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19 Cards in this Set

  • Front
  • Back
How many use CAM
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
Who is using CAM
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
Why psychiatric disorders and CAM
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
Other medical areas where CAM is common
Chronic Pain
Nausea from Chemotherapy
Chronic Fatigue
Who uses CAM most?
Women than men
People with higher educational levels
People who have been hospitalized in the past year
What are Patients Looking Seeking in CAM?
Modification of symptoms
Feeling of self-efficacy
No side effects
Improved health
Avoidance of the sick role
Low cost
St. John’s Wart (Hypericum perforatum)
Centuries-old supplement
Widely available supplement
May be similar in activity to SSRI
Widely prescribed in Europe for depression
Supporting Evidence of St. John's Wart
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)
Detracting Evidence of St. John's Wart
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;
Risks of St. Johns Wart
Drug-drug interactions
Risk of poorly treated depression
-Nausea, dry-mouth, fatigue
Benefits of St. Johns Wart
Lower cost
No sexual side effects
No need to see a Doctor
SAMe (S-Adenosyl-L-methionine)
Metabolite of essential amino acid
Used for mood elevation and osteoarthritis
No known drug interactions
Clinical Trials on SAMe
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
Challenges of SAMe
Must evaluate for overly elevated mood
Dosage varies widely (200-1600mg)
Caution in patients with cancer
Fish Oil (omega-3 fatty acid)
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
Fish Oil (omega-3 fatty acid)studies
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)
Adverse Effects of Fish Oil
GI upset
Fishy-smelling breath
Caution in hemophiliacs
Interacts: coumadin, ASA, NSAIDs, garlic, ginkgo
Stop prior to surgery
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
Non-supplement Techniques
Chelation therapy
Self-help groups
-AA, Overeaters Anonymous
Pastoral Counseling