Herbal and naturopathic medicine for anxiety and depression


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Overview: Approximately 20%-25% of the population will be affected with an anxiety or depressive disorders at some point in their lives. This area represents a significant treatment focus of CAM clinicians. Methods: This presentation reviews the current evidence of herbal and naturopathic medicine with evolving evidence in the treatment of anxiety and mood disorders. Specifically the presentation begins with discussion on the results of our recent review of herbal anxiolytics. Next the results of an RCT using kava for the treatment of generalised anxiety disorder will be detailed. The presentation concludes with the results of the first observational pilot study of naturopathic medicine for treating depression and anxiety. Results: Our literature review revealed 54 plants with preclinical evidence of anxiolytic activity. Of these plants, 21 had human clinical trial evidence, with other 33 having solely preclinical studies. Some of the plants, including St John's wort, are discussed in this presentation. One specific study concerns a recent 6-week RCT using standardized kava tablets versus placebo for 75 patients with GAD. Results revealed a significant reduction in HAMA-rated anxiety for the kava group compared to the placebo group with a moderate effect size (p=0.046, d=0.62). Within the kava group, GABA transporter polymorphisms rs2601126 (p=0.046) and rs2697153 (p=0.02) were associated with HAMA reduction. The presentation concludes with findings of an observational pilot study of naturopathic consultations of adults (aged 18-70) who presented with self-reported depression or anxiety. Eleven naturopaths provided data for analysis, consisting of 31 consultations from 16 patients. Across time from baseline to study conclusion (over two follow-up visits), a significant reduction occurred for DASS depression, anxiety, and stress; GHQ somatic symptoms, anxiety/insomnia and social dysfunction. Results were mirrored on the POMS. Conclusions: Evidence is evolving for the use of select herbal anxiolytics and antidepressants, while our preliminary pilot study indicates that naturopathic medicine may be an effective integrative approach for improving mental health. 

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