaded by Naseem Akhtar Qureshi
Author content
All content in this area was uploaded by Naseem Akhtar Qureshi on Mar 12, 2014
Content may be subject to copyright.
Mood disorders and complementary and alternative medicine: A literature revi
ew.pdf
Available via license: CC BY-NC 3.0
Content may be subject to copyright.
A preview of the PDF is not available
... Divalproex Sodium and Carbamazepine are effective in the treatment of acute mania and Lamotrigine is effective at treating and preventing bipolar depression. [11] It is very important that clinicians and patients as well as caregivers are well informed about these risks when deciding to start maintenance treatment or not, following the onset of a single manic or mixed episode. [7] At present, although alternative medicine therapies are not the primary treatment of mood disorders, evidence could emerge in the future showing that such treatments are effective. ...
... [7] At present, although alternative medicine therapies are not the primary treatment of mood disorders, evidence could emerge in the future showing that such treatments are effective. [11] An updated review method allows the inclusion of both experimental and non-experimental studies and has the potential to allow for diverse primary research methods. [12,13] Homoeopathy has synthesised evidence base in the treatment of psychiatric disorders such as schizophrenia [14] , autism [15] , depression [16] and attention deficit hyperactive disorder [17] but there is no coalesced information from published literature on the effectiveness of Homoeopathy in bipolar disorder. ...
View
... Herbal medicine or plant-derived natural products can serve as a cost-effective complementary and alternative treatment for depressive disorders, often with fewer side effects and comparable efficacy to conventional antidepressants [16]. Plant extracts are considered one of the most promising sources of new drugs and have shown promising results in the treatment of depression [17]. ...
Therapeutic Targets and Molecular Mechanisms of Calycosin in the Treatment of Depression: Insights From Chronic Mild Stress Animal Models
Article
Full-text available
Background Depression is a complex psychiatric disorder with limited therapeutic options and various side effects. Calycosin, a bioactive compound derived from Astragalus membranaceus, possesses multiple pharmacological properties. This study aimed to investigate the antidepressant effects of calycosin in chronic mild stress (CMS) animal models of depression and to elucidate its underlying mechanisms. Methods The antidepressant effects of calycosin were assessed in vivo using CMS animal models of depression, including the grooming frequency test, sucrose intake test, tail suspension test, and open field test. Neurogenic effects were evaluated by measuring the levels of BDNF, GDNF, and NGF in isolated hippocampus tissues. The hepatoprotective effects were assessed by measuring liver enzyme levels. The molecular mechanisms underlying calycosin's antidepressant effects were explored in vitro using PC12 cells. Results Calycosin exhibited potent antidepressant‐like activities in CMS animal models of depression. Treatment with calycosin significantly alleviated depressive symptoms and improved neurogenic effects. Additionally, calycosin displayed hepatoprotective effects by modulating liver enzymes in vitro. The antidepressant effects of calycosin are mediated by the stimulation of the TrkB–MEK–Erk1/2–CREB signaling pathway. Conclusion In conclusion, calycosin shows promise as a novel therapeutic agent for depression due to its potent antidepressant‐like activities and diverse pharmacological properties. Further studies are warranted to elucidate the exact molecular targets of calycosin and to assess its efficacy and safety in clinical settings.
View
... An increasing number of patients struggling with TRD are seeking alternative and unconventional methods to manage their symptoms. Complementary and alternative medicine (CAM) therapies offer more than 120 health systems, practices, or products distinct from conventional medicine [97]. Nonetheless, few of them have sufficiently proven evidence to be considered effective in TRD therapy. ...
Innovative approaches in the treatment-resistant depression: exploring different therapeutic pathways
Article
Full-text available
  • Mar 2025
Treatment-resistant depression (TRD) remains a vital challenge in psychiatry, affecting a significant number of patients with major depressive disorder. Current pharmacological approaches often do not provide sufficient therapeutic results, prompting the need for innovative treatments. This review summarizes recent advances in TRD management, including non-pharmacological therapies such as transcranial magnetic stimulation, deep brain stimulation, electroconvulsive therapy, and vagus nerve stimulation, and describes their mechanisms of action. Novel pharmacotherapies, particularly glutamatergic modulators like ketamine and esketamine, have shown promising results with esketamine being available to eligible patients in Poland since 2023 within a drug program. Electroconvulsive therapy remains an effective treatment for TRD, usually with small side effects mainly including transient memory impairment, headache, or cardiovascular changes. Transcranial magnetic stimulation is a non-invasive procedure with proven efficacy; therefore several psychiatric organizations recommend it as a treatment option for major depressive disorder in their clinical guidelines. Deep brain stimulation is a relatively new treatment modality for TRD, with its primary risk being associated with the required neurosurgical procedure. Vagus nerve stimulation seems to be a promising adjunctive treatment for TRD, showing significant improvements in depressive symptoms, especially at higher electrical doses but with no side effects. While these treatments appear to have potential, personalized approaches are crucial for optimizing outcomes. Future research should focus on refining the techniques, improving safety profiles, and validating the long-term efficacy.
View
... Patients should be assessed for potential contraindications, including interactions with other medications and underlying health conditions. Evaluating the patient's overall health, treatment history, and preferences is crucial to determine whether SJW is a suitable addition to their therapeutic regimen (Kenda et al., 2022;Qureshi & Al-Bedah, 2013). Careful selection helps maximize the benefits of SJW while minimizing potential risks. ...
Beyond Medication: The Impact of Physical Activity and Herbal Options in Managing Depression
Article
Full-text available
  • Dec 2024
Physical activity has been gaining recognition as a key component in managing depression, with its physiological, biochemical, and neurological effects playing a crucial role in improving mental health. Exercise enhances neuroplasticity, promotes the release of mood-regulating neurochemicals, and reduces stress, all contributing to alleviating depressive symptoms. Also, lifestyle modifications, including physical activity, are increasingly integrated into clinical practice as essential non-pharmacological interventions for depression. Alongside these interventions, the growing recognition of St. John’s wort (SJW) as an effective treatment for mild to moderate depression underscores its potential as an alternative or adjunct to conventional antidepressants. Both physical activity and SJW represent promising approaches in the comprehensive treatment of depression, offering safe, effective, and well-supported options for individuals struggling with depressive disorders. This review will explore the integration of lifestyle interventions, including exercise and SJW, in depression management.
View
... The existing literature (18)(19)(20) demonstrates that many patients have utilized or would like to further explore the use of CAIM to relieve their symptoms, however, it has also been found that many healthcare practitioners do not receive adequate training and education about CAIM (21), making it difficult for them to appropriately recommend these therapies to patients (22). In addition, clinical practice guideline recommendations for a range of CAIMs pertaining to the treatment and management of disorders such as depression and anxiety are uncertain, as these recommendations contain great variability and are of sub-optimal quality (23). ...
An international, cross-sectional survey of psychiatry researchers and clinicians: perceptions of complementary, alternative, and integrative medicine
Article
Full-text available
  • Aug 2024
Background Psychiatry is a branch of medicine that focuses on mental, behavioral and emotional well-being. Complementary, alternative, and integrative medicine has been an increasingly popular choice for patients with psychiatric disorders, therefore our study aimed to explore the perceptions of psychiatry researchers and clinicians on the use of CAIM. Methods We conducted an online, anonymous, cross-sectional survey for researchers and clinicians who have published their work in psychiatry medical journals that are indexed in MEDLINE. 42,667 researchers and clinicians were sent the link to the survey after extraction of their email addresses from their respective publications. Respondents were asked numerous multiple-choice questions regarding their perceptions on various CAIM therapies, followed by an open-ended question where they could include any additional thoughts. Results The survey was completed by 987 respondents, with a majority identifying as a researcher (n=447, 46.51%), or as both a researcher and a clinician (n=368, 38.29%) within the field of psychiatry. Most respondents (n=629, 78.04%) perceived mind-body therapies such as meditation, biofeedback, hypnosis, and yoga to be the most promising CAIM therapy for the prevention, treatment, and management of psychiatric diseases. Many participants said that they agree (n=285, 38.14%) that most CAIM therapies in general are safe, however, many disagree that CAIM therapies are effective (n=245, 32.93%). Respondents indicated that there is value to conducting research on CAIM therapies (n=356, 47.91%), and that there should be more funding allocated to researching these therapies (n=265, 35.71%). Respondents were also in agreement that clinicians should receive training on CAIM therapies through formal education (n=295, 39.76%) or supplementary education (n=380, 51.28%). Conclusion The findings from this study showed that there is great interest and potential in researching CAIM within the field of psychiatry. This information can be used as a basis for further research and to develop tailored educational resources for researchers and clinicians in psychiatry.
View
A STUDY TO DETERMINE THE EFFECTIVENESS OF HOMOEOPATHIC POLYCREST REMEDIES IN THE TREATMENT OF BIPOLAR DISORDER
Article
Full-text available
  • Sep 2024
This study investigates the effectiveness of homoeopathic polycrest remedies in managing symptoms associated with bipolar disorder, a chronic psychiatric illness marked by alternating episodes of mania and depression. “Given the growing interest in alternative and complementary medicine, particularly homoeopathy, this research evaluates whether classical homoeopathic treatment using polycrest remedies can offer therapeutic benefits beyond placebo effects. A randomized controlled trial was designed to compare the outcomes of patients receiving individualized polycrest remedies against those undergoing conventional psychiatric care and placebo treatment. Participants were evaluated over a 12-month period using validated clinical scales including the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), and WHOQOL-BREF. The methodology incorporated a holistic assessment based on homoeopathic case-taking principles and repertorization to select the most suitable polycrest remedies such as Natrum Muriaticum, Lycopodium, Phosphorus, and Sulphur. Preliminary results indicate a statistically significant reduction in symptom severity and improved quality of life among patients under homoeopathic care, suggesting potential adjunctive or alternative value.
View
Complimentary Contributor Copy
Chapter
Full-text available
  • Feb 2025
View
Understanding immune system dysfunction and its context in mood disorders: psychoneuroimmunoendocrinology and clinical interventions
Article
Full-text available
  • Dec 2024
Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society, being mainly represented by major depressive disorder (MDD) and bipolar disorder (BD). The etiopathogenesis of mood disorders is extremely complex, with a wide spectrum of biological, psychological, and sociocultural factors being responsible for their appearance and development. In this sense, immune system dysfunction represents a key mechanism in the onset and pathophysiology of mood disorders, worsening mainly the central nervous system (neuroinflammation) and the periphery of the body (systemic inflammation). However, these alterations cannot be understood separately, but as part of a complex picture in which different factors and systems interact with each other. Psychoneuroimmunoendocrinology (PNIE) is the area responsible for studying the relationship between these elements and the impact of mind–body integration, placing the immune system as part of a whole. Thus, the dysfunction of the immune system is capable of influencing and activating different mechanisms that promote disruption of the psyche, damage to the nervous system, alterations to the endocrine and metabolic systems, and disruption of the microbiota and intestinal ecosystem, as well as of other organs and, in turn, all these mechanisms are responsible for inducing and enhancing the immune dysfunction. Similarly, the clinical approach to these patients is usually multidisciplinary, and the therapeutic arsenal includes different pharmacological (for example, antidepressants, antipsychotics, and lithium) and non-pharmacological (i.e., psychotherapy, lifestyle, and electroconvulsive therapy) treatments. These interventions also modulate the immune system and other elements of the PNIE in these patients, which may be interesting to understand the therapeutic success or failure of these approaches. In this sense, this review aims to delve into the relationship between immune dysfunction and mood disorders and their integration in the complex context of PNIE. Likewise, an attempt will be made to explore the effects on the immune system of different strategies available in the clinical approach to these patients, in order to identify the mechanisms described and their possible uses as biomarkers.
View
Possession and the Soul in the Context of New Shamanism
Chapter
  • Oct 2024
The idea that an external force can enter an individual and possess their body is prevalent in most cultures across the globe and throughout history. This “possession” can last for varying lengths of time, and its effects can be considered positive—when a “spirit” provides the individual with powers, abilities, knowledge, or authority—or negative—when the individual suffers and the “spirit” should ideally be cast out, usually through a ritual performed by someone with a designated role. The study of possession remains marginal in most academic disciplines, but current public discourses indicate that the topic remains relevant across modern and postmodern societies. A globalized world has brought about an unprecedented situation in which decidedly different ideas about possession influence one another, and people attribute a wide variety of experiences and behaviors to spiritual possession. There are those who describe themselves as possessed, sometimes as an inherent element of their identities, and those who are labelled as possessed by others, though this label often comes with a stigma. Ideas of Possession brings together scholars of various disciplines to consolidate an ongoing academic discussion on how possession is understood within different cultural contexts, demonstrating how each approach to this subject can benefit from interdisciplinary dialogue as we attempt to make sense of such a broad range of interpretations.
View
A Narrative review on minor depressive disorder
Article
Full-text available
  • Sep 2023
Minor depressive disorder is a eloquent mental health Condition influencing the individuals in all ages of both sexes.Homoeopathy is a holistic healthcare approach that utilizes constitutional remedies to address the underlying causes of minor depressive disorder. It offers a personalized and individualized approach of treatment that considers the unique characteristics of everyone, which Ameliorates the minor depressive disorder in young people.The main aim of this study is to explore the role of homoeopathic constitutional remedies in managing minor depressive disorder in young age group through review of published literature. Articles published between January 1990 and January 2022 were Solicited from pub med, google scholar data bases. The findings indicate that homoeopathic constitutional remedies can provide significant relief from symptoms of minor depressive disorder and improve overall well being. In conclusion, homoeopathy can be a valuable alternative treatment option form minor depressive disorder in young individuals, providing safe and effective relief from symptoms while addressing the underlying causes of the condition.
View
Scientific Basis for the Use of Indian Ayurvedic Medicinal Plants in the Treatment of Neurodegenerative Disorders: 1. Ashwagandha
Article
Full-text available
  • Sep 2010
Ayurveda is a Sanskrit word, which means "the scripture for longevity". It represents an ancient system of traditional medicine prevalent in India and in several other south Asian countries. It is based on a holistic view of treatment which is believed to cure human diseases through establishment of equilibrium in the different elements of human life, the body, the mind, the intellect and the soul [1].
View
Ayurvedic Treatments: Complementary and Alternative Treatments in Mental Health Care
Chapter
Full-text available
  • Jan 2007
The widespread use of nonconventional treatments, or complementary and alternative medicine (CAM), and the increasing evidence supporting their therapeutic benefits call for a concerted scientific effort to integrate treatments that work into mainstream medicines. Answering that call is the groundbreaking Complementary and Alternative Treatments in Mental Health Care, a concise, practical reference that reviews the many CAM approaches used in North America and Europe to treat—or self-treat—mental health problems, and the history and rationale for a variety of CAM treatments, including the risks and benefits of their integration into mainstream mental health care. Two dozen contributors with both conventional and nonconventional expertise present current information about safe, effective mental health treatments—including herbals and other natural products, stress management, homeopathy, Ayurveda, and traditional Chinese medicine—that have not yet been fully examined or endorsed by the institutions of conventional biomedicine.
View
View
Omega-3 polyunsaturated essential fatty acid status as a predictor of future suicide risk
Article
  • Jun 2006
Objective: Low levels of docosahexaenoic acid, a polyunsaturated fatty acid, and elevated ratios of omega-6/omega-3 fatty acids are associated with major depression and, possibly, suicidal behavior. Predicting risk of future suicidal behaviors by essential fatty acid status merits examination. Method: Plasma polyunsaturated fatty acid levels in phospholipids were measured in 33 medication-free depressed subjects monitored for suicide attempt over a 2-year period. Survival analysis examined the association of plasma polyunsaturated fatty acid status and pathological outcome. Results: Seven subjects attempted suicide on follow-up. A lower docosahexaenoic acid percentage of total plasma polyunsaturated fatty acids and a higher omega-6/omega-3 ratio predicted suicide attempt. Conclusions: A low docosahexaenoic acid percentage and low omega-3 proportions of lipid profile predicted risk of suicidal behavior among depressed patients over the 2-year period. If confirmed, this finding would have implications for the neurobiology of suicide and reduction of suicide risk.
View
Omega-3 fatty acids and mood disorders
Article
  • Jun 2006
Objective: This article is an overview of epidemiological and treatment studies suggesting that deficits in dietary-based omega-3 polyunsaturated fatty acids may make an etiological contribution to mood disorders and that supplementation with omega-3 fatty acids may provide a therapeutic strategy. Method: Relevant published studies are detailed and considered. Results: Several epidemiological studies suggest covariation between seafood consumption and rates of mood disorders. Biological marker studies indicate deficits in omega-3 fatty acids in people with depressive disorders, while several treatment studies indicate therapeutic benefits from omega-3 supplementation. A similar contribution of omega-3 fatty acids to coronary artery disease may explain the well-described links between coronary artery disease and depression. Conclusions: Deficits in omega-3 fatty acids have been identified as a contributing factor to mood disorders and offer a potential rational treatment approach. This review identifies a number of hypotheses and studies for consideration. In particular, the authors argue for studies clarifying the efficacy of omega-3 supplementation for unipolar and bipolar depressive disorders, both as individual and augmentation treatment strategies, and for studies pursuing which omega-3 fatty acid, eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA), is likely to provide the greatest benefit.
View
View
View
S-Adenosyl-L-methionine: its role in the treatment of liver disorders
Conference Paper
  • Nov 2002
S-Adenosyl-L-methionine (SAMe) exerts many key functions in the liver, including serving as a precursor for cysteine, 1 of 3 amino acids of glutathione-the major physiologic defense mechanism against oxidative stress. SAMe is particularly important in opposing the toxicity of free oxygen radicals generated by various pathogens, including alcohol, which cause oxidative stress largely by the induction of cytochrome P4502E1 (CYP2E1) and by its metabolite acetaldehyde. SAMe also acts as the main methylating agent in the liver. The precursor of SAMe is methionine, one of the essential amino acids, which is activated by SAMe-synthetase (EC 2.5.1.6). Unfortunately, the activity of this enzyme is significantly decreased as a consequence of liver disease. Because of decreased utilization, methionine accumulates and, simultaneously, there is a decrease in SAMe that acquires the status of an essential nutrient and therefore must be provided exogenously as a supernutrient to compensate for its deficiency. Administration of this innocuous supernutrient results in many beneficial effects in various tissues, mainly in the liver, and especially in the mitochondria. This was shown in alcohol-fed baboons and in other experimental models of liver injury and in clinical trials, some of which are reviewed in other articles in this issue.
View
Effectiveness of St. John's Wort in major depression: A randomized controlled trial
Article
  • Jan 2001
Background: Extracts of St. John's wort (Hypericum perforatum) are widely used to treat depressive disorders. Although an extensive literature purports the effectiveness of St. John's wort in treating depression, most studies involving this herbal remedy have been compromised by methodological shortcomings. This multicenter, randomized, double-blind, placebocontrolled trial was conducted to ascertain the efficacy, safety, and tolerability of a standardized preparation of St. John's wort in the treatment of DSM-IV major depressive disorder. Method: After a 1-week placebo run-in. 200 adult outpatients (mean age = 42 years; 67.0% female, 85.9% white) with major depression who had a baseline Hamilton Rating Scale for Depression (HAM-D) score a 20 were randomly assigned to receive 8 weeks of treatment with either St. John's wort (N = 98; 900 mg/day for 4 weeks and increased to 1200 mg/day in absence of adequate response) or placebo (N = 102). In addition to the primary outcome measure of rate of change on the HAM-D, other outcome measures included the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Anxiety (HAM-A), the Global Assessment of Function (GAP), and the Clinical Global Impressions-Severity of Illness and -Improvement scales (CGIS and CG1-I). Results: Although St. John's wort was safe and well-tolerated, no significant effect was found for treatment (p = .16) or time-by-treatment interaction (p = .58) as measured by HAM-D scores, and nonsignificant effects were found for BDI and GAP scores. No difference in the proportion of subjects responding to treatment was found between groups. Although significantly more St. John's wort-treated subjects than placebotreated subjects achieved remission (p = .02). the rates in both groups were low (St. John's wort, 14/98 [ 14.3%]; placebo, 5/102 [4.9%]). Conclusion: This study did not find St. John's wort to be effective for the treatment of major depressive disorder.
View
View