Complementary and Alternative Medicine

Complementary and Alternative Medicine

Complementary and alternative medicine (CAM) is a broad category that includes any medical practices outside the mainstream. Complementary and alternative medicine (CAM) approaches might consist of changes to one’s diet, vitamins, herbal treatments, way of life, and mind-body activities. More and more people are turning to CAM as an adjunct to or replacement for conventional pharmaceuticals in psychiatric mental health care and functional medicine. In this discussion, I will explore the use of CAM in treating depression, a common mental health disorder.

Diagnostic Testing and Assessments

Before any CAM therapies, diagnostic tests and assessments should be carried out since they might reveal crucial information on a patient’s mental health. The use of established measures, such as the Beck Depression Inventory, may make an early evaluation of the severity of the depression. Additionally, laboratory examinations like a complete blood count may provide essential details about a person’s general health.

Pharmacologic Interventions

Hypericum perforatum, commonly known as St. John’s Wort, is a frequently employed CAM modality utilized for the amelioration of depressive symptoms. The medication is usually in a tablet formulation and may be ingested up to thrice per diem. The prescribed administration entails oral ingestion of 600-900 mg on a daily basis, partitioned into 2-3 intervals for a maximum of 12 weeks (NCCIH, 2020; WebMD, 2023). St. John’s wort can be procured in various topical formulations, such as ointments, creams, and gels.

Apart from St. John’s Wort, the utilization of omega-3 fatty acids has been observed as a potential remedy for depression. Omega-3 fatty acids can be observed in various sources such as fish, flaxseed, and walnuts (Liao et al., 2019; Mischoulon, 2020). Additionally, these essential nutrients can also be consumed in the form of dietary supplements. The adult populace is advised to consume a daily dosage of 1,000 mg of omega-3 fatty acids.

Mechanism of Action (MOA)

It is postulated that the mechanism of action of St. John’s Wort involves the augmentation of serotonin, dopamine, and norepinephrine levels, which are critical neurotransmitters implicated in the modulation of mood (NCCIH, 2020; WebMD, 2023). On the other hand, the mechanism of action of omega-3 fatty acids is also postulated to involve the augmentation of serotonin levels and the enhancement of neuronal activity within the cerebral cortex (Liao et al., 2019; Mischoulon, 2020).

Contraindications

It is imperative to exercise caution when consuming St. John’s Wort in conjunction with specific medications, including but not limited to antidepressants, anticoagulants, and oral contraceptives. Furthermore, it is noteworthy that St. John’s Wort can potentially diminish the efficacy of various medications, including immunosuppressants and chemotherapy drugs (NCCIH, 2020; WebMD, 2023). Henceforth, engaging in a discourse with a healthcare professional regarding any pharmaceuticals ingested before using St. John’s Wort is imperative.

The consumption of omega-3 fatty acids has been observed to potentially interact with anticoagulant medications, such as warfarin, thereby augmenting the likelihood of bleeding in specific individuals (Mischoulon, 2020). Henceforth, it is imperative to deliberate upon pharmacological interventions with a medical professional before commencing an omega-3 adjunct.

Education, Health Promotion, Maintenance, and Psychosocial Needs

Patients should be informed of the advantages and disadvantages of CAM therapies before deciding to use them (Stahl, 2013). Discussions on how regular exercise, a good diet and sufficient sleep may alleviate symptoms of depression should also occur. Patients should also be encouraged to participate in stress-relieving and life-enhancing activities like yoga, meditation, and mindfulness.

Referrals

Referrals to additional medical specialists such as psychiatrists, psychologists, and counselors should be made as needed. These recommendations may guarantee patients a thorough treatment plan that suits their unique requirements (Stahl, 2013).

Follow-Up

Patients should have routine follow-ups to evaluate their development and make any required modifications to their treatment plan (Stahl, 2013). A return to clinic (RTC) should be scheduled for within one month to assess the effectiveness of the CAM therapy and to ensure that symptoms have not worsened. A symptom assessment, a discussion of any side effects or concerns, and monitoring of any required laboratory testing should all be included in follow-up appointments.

Conclusion

CAM therapy for depression may be beneficial in place of or in addition to conventional pharmaceutical treatments. Two frequently used CAM therapies that have shown potential in treating depression are St. John’s wort and omega-3 fatty acids. Before beginning any CAM intervention, discussing with a healthcare physician about any drugs being used is crucial. Additionally, patients should get information on the possible advantages and disadvantages of any CAM intervention they are thinking about, and where required, referrals to other healthcare specialists should be made. Any required laboratory testing should also be monitored at follow-up visits, along with a discussion of any side effects or concerns.

References

Liao, Y., Xie, B., Zhang, H., He, Q., Guo, L., Subramaniapillai, M., Fan, B., Lu, C., & McIntyre, R. S. (2019). Efficacy of omega-3 PUFAs in depression: A meta-analysis. Translational Psychiatry, 9(1). https://doi.org/10.1038/s41398-019-0515-5

Mischoulon, D. (2020). Omega-3 fatty acids for mood disorders. Harvard Health Blog. https://www.health.harvard.edu/blog/omega-3-fatty-acids-for-mood-disorders-2018080314414

NCCIH. (2020). St. John’s Wort. NCCIH. https://www.nccih.nih.gov/health/st-johns-wort

Stahl, S. M. (2013). Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. In Google Books. Cambridge University Press. https://www.google.com/books/edition/Stahl_s_Essential_Psychopharmacology/cOZp5B_dwZUC?hl=en&gbpv=1&printsec=frontcover

WebMD. (2023). St. John’s Wort: Uses, Side Effects, Interactions, Dosage, and Warning. Webmd.com. https://www.webmd.com/vitamins/ai/ingredientmono-329/st-johns-wort

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Topic: Complementary and Alternative Medicine

Explore options for complementary and alternative medicine in psychiatric mental health care or functional medicine aspects that you could envision incorporating into your practice. For this discussion, since this ends your psychopharmacology and prescribing course, keep your options focused on supplements, herbs, etc.

Choose a specific diagnosis or situation that could be treated using complementary pharmacological options and include all information listed below:

Include the following:

Diagnostic testing and assessments.
Pharmacologic interventions: including dosage, route, and frequency.
Mechanism of action (MOA).
Contraindications.
Education, including health promotion, maintenance, and psychosocial needs.
Referrals.
Follow-up, including a return to the clinic (RTC) with timeframe and reason and any labs

Support your choice with at least one peer-reviewed article within the timeframe of the last 5 years.