Complementary and Alternative Medicine in the Treatment of Anxiety and Depression

Gill van der Watt; Jonathan Laugharne; Aleksandar Janca

Disclosures

Curr Opin Psychiatry. 2008;21(1):37-42. 

In This Article

Abstract and Introduction

Abstract

Purpose of Review: There is well documented evidence for the increasing widespread use of complementary and alternative medicine in the treatment of physical and psychiatric symptoms and disorders within Western populations. Here we provide a review of the recent literature on evidence for using such interventions in the treatment of anxiety and depression.
Recent Findings: With regard to herbal treatments, kava is effective in reducing anxiety symptoms and St John's wort in treating mild to moderate depression. The association of kava with hepatotoxicity, however, is a significant concern. Promising data continue to emerge for the use of omega-3 fatty acids in managing depression. Evidence for the use of acupuncture in treating anxiety disorders is becoming stronger, although there is currently minimal empirical evidence for the use of aromatherapy or mindfulness-based meditation.
Summary: The evidence base for the efficacy of the majority of complementary and alternative interventions used to treat anxiety and depression remains poor. Recent systematic reviews all point to a significant lack of methodologically rigorous studies within the field. This lack of evidence does not diminish the popularity of such interventions within the general Western population.

Introduction

Interest in complementary and alternative medicine (CAM) continues to grow as an increasing number of people, including health care professionals, look at ways to improve their own lives and those of others by using a variety of alternatives to conventional medicine. There are difficulties in reviewing research in CAM because of the diversity of practices included under the term and the various ways in which it is applied across different cultures. The World Health Organization refers to the increase in the use of nonconventional medicine, meaning traditional, complementary and alternative medicine, in countries all over the world in its Traditional Medicine Strategy 2002-2005.[1] Some authors group complementary medicines into herbal remedies (food supplements that include vitamin preparations and other organic and inorganic substances, such as omega-3 fatty acids),[2*] whereas others list individual therapies such as acupuncture, aromatherapy, herbal therapy, homeopathy, iridology, naturopathy and reflexology under the umbrella of CAM.[3,4,5,6,7*,8*,9] There is ongoing debate regarding the level of evidence required by the scientific community and appropriate methodological approaches in CAM research, including the feasibility and complexities of using randomized controlled trials (RCTs) and difficulties in identifying suitable placebos.[10]

Kessler et al.[11] reported data on the use of complementary therapies to treat anxiety and depression in the USA, which indicate that complementary and alternative therapies are used more than conventional therapies by people with anxiety and severe depression. This large-scale study found depression, anxiety and insomnia to be among the most common reasons for people to use complementary therapies. For example, 53.6% of respondents suffering from severe depression reported using complementary and alternative medicine for treatment during the 12 months before the survey.

In the UK, estimates of the proportion of the general population using CAM range from 14% to 30%[12] and consumer surveys in other European countries indicate positive public attitudes toward the use of complementary therapies, with acupuncture being identified as one of the most popular forms of complementary treatment.[13] The findings of a large postal survey conducted in Australia[3] showed that people who were experiencing mild to moderate depression chose self-help strategies and complementary therapies such as aromatherapy, St John's wort, meditation and nutritional supplements rather than seeking professional help. In contrast, those with severe depression were more likely to seek conventional professional help and did not tend to use complementary therapies.

Here we review recent research in CAM approaches to the treatment of anxiety and depression, including use of herbal interventions, nutritional and dietary supplements, acupuncture, light therapy, meditation and hypnosis.

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