Results
Our searches generated 378 articles, of which 340 had to be excluded (Figure 1). Thus, 35 reports met our eligibility criteria.[5–40] Table 1 summarises direct AEs associated with the use of homeopathy. Table 2 presents indirect AEs related to the substitution of conventional care with homeopathy.
Figure 1.
Flow diagram
The total number of patients amounted to 1159 (of those 1142 AEs were classified as direct and 17 as indirect AEs). The included articles originated from Austria,[5] Belgium,[20,31] Brazil,[16] Denmark,[23] France,[10,13,15] Germany,[36,38,40] Holland,[37] India,[32] Ireland,[18] Israel,[9,17,26] Italy,[11] Mexico,[29] Spain,[6,8,33] Sweden,[19] Switzerland,[25,39] UK[21,28] and the US.[14,22,24] They were published between 1978 and 2010.
The implicated homeopathic remedies included Aconitum 1000, AKO-PLEX, Arsenic Bromide 1-X, Arsenicum Sulfuratum Flavum-1-X, Baryta carbonica, BHI Regeneration Tablets, calcium carbonicum, Cantharis 1000, caesium chloride, chromium, Forte Saponaria, Gambogia, Gali-col Baby, hypericum perforatuma, Ipecacuanha, iron, Kalium Bichromicum, Ledum Palustre, Lilium Compositum, Loco X112, Lycopodium, Malaria Officinalis, Mercurius Heel®S, Mercurius 6a, Mercurius Sublimatus Corrosivus, Nat Mur 200, Notakehl, Nux Vomica, OT-10 and Penicillium Chrysogenum, Pentackan Sinnabaum, Petroleum D-5, Peruvian bark, Pulsatilla, Rhododendron Ferrugineum, Rhus Toxicodendron, Ruta Graveolens, Sedativ PC, Slenderness Drops, Solanum Compositum, sulphur, tanacetum, thuja, tuberculinum or unspecified homeopathic remedies.
Direct AEs included abdominal pain, flatulence, acute erythroderma, acute pancreatitis, severe allergic reactions, atopic dermatitis, burning lips, nausea, emesis, apnoea, cyanosis, regurgitation, anaphylaxis, arsenical keratosis and cancer, bladder cancer, bullous pemphigoid, severe asthenia, cardiac arrest, cognitive-behavioural disorders, coma, death, dermatitis, severe pulmonary involvement, emesis, euphoria, extreme agitation, hyponatraemia and hypoalbuminaemia, erythaema, limb oedema, irritability and albuminuria, melanosis and keratosis, skin lesions, acute gastrointestinal illness, leukopaenia, thrombocytopaenia, diffuse dermal melanosis, metabolic acidosis, weight loss, chronic diarrhoea, morbiliform and pruritic rash with hospital admission, multiple alopecia and hair loss, pain, pancreatitis, problem with balance, somnolence, pruritus, swelling and erythroderma, renal failure with metabolic acidosis, interstitial nephritis and hyperkalaemia, severe acute tubulointerstinal nephritis, severe bradycardia, reversible panconduction defect, hypotension and syncope, severe swelling, bleeding, rashes, sneezing, rhinitis, slight lethargy, symptoms of thall poisoning, tachypnea, high fever, lower limb areflexia, hypotension, pupillary abnormalities, gait ataxia, widespread leukocytosis and widespread maculopapular vesicular rash. Direct AEs of homeopathy occasionally resulted in serious outcomes including cancer, death, dialysis, toxic polyneuropathy and quadriparesis. In several instances, patients presenting AEs required hospital admission[7,14,18,19,24] and pharmacotherapy.[5,18,29,35,36]
Indirect AEs included deterioration of pulmonary allergy, deterioration of sarcoidosis glomerulonephritis, hypertensive heart failure and encephalopathy, haemophilus influenzae meningitis, septicaemia high fever and seizures, malignant melanoma, multiple organ system failure, oedema, pneumococcal pneumonia with purulent pericarditis and coma, sepsis and death and severe aggravation of atopic dermatitis. Indirect AEs of homeopathy resulted in the following clinical outcomes: death, permanent hypertension, hydrocephalus and the need for neuro-surgical drainage.
The duration of AEs ranged from a few hours[22] to 7 months.[9,16] Eighteen patients experienced a full recovery[6,7,9–12,14,16,18,21–25,29–31,33,35,36,39] and four died.[8,26,32,41] In six cases, details of AEs were insufficient for a judgment regarding cause and effect.[13,19,27,28,34,37,38,40] In 17 cases, causality was deemed to be likely, certain in six, almost certain in 12 and unclear in one. The AEs were caused by allergic reactions,[5,6,8,11,19,27,34,36,39] ingestion of toxic substances[6,7,12,21,22,24,25,29–33,35,37] and substitution of conventional care.[9,13,15,17,19,23,26,41]
Int J Clin Pract. 2012;66(12):1178-1188. © 2012 Blackwell Publishing
