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Current Research on Complementary and Alternative Medicine (CAM) in the Treatment of Depression: Evidence-Based Review

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Understanding Depression

Abstract

Complementary and alternative medicine (CAM) refers to a range of treatments, therapies and practices that are not considered part of conventional medicine. CAM approaches are widely used, and depression has been identified as one of the most frequent indications for CAM use. Prevalence and patterns of use are highly variable across different countries but frequently involve self-diagnosis and self-treatment. A critical review of the evidence on efficacy of CAM treatments in depression indicates that the approaches that have generated the most research interest include acupuncture, Chinese herbs, hypericum (St John’s wort), mindfulness and omega-3 fatty acids. Based on a critical review of the evidence, it appears that the most promising evidence is for hypericum (but with concerns with adverse effects and interactions), mindfulness, relaxation and yoga. Many trials are small, comparison interventions are varied, and there is a lack of systematically collated data on adverse events or long-term effects. Even where there is a strong evidence base, there may be factors preventing wider adoption for clinical use, such as concerns related to interactions or lack of standardisation or regulation of the practice and practitioners. Challenges in developing a rigorous evidence base in this area are also briefly discussed.

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References

  • Adler UC, Krüger S, Teut M, Lüdtke R, Schützler L, Martins F, Willich SN, Linde K, Witt CM. Homeopathy for depression: a randomized, partially double-blind, placebo-controlled, four-armed study (DEP-HOM). PLoS One. 2013;8(9):e74537.

    Article  CAS  Google Scholar 

  • Adler UC, Paiva NM, Cesar AT, Adler MS, Molina A, Padula AE, Calil HM. Homeopathic individualized Q-potencies versus fluoxetine for moderate to severe depression: double-blind, randomized non-inferiority trial. Evid Based Complement Alternat Med. 2011;2011:520182.

    Article  CAS  Google Scholar 

  • Akhondzadeh S, Kashani L, Fotouhi A, Jarvandi S, Mobaseri M, Moin M, Khani M, Jamshidi AH, Baghalian K, Taghizadeh M. Comparison of Lavandula angustifolia Mill. tincture and imipramine in the treatment of mild to moderate depression: a double-blind, randomized trial. Prog Neuropsychopharmacol Biol Psychiatry. 2003;27(1):123–7.

    Article  CAS  Google Scholar 

  • Al-Karawi D, Al Mamoori DA, Tayyar Y. The Role of Curcumin Administration in Patients with Major Depressive Disorder: Mini Meta-Analysis of Clinical Trials. Phytother Res. 2016;30(2):175–83.

    Article  Google Scholar 

  • Apaydin EA, Maher AR, Shanman R, Booth MS, Miles JN, Sorbero ME, Hempel S. A systematic review of St. John’s wort for major depressive disorder. Syst Rev. 2016;5(1):148.

    Article  Google Scholar 

  • Appleton KM, Sallis HM, Perry R, Ness AR, Churchill R. Omega-3 fatty acids for depression in adults. Cochrane Database Syst Rev. 2015;11:CD004692.

    Google Scholar 

  • Butler L, Pilkington K. Chinese herbal medicine and depression: the research evidence. Evid Based Complement Alternat Med. 2013;2013:739716.

    Article  Google Scholar 

  • Cavanagh HM, Wilkinson JM. Biological activities of lavender essential oil. Phytother Res. 2002;16(4):301–8.

    Article  CAS  Google Scholar 

  • Chan YY, Lo WY, Yang SN, Chen YH, Lin JG. The benefit of combined acupuncture and antidepressant medication for depression: a systematic review and meta-analysis. J Affect Disord. 2015;176:106–17.

    Article  Google Scholar 

  • Churchill R, Moore TH, Furukawa TA, Caldwell DM, Davies P, Jones H, Shinohara K, Imai H, Lewis G, Hunot V. ‘Third wave’ cognitive and behavioural therapies versus treatment as usual for depression. Cochrane Database Syst Rev. 2013;10:CD008705.

    Google Scholar 

  • Coelho HF, Boddy K, Ernst E. Massage therapy for the treatment of depression: a systematic review. Int J Clin Pract. 2008;62(2):325–33.

    Article  CAS  Google Scholar 

  • Cramer H, Anheyer D, Lauche R, Dobos G. A systematic review of yoga for major depressive disorder. J Affect Disord. 2017;213:70–7.

    Article  Google Scholar 

  • Cramer H, Lauche R, Langhorst J, Dobos G. Yoga for depression: a systematic review and meta-analysis. Depress Anxiety. 2013;30(11):1068–83.

    Article  Google Scholar 

  • Cramer H, Ward L, Saper R, Fishbein D, Dobos G, Lauche R. The safety of yoga: a systematic review and meta-analysis of randomized controlled trials. Am J Epidemiol. 2015;182(4):281–93.

    Article  Google Scholar 

  • Darbinyan V, Aslanyan G, Amroyan E, Gabrielyan E, Malmstrom C, Panossian A. Clinical trial of Rhodiola rosea L. extract SHR-5 in the treatment of mild to moderate depression. Nord J Psychiatry. 2007;61:343–8.

    Article  CAS  Google Scholar 

  • Dwyer AV, Whitten DL, Hawrelak JA. Herbal medicines, other than St. John’s Wort, in the treatment of depression: a systematic review. Altern Med Rev. 2011;16(1):40–9.

    PubMed  Google Scholar 

  • Feng L, Chiam PC, Kua EH, Ng TP. Use of complementary and alternative medicines and mental disorders in community-living Asian older adults. Arch Gerontol Geriatr. 2010;50(3):243–9.

    Article  Google Scholar 

  • Fißler M, Quante A. A case series on the use of lavendula oil capsules in patients suffering from major depressive disorder and symptoms of psychomotor agitation, insomnia and anxiety. Complement Ther Med. 2014;22(1):63–9.

    Article  Google Scholar 

  • Freeman MP, Mischoulon D, Tedeschini E, Goodness T, Cohen LS, Fava M, Papakostas GI. Complementary and alternative medicine for major depressive disorder: a meta-analysis of patient characteristics, placebo-response rates, and treatment outcomes relative to standard antidepressants. J Clin Psychiatry. 2010;71(6):682–8.

    Article  Google Scholar 

  • Galizia I, Oldani L, Macritchie K, Amari E, Dougall D, Jones TN, Lam RW, Massei GJ, Yatham LN, Young AH. S-adenosyl methionine (SAMe) for depression in adults. Cochrane Database Syst Rev. 2016;10:CD011286.

    PubMed  Google Scholar 

  • Hansen AH, Kristoffersen AE. The use of CAM providers and psychiatric outpatient services in people with anxiety/depression: a cross-sectional survey. BMC Complement Altern Med. 2016;16(1):461.

    Article  Google Scholar 

  • Hausenblas HA, Saha D, Dubyak PJ, Anton SD. Saffron (Crocus sativus L.) and major depressive disorder: a meta-analysis of randomized clinical trials. J Integr Med. 2013;11(6):377–83.

    Article  Google Scholar 

  • Henderson L, Yue QY, Bergquist C, Gerden B, Arlett P. St John’s wort (Hypericum perforatum): drug interactions and clinical outcomes. Br J Clin Pharmacol. 2002;54(4):349–56.

    Article  CAS  Google Scholar 

  • Hou WH, Chiang PT, Hsu TY, Chiu SY, Yen YC. Treatment effects of massage therapy in depressed people: a meta-analysis. J Clin Psychiatry. 2010;71(7):894–901.

    Article  Google Scholar 

  • Hsu MC, Creedy D, Moyle W, Venturato L, Tsay SL, Ouyang WC. Use of complementary and alternative medicine among adult patients for depression in Taiwan. J Affect Disord. 2008;111(2–3):360–5.

    Article  Google Scholar 

  • Jain FA, Walsh RN, Eisendrath SJ, Christensen S, Rael Cahn B. Critical analysis of the efficacy of meditation therapies for acute and subacute phase treatment of depressive disorders: a systematic review. Psychosomatics. 2015;56(2):140–52.

    Article  Google Scholar 

  • Jeong HG, Ko YH, SY O, Han C, Kim T, Joe SH. Effect of Korean Red Ginseng as an adjuvant treatment for women with residual symptoms of major depression. Asia Pacific Psychiatry. 2015;7(3):330–6.

    Article  Google Scholar 

  • Jorm AF, Morgan AJ, Hetrick SE. Relaxation for depression. Cochrane Database Syst Rev. 2008;4:CD007142.

    Google Scholar 

  • Kasper S, Volz HP, Dienel A, Schläfke S. Efficacy of Silexan in mixed anxiety-depression–A randomized, placebo-controlled trial. Eur Neuropsychopharmacol. 2016;26(2):331–40.

    Article  CAS  Google Scholar 

  • Kessler RC, Soukup J, Davis RB, Foster DF, Wilkey SA, Van Rompay MI, Eisenberg DM. The use of complementary and alternative therapies to treat anxiety and depression in the United States. Am J Psychiatry. 2001;158(2):289–94.

    Article  CAS  Google Scholar 

  • Komori T, Fujiwara R, Tanida M, Nomura J, Yokoyama MM. Effects of citrus fragrance on immune function and depressive states. Neuroimmunomodulation. 1995;2(3):174–80.

    Article  CAS  Google Scholar 

  • Kulkarni SK, Bhutani MK, Bishnoi M. Antidepressant activity of curcumin: involvement of serotonin and dopamine system. Psychopharmacology (Berl). 2008;201(3):435–42.

    Article  CAS  Google Scholar 

  • Lai J, Moxey A, Nowak G, Vashum K, Bailey K, McEvoy M. The efficacy of zinc supplementation in depression: systematic review of randomised controlled trials. J Affect Disord. 2012;136(1–2):e31–9.

    Article  CAS  Google Scholar 

  • Lemon K. An assessment of treating depression and anxiety with aromatherapy. Int J Aromather. 2004;14(2):63–9.

    Article  Google Scholar 

  • Linde K, Berner MM, Kriston L. St John’s wort for major depression. Cochrane Database Syst Rev. 2008;4:CD000448.

    Google Scholar 

  • Linde K, Mulrow CD, Berner M, Egger M. St John’s wort for depression. Cochrane Database Syst Rev. 2005;2:CD000448.

    Google Scholar 

  • Liu X, Clark J, Siskind D, Williams GM, Byrne G, Yang JL, Doi SA. A systematic review and meta-analysis of the effects of Qigong and Tai Chi for depressive symptoms. Complement Ther Med. 2015;23(4):516–34.

    Article  Google Scholar 

  • Lopresti AL, Drummond PD. Saffron (Crocus sativus) for depression: a systematic review of clinical studies and examination of underlying antidepressant mechanisms of action. Hum Psychopharmacol. 2014;29(6):517–27.

    Article  Google Scholar 

  • Mao JJ, Xie SX, Zee J, Soeller I, Li QS, Rockwell K, Amsterdam JD. Rhodiola rosea versus sertraline for major depressive disorder: a randomized placebo-controlled trial. Phytomedicine. 2015;22(3):394–9.

    Article  CAS  Google Scholar 

  • Ng QX, Koh SSH, Chan HW, Ho CYX. Clinical use of curcumin in depression: A meta-analysis. J Am Med Dir Assoc. 2017;18(6):503–8.

    Article  Google Scholar 

  • Ng QX, Venkatanarayanan N, Ho CY. Clinical use of hypericum perforatum (St John’s wort) in depression: a meta-analysis. J Affect Disord. 2017;210:211–21.

    Article  CAS  Google Scholar 

  • Oh B, Choi SM, Inamori A, Rosenthal D, Yeung A. Effects of qigong on depression: a systemic review. Evid Based Complement Alternat Med. 2013;2013:134737.

    Article  Google Scholar 

  • Okamoto A, Kuriyama H, Watanabe S, Aihara Y, Tadai T, Imanishi J, Fukui K. The effect of aromatherapy massage on mild depression: a pilot study. Psychiatry Clin Neurosci. 2005;59(3):363.

    Article  Google Scholar 

  • Parslow RA, Jorm AF. Use of prescription medications and complementary and alternative medicines to treat depressive and anxiety symptoms: results from a community sample. J Affect Disord. 2004;82(1):77–84.

    Article  Google Scholar 

  • Pilkington K, Kirkwood G, Rampes H, Fisher P, Richardson J. Homeopathy for depression: a systematic review of the research evidence. Homeopathy. 2005;94(3):153–63.

    Article  CAS  Google Scholar 

  • Pilkington K, Kirkwood G, Rampes H, Richardson J. Yoga for depression: the research evidence. J Affect Disord. 2005;89(1–3):13–24.

    Article  Google Scholar 

  • Ranjbar E, Kasaei MS, Mohammad-Shirazi M, Nasrollahzadeh J, Rashidkhani B, Shams J, Mostafavi SA, Mohammadi MR. Effects of zinc supplementation in patients with major depression: a randomized clinical trial. Iran J Psychiatry. 2013;8(2):73–9.

    PubMed  PubMed Central  Google Scholar 

  • Riley D. Hatha yoga and the treatment of illness. Altern Ther Health Med. 2004;10(2):20–1.

    Google Scholar 

  • Russo E, Scicchitano F, Whalley BJ, Mazzitello C, Ciriaco M, Esposito S, Patanè M, Upton R, Pugliese M, Chimirri S, Mammì M, Palleria C, De Sarro G. Hypericum perforatum: pharmacokinetic, mechanism of action, tolerability, and clinical drug-drug interactions. Phytother Res. 2014;28(5):643–55.

    Article  CAS  Google Scholar 

  • Sánchez-Vidaña DI, Ngai SP, He W, Chow JK, Lau BW, Tsang HW. The effectiveness of aromatherapy for depressive symptoms: a systematic review. Evid Based Complement Alternat Med. 2017;2017:5869315.

    PubMed  PubMed Central  Google Scholar 

  • Sarris J, Murphy J, Mischoulon D, Papakostas GI, Fava M, Berk M, Ng CH. Adjunctive nutraceuticals for depression: a systematic review and meta-analyses. Am J Psychiatry. 2016;173(6):575–87.

    Article  Google Scholar 

  • Sarris J, Panossian A, Schweitzer I, Stough C, Scholey A. Herbal medicine for depression, anxiety and insomnia: a review of psychopharmacology and clinical evidence. Eur Neuropsychopharmacol. 2011;21(12):841–60.

    Article  CAS  Google Scholar 

  • Sayyah M, Sayyah M, Kamalinejad M. A preliminary randomized double blind clinical trial on the efficacy of aqueous extract of Echium amoenum in the treatment of mild to moderate major depression. Prog Neuropsychopharmacol Biol Psychiatry. 2006;30(1):166–9.

    Article  Google Scholar 

  • Schrader E. Equivalence of St John’s wort extract (Ze 117) and fluoxetine: a randomized, controlled study in mildmoderate depression. Int Clin Psychopharmacol. 2000;15(2):61–8.

    Article  CAS  Google Scholar 

  • Shaw K, Turner J, Del Mar C. Tryptophan and 5-hydroxytryptophan for depression. Cochrane Database Syst Rev. 2002;1:CD003198.

    Google Scholar 

  • Shih M, Yang YH, Koo M. A meta-analysis of hypnosis in the treatment of depressive symptoms: a brief communication. Int J Clin Exp Hypn. 2009;57(4):431–42.

    Article  Google Scholar 

  • Smith CA, Hay PP, Macpherson H. Acupuncture for depression. Cochrane Database Syst Rev. 2010;1:CD004046.

    Google Scholar 

  • Solomon D, Adams J, Graves N. Economic evaluation of St. John’s wort (Hypericum perforatum) for the treatment of mild to moderate depression. J Affect Disord. 2013;148(2–3):228–34.

    Article  Google Scholar 

  • Solomon D, Adams J. The use of complementary and alternative medicine in adults with depressive disorders. A critical integrative review. J Affect Disord. 2015;179:101–13.

    Article  Google Scholar 

  • Sorbero ME, Reynolds K, Colaiaco B, Lovejoy SL, Farris C, Vaughan CA, Sloan J, Kandrack R, Apaydin E, Herman PM. Acupuncture for major depressive disorder: a systematic review. Rand Health Q. 2016;5(4):7.

    PubMed  PubMed Central  Google Scholar 

  • Taylor MJ, Carney S, Geddes J, Goodwin G. Folate for depressive disorders. Cochrane Database Syst Rev. 2003;2:CD003390.

    Google Scholar 

  • Taylor MJ, Wilder H, Bhagwagar Z, Geddes J. Inositol for depressive disorders. Cochrane Database Syst Rev. 2004;2:CD004049.

    Google Scholar 

  • Teasdale JD, Segal ZV, Williams JM, Ridgeway VA, Soulsby JM, Lau MA. Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol. 2000;68(4):615–23.

    Article  CAS  Google Scholar 

  • Unützer J, Klap R, Sturm R, Young AS, Marmon T, Shatkin J, Wells KB. Mental disorders and the use of alternative medicine: results from a national survey. Am J Psychiatry. 2000;157(11):1851–7.

    Article  Google Scholar 

  • Yary T, Lehto SM, Tolmunen T, Tuomainen TP, Kauhanen J, Voutilainen S, Ruusunen A. Dietary magnesium intake and the incidence of depression: a 20-year follow-up study. J Affect Disord. 2016;193:94–8.

    Article  CAS  Google Scholar 

  • Yeung WF, Chung KF, Ng KY, Yu YM, Zhang SP, Ng BF, Ziea ET. Prescription of Chinese herbal medicine in pattern-based traditional Chinese medicine treatment for depression: a systematic review. Evid Based Complement Alternat Med. 2015;2015:160189.

    Article  Google Scholar 

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Pilkington, K. (2018). Current Research on Complementary and Alternative Medicine (CAM) in the Treatment of Depression: Evidence-Based Review. In: Kim, YK. (eds) Understanding Depression. Springer, Singapore. https://doi.org/10.1007/978-981-10-6577-4_23

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  • DOI: https://doi.org/10.1007/978-981-10-6577-4_23

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