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19 Cards in this Set
- Front
- Back
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How many use CAM
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Up to 50% of people seeking care are using CAM
Up to 77% of those people do not disclose to their Doctor that they are |
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Who is using CAM
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Black americans have highest rates(70%) other races are at about (60%)
those with psychiatric diseases are most likely to use CAM than other diseases |
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Why psychiatric disorders and CAM
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CAM used more for chronic disease
Stigma keeps patients away from Doctor’s offices Fear of addiction or abuse with prescription meds Search for a “healthy” way to cure illness |
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Other medical areas where CAM is common
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Chronic Pain
Nausea from Chemotherapy Chronic Fatigue Arthritis Menopause HIV+ |
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Who uses CAM most?
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Women than men
People with higher educational levels People who have been hospitalized in the past year |
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What are Patients Looking Seeking in CAM?
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Modification of symptoms
Feeling of self-efficacy No side effects Improved health Avoidance of the sick role Low cost |
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St. John’s Wart (Hypericum perforatum)
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Centuries-old supplement
Widely available supplement May be similar in activity to SSRI Widely prescribed in Europe for depression |
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Supporting Evidence of St. John's Wart
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A review of 23 clinical studies found that the herb might be useful in cases of mild to moderate depression. The studies, which included 1,757 outpatients, reported that St. John's wort was more effective than a placebo and appeared to produce fewer side effects than some standard antidepressants (Linde et al. British Medical Journal, 1996)
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Detracting Evidence of St. John's Wart
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A large government-sponsored research study found that St. John's Wort was no more effective for treating major depression of moderate severity than placebo (Hypericum Depression Trial Study Group. JAMA, 2002;
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Risks of St. Johns Wart
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Drug-drug interactions
Risk of poorly treated depression Side-effects -Nausea, dry-mouth, fatigue |
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Benefits of St. Johns Wart
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Lower cost
No sexual side effects No need to see a Doctor |
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SAMe (S-Adenosyl-L-methionine)
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Metabolite of essential amino acid
Used for mood elevation and osteoarthritis No known drug interactions |
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Clinical Trials on SAMe
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Compared to placebo, treatment with SAMe was associated with statistically as well as clinically significant improvement and is equivalent to a partial response to treatment.
Compared to treatment with conventional antidepressant pharmacology, treatment with SAMe was not associated with a statistically significant difference in outcomes http://www.ahrq.gov/clinic/epcsums/samesum.htm |
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Challenges of SAMe
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Must evaluate for overly elevated mood
Dosage varies widely (200-1600mg) Caution in patients with cancer |
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Fish Oil (omega-3 fatty acid)
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Lipid found in fish
Some evidence that mood disorders are associate with fatty acid composition Few clinical trials showing benefit in bipolar disorder and in schizophrenia |
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Fish Oil (omega-3 fatty acid)studies
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In 2001, Dr. Joseph Hibbeln, a senior clinical investigator at the National Institutes of Health, published a study, provocatively titled "Seafood Consumption and Homicide Mortality," that found a correlation between a higher intake of omega-3 fatty acids (most often obtained from fish) and lower murder rates. (New York Times, April 16, 2006)
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Adverse Effects of Fish Oil
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GI upset
Fishy-smelling breath Caution in hemophiliacs Interacts: coumadin, ASA, NSAIDs, garlic, ginkgo Stop prior to surgery |
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Melatonin
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Hormone found in the pineal gland
Used for sleep disturbance Sets timing of circadian rhythm endogenously Studies show safety but limited use in secondary sleep disorders Overdose a risk |
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Non-supplement Techniques
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Chelation therapy
Accupuncture/accupressure Self-help groups -AA, Overeaters Anonymous Yoga Pastoral Counseling |
