There are several natural treatments out there that may be helpful in psychiatry. Recently, the British Journal of Psychiatry published a review of “complementary medicines in psychiatry,” (Br J Psychiatry 2006;188:109-121). Based on this paper and our own review of recent better quality studies, TCPR offers the following list of potentially useful natural treatments.
A number of natural treatments have been subjected to the same kinds of rigorous double blind studies required of conventional medications and they have fared poorly. Four of the most commercially popular of these treatments have received particularly harsh treatment from the scientific method.
David Mischoulon, MD, PhD
Assistant Professor of Psychiatry, Harvard Medical School
Director of Alternative Remedy Studies, Depression Clinical and Research Program, Massachusetts General Hospital
Dr. Mischoulon has disclosed that he has no significant relationships with or financial interests in any commercial companies pertaining to this educational activity. The author has disclosed that acupuncture has not been approved by the U.S. Food and Drug Administration for use in the treatment of depression or substance abuse. Please consult product labeling for the approved usage of this treatment.
Dr. Mischoulon, thank you for returning to the pages of The Carlat Psychiatry Report. I know that since our last interview, you have been involved in studying the use of acupuncture in psychiatry. Tell us about that.
Andrew Weil, M.D., who founded and directs the Program in Integrative Medicine at the University of Arizona’s Health Sciences Center in Tucson, has become the symbol of alternative medicine gone mainstream.
In the dark old days of American Psychiatry, most patients were diagnosed with schizophrenia and prescribed Thorazine (chlorpromazine) or its equivalent. One of the true pioneers of rational medication treatment is Donald Klein of Columbia University, who in 1962 was a psychiatrist practicing at Hillside Hospital in New York.
Alright, we can see you stifling that yawn, and we know what you’re thinking: “What on earth is there to say about treating panic disorder other than to use SSRIs or benzos?” Well, we’re up for the challenge!
Nobody doubts that benzodiazepines (“benzos” or BZs) are effective in treating a wide range of anxiety disorders, but many believe that they are addictive, difficult and perhaps dangerous to stop taking, and that they cover up anxiety instead of truly treating it. Let’s take a closer look at each of the concerns.
Andrew Goddard, MD
Professor of Psychiatry and Radiology; Director, Adult Outpatient Clinic and Anxiety Program, Indiana University Department of Psychiatry
Dr. Goddard has disclosed that he was or is the recipient of research grants from Cephalon and Pfizer Pharmaceuticals; and was or is a consultant for AstraZeneca; and was or is a member of the speakers bureau of Pfizer Pharmaceuticals. The editors of The Carlat Psychiatry Report have closely reviewed the content of Dr. Goddard’s interview and have determined that there are no financial conflicts of interest regarding this educational activity. The author has disclosed that D-cycloserine, gabapentin, lamotrigine, pregabalin, and tiagabine have not been approved by the U.S. Food and Drug Administration for use in the treatment of anxiety. Please consult product labeling for the approved usage of these drugs.
Dr. Goddard, you’ve done a lot of neurobiological research in anxiety disorders. It’s a very complex area, but basically what goes on in patients’ brains when they have a panic attack?