Complementary and Alternative Medicines 1.· This leaflet is for anyone who would like to try complementary

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  • Complementary and Alternative Medicines 1.

    Need more information? See our latest title The Mind: A User's Guide

    Related leaflets: Complementary and Alternative treatments 2. (Acupuncture, massage and other physical treatments).

    Herbal remedies and supplements This leaflet is for anyone who would like to try complementary medicines for a mental health problem. It covers:

    Brain function and dementia Anxiety and sleep problems Depression and bipolar disorder Psychotic states Movement disorders Addictions Finding a practitioner Useful websites

    What are complementary and alternative medicines (CAMs)?

    They are ways of treating illness that have developed outside the mainstream of modern medicine. Many are traditional remedies that have developed in different cultures over the centuries. They include:

    herbal medicines foods nutritional supplements, such as vitamins and minerals

    All these treatments can be used on their own, or with conventional medicine.

    CAMs and mental health problems

    Many CAMs have been used for mental health problems but there is little good evidence to support

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  • their use. Some of these treatments may work, but most have not been thoroughly tested. The studies have often been too small to give a clear answer. We know most about the treatments for depression, anxiety and insomnia.

    Who can I speak to about CAMs?

    Your doctor, pharmacist or nurse may be able to help or suggest somebody who knows more.

    How to use CAMs safely?

    Do

    choose a qualified practitioner who is a member of a recognised society ask about their qualification and experience ask about side effects if in doubt, ask your doctor, nurse or pharmacist tell professionals involved in your care, including your CAM practitioner, about all your treatments and medications tell them if you are pregnant, plan to become pregnant or breast-feed tell them about your physical health and allergies discuss your concerns about treatment seek medical advice if you experience unusual symptoms make special time for your treatment sessions find a reliable source for your information about therapies

    Dont

    stop conventional medicines without telling your doctor believe claims for wonder cures take high doses of supplements unless confirmed with an experienced health professional combine many different remedies take complementary medicines without knowing what they are for take somebody elses complementary medicines give remedies to children without seeking specialist advice take remedies from an unreliable source - this includes the internet eat or drink raw plant material, such as flowers, fruits, leaves, seeds or the root unless you are sure it is absolutely safe. Many plants are poisonous and need to be processed before they can be used safely prepare your own teas and extracts unless you are sure it is safe smoke raw plant material pay large sums of money up front practice acupuncture or any other physical treatment on yourself unless you have been trained blame yourself if a treatment does not work.

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  • Herbal remedies and supplements Herbal remedies come from plants. If possible, choose a remedy which has been standardised, i.e. the contents are approximately the same in each bottle or tablet you buy. Plant remedies are not always safer than ordinary medicines. All of them can have side effects and interact with other medicines.

    Supplements include vitamins, minerals and animal and plant products, such as cod liver oil. They can also have side effects and interact with other medicines. Some people take supplements like vitamin C in high doses. But, this can damage the liver or kidneys. Many supplements have a recommended daily intake (RDI), or allowance (RDA). Do not go beyond this dose without talking to an experienced health professional.

    Brain function and dementia

    These are called cognitive enhancers and can improve concentration. They include:

    Ginkgo (ginkgo biloba) Ginseng (panax ginseng) Hydergine (Ergot) (claviceps purpurea) Sage (Salvia officinalis, salvia lavandulaefolia)

    Vitamin E

    Ginkgo

    Ginkgo is a tree originating in China. Extracts of its seeds and leaves are used to improve thinking in healthy people, as well as people with dementia.

    ginko

    How does it work?

    We don't know. It may:

    act as an antioxidant to prevent cell damage; increase the blood flow in the brain or increase chemical transmitters in the brain.

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  • How good is it? Research shows that Ginkgo may help in dementia. The same is true of its use in healthy adults.

    Side effects: It may, rarely, cause bleeding into the brain; an increased risk of fits and of lower fertility in men and women.

    Drug interactions with:

    blood thinning drugs such as aspirin, ibuprofen, warfarin (increases bleeding time) trazodone, (one case of coma has been reported) antidepressants, (increase the risk of going high- mania)

    anticonvulsants, reduces their effectiveness.

    Ginseng

    Ginseng grows in many parts of the world. Panax ginseng or Korean ginseng are most commonly used.

    ginseng

    How does it work?

    We don't know. It may:

    thin the blood; prevent cell damage through antioxidant activity

    How good is it? It might improve cognitive performance, but there is no evidence that it delays ageing.

    Side effects: agitation and mania; sleep problems; blood pressure changes; changes in bleeding time

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  • so people with bleeding disorders such as stroke and blood clots (thrombosis) should avoid it; it may possibly stimulate some breast cancers.

    Drug interactions with:

    drugs used in diabetes, (lower blood sugar) blood thinning agents such as aspirin, ibuprofen and warfarin, (changes in bleeding time) MAOI antidepressants (eg. Phenelzine), may lead to agitation and sleep problems.

    Hydergine

    This comes from a fungus which lives on rye. For hundreds of years it has caused epidemics of poisoning (ergotism). This is caused by eating bread made from infected rye flour.

    How does it work? It may affect the activity of brain transmitters.

    How good is it? It may improve memory in dementia.

    Side effects: It can cause fits; confusion, hallucinations and psychosis. Severe poisoning can cause gangrene.

    Drug interactions with:

    antidepressants and some pain killers; drugs for dementia; drugs for migraine.

    Sage

    Sage produces oils which are used in aromatherapy. It is used to improve concentration and memory and has been suggested as a treatment of depression and anxiety.

    How does it work? It may:

    sage plant

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  • increase some brain transmitters have antioxidant, anti-inflammatory and oestrogen effects

    How good is it? There is some evidence for improved memory in volunteers. One study found that it improved mood, alertness, calmness and contentedness. It may help concentration in people with dementia.

    Side effects: Although safe when used in amounts commonly found in foods, some types when taken orally can cause convulsions. Sage may also lower blood sugar. It should not be used in pregnancy or breast feeding

    Drug interactions with:

    drugs for diabetes; drugs for epilepsy; sedatives.

    Vitamin E (alpha-tocopherol)

    Vitamin E is found in plant oils, nuts, vegetables and to a lesser degree in meat and dairy products.

    How does it work? Antioxidant properties may prevent cell damage.

    How good is it? It may improve behaviour in dementia, but there is no good evidence that it improves memory or slows the progress of the disease.

    Side effects: A recent study found that a daily intake of more than 400IU (270 mg of alpha-tocopherol) resulted in an increase of death from all causes, and an increased risk of bleeding and stroke.

    Drug interactions with:

    drugs to thin the blood; anaesthetics and cocaine; drugs to lower cholesterol and some cancer treatments.

    Anxiety and sleep problems

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  • Most of these treatments seem to work on gamma-amino-butyric acid (GABA), a chemical in the brain linked to anxiety. We do not know if these drugs can cause addiction. They are less powerful than conventional sedatives or sleeping tablets.

    NOTE

    Kava (piper methysticum) has been withdrawn in the UK due to concerns that it might cause liver damage. It should not be used. Combinations of extracts may be less safe. There have been concerns about liver damage from combinations of valerian and other herbs.

    Remedies include

    Valerian (valeriana officinalis) Passion flower (passiflora incarnata) German chamomile (matricaria recutita) Hops (humulus lupulus) Oats (avena sativa) Starflower / borage (borago officinalis) Lemon balm (me