Complementary medicines in psychiatry: review of effectiveness and safety.

Complementary medicines are commonly used by people with mental health problems, but their effectiveness is often unproven and they may not be as harmless as assumed. A review of the literature found potentially useful substances: 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. Evidence is less conclusive for omega-3 fatty acids in schizophrenia, melatonin for tardive dyskinesia, and an ibogaine derivative for addiction. Systematic clinical trials are needed, and users should seek appropriate advice.

Study at a glance

Abstract

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. To review the complementary medicines routinely encountered in psychiatric practice, their effectiveness, potential adverse effects and interactions. Electronic and manual literature search on the effectiveness and safety of psychotropic complementary medicines. 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. Systematic clinical trials are needed to test promising substances. Meanwhile, those wishing to take psychotropic complementary medicines require appropriate advice.