Complementary medicines in psychiatry: review of effectiveness and safety.
BACKGROUND
The use of complementary medicines in those with mental health problems is well documented. However, their effectiveness is often not established and they may be less harmless than commonly assumed.


OBJECTIVE
To review the complementary medicines routinely encountered in psychiatric practice, their effectiveness, potential adverse effects and interactions.


METHODS
Electronic and manual literature search on the effectiveness and safety of psychotropic complementary medicines.


RESULTS
Potentially useful substances include ginkgo and hydergine as cognitive enhancers, passion flower and valerian as sedatives, St John's wort and s-adenosylmethionine as antidepressants, and selenium and folate to complement antidepressants. The evidence is less conclusive for the use of omega-3 fatty acids as augmentation treatment in schizophrenia, melatonin for tardive dyskinesia and 18-methoxycoronaridine, an ibogaine derivative, for the treatment of cocaine and heroin addiction.


CONCLUSIONS
Systematic clinical trials are needed to test promising substances. Meanwhile, those wishing to take psychotropic complementary medicines require appropriate advice.
Werneke
Ursula
U
Division of Psychiatry, Homerton University Hospital, East Wing, Homerton Row, London E9 6SR, UK. Ursula.Werneke@elcmht.nhs.uk
Turner
Trevor
T
Priebe
Stefan
S
D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000188:drug therapy; D000529:Complementary Therapies / Q000009:adverse effects / Q000379:methods*; D003704:Dementia / Q000188:drug therapy; D020820:Dyskinesias / Q000188:drug therapy; D004877:Ergoloid Mesylates / Q000627:therapeutic use; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D001523:Mental Disorders / Q000628:therapy*; D018697:Nootropic Agents / Q000627:therapeutic use; D008517:Phytotherapy / Q000379:methods; D028321:Plant Preparations / Q000627:therapeutic use; D012436:S-Adenosylmethionine / Q000627:therapeutic use; D012643:Selenium / Q000627:therapeutic use; D019966:Substance-Related Disorders / Q000188:drug therapy
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives; D018697:Nootropic Agents; D028321:Plant Preparations; D012436:S-Adenosylmethionine; D004877:Ergoloid Mesylates; D005492:Folic Acid; D012643:Selenium