Provided by David Satcher, M.D., Ph.D.
Surgeon General of the United States of America
Chapter 2
Overview of Treatment
Complementary and Alternative Treatment
Recent interest in the health benefits of a plethora of
natural products has engendered claims related to putative effects on mental
health. These have ranged from reports of enhanced memory in people taking the
herb, ginseng, to the use of the St. John’s wort flowers as an antidepressant
(see Chapter 4).
There are major challenges to evaluating the role of complementary and
alternative treatments in maintaining mental health or treating mental
disorders. In many cases, preparations are not standardized and consist of a
variable mixture of substances, any of which may be the active ingredient(s).
Purity, bioavailability, amount and timing of doses, and other factors that are
standardized for traditional pharmaceutical agents prior to testing cannot be
taken for granted with natural products. Current regulations in the United
States classify most complementary and alternative treatments as “food
supplements,” which are not subject to premarketing approval of the Food and
Drug Administration.
At present, no conclusions about the role, if any, of complementary and
alternative treatments in mental health or illness can be accepted with
certainty, as very few claims or studies meet acceptable scientific standards.
With funding from government and private industry, controlled clinical trials
are under way, including the use of St. John’s wort (Hypericum perforatum) as a
treatment for depression, and omega-3 fatty acids (fish oils) as a mood
stabilizer in bipolar depression. In addition, it is important for clinicians
and investigators to account for any herbs or natural products being taken by
their patients or research subjects that might interact with traditional
treatments.
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