Friday, January 7, 2011

Healthier Ways to Treat Depression: Homeopathy to the Rescue (again)

Depression lowers the spirits and drowns the eyes in sorrow, though tears aren't the only reason why depressed people sometimes can't see straight. Depression also caves in the chest, slumps the shoulders, and inhibits full breathing, usually forcing unhappy people to try to catch their breath by frequent sighing. It is sometimes said that depression brings you down to sighs (my apology to those readers who get depressed by bad puns).


On a much more serious note, depression can be a temporary passing experience or a deeply disturbing condition that may lead to suicide. Except in cases of minor depressive states, professional attention is generally recommended to help a person go through this emotional experience in a conscious manner.



The Real Dangers of Conventional Medical Treatment


Recent studies published in leading medical journals have seriously questioned the efficacy of conventional pharmaceutical treatment of people with mild or moderate depression.

In early 2010, major media reported on a significant review of research testing antidepressant medications.(1) What is unique about this review of research is that the researchers evaluated studies that were submitted to the U.S. Food and Drug Administration (FDA), though the researchers discovered that many studies submitted to the FDA were unpublished (they found that the unpublished research consistently showed negative results of antidepressants).

This meta-analysis of antidepressant medications found only modest benefits over placebo treatment in published research, but when unpublished trial data is included, the benefit falls below accepted criteria for clinical significance.

Perhaps most startling about this research is the fact the FDA only requires drug manufacturers to provide them with two positive studies on depression to attain FDA-approval status, even if these same drug companies submit many more studies with negative results. Such information forces consumers to question the efficacy of "FDA approved drugs," and it explains why so many conventional medications eventually get withdrawn from marketplace.


At the same time that the above review research was published, another review of research was published in JAMA (Journal of the American Medical Association), and they found similar results, "The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms."(2) These researchers did find benefits from the use of antidepressants in the treatment of severe depression, but because the majority of people taking antidepressants today do not have "severe depression," it is prudent for many people with depression to talk to their doctors about safer and more effective alternatives.

Sadly (and strangely), when conventional doctors today do not obtain adequately effective results with one drug, they often simply prescribe more drugs in hopes that one of them, or their combination, will be more effective (whether this increased use of drugs is effective or not, there are certain "benefits" that drug companies receive from this strategy). However, increasing research is finding that "polypharmacy" (the use of multiple drugs concurrently) may lead to worse, not better, results. New research has shown that polypharmacy with psychotropic medications in suicidal adolescent inpatients has been linked to a significantly increased risk for early readmission.(3)

Presented at Ohio State University and Nationwide Children's Hospital, the researchers found that suicidal adolescent inpatients receiving three or more different classes of psychotropic medications had a 2.6-fold increased risk of being re-admitted within 30 days of discharge.

Cynthia A Fontanella, PhD, the lead researcher, asserted, "Our finding that polypharmacy was associated with an increased risk of readmission is concerning, although not surprising." Even though the serious problems with polypharmacy are known and expected, polypharmacy is growing in mental health care, not decreasing.

Other researchers discovered a disturbing trend among the over 13,000 visits of outpatients with mental disorder diagnoses: the number of psychotropic medications prescribed increased in successive years. Visits in which two or more medications were prescribed increased from 42.6 percent in 1996-1997 to 59.8 percent in 2005-2006, and those in which at least 3 medications were prescribed virtually doubled from 16.9 percent to 33.2 percent.(4)


Why Mental Illness is Increasing

There are numerous theories for why the number of people suffering from mental illness is increasing and why it is afflicting people at younger and younger ages. The homeopathic analysis for this epidemic is unique and may provide additional insight as to why this is occurring.

Like most observers of health and medicine today, homeopaths do not believe that there is simply one reason for the increase in mental illness, though many homeopaths assert that iatrogenesis (doctor-induced disease) plays a much greater role than is commonly recognized.

Homeopaths, like modern-day physiologists, understand that symptoms of illness represent the body's defenses in its efforts to adapt to and respond against infection, environmental assault, or stress of some kind. As discomforting as symptoms can be, they still represent the living organism's best efforts at the time to try to defend and heal him or herself. Such defenses are an innate part of our evolutionary efforts to survive. The symptoms that a person experiences are a part of the body's innate wisdom, commonly referred to as "vis mediatrix naturae" (the healing power of nature).

Using conventional medications to inhibit or suppress a symptom may be effective temporarily, but THIS is often the "bad news." Because symptoms as diverse as fevers, coughs, nasal discharges, or even high blood pressure are recognized by physiologists as adaptations and defenses of the body, drugs that inhibit these symptoms may provide a short-term benefit, but such drugs also reduce the person's ability to get over the illness. More significantly and more seriously, conventional medications may actually suppress the disease process and the wisdom of the body, thereby creating a deeper and more serious illness.

The irony to "modern scientific medicine" is that the evidence that doctors proudly show that a drug "works" is often actually evidence that the drug is effective in suppressing, not curing, a specific symptom (there are, of course, many exceptions to this general observation, such as antibiotics, but antibiotic drugs create other problems about which this writer and many others have commented already).

For over 200 years homeopaths have observed the ability of many conventional drugs to suppress acute illness into more deep chronic illness. During this time, homeopaths have also found that this disease suppression also creates more and greater mental illness. When reviewing the side-effects of many drugs, it is not uncommon to find that drugs are known to lead to various states of mental illness from depression to delusion to suicidal propensities.

Just as suppressing one's emotions often leads to a later explosion of these emotions to someone who happens to be at the wrong place at the wrong time, suppressing physical symptoms can lead to a more serious physical disease or a more disturbing mental illness. Using drugs to provide temporary relief does have some type of cost, and the cost is usually a later and more serious ailment.


Homeopathic Treatment of Depression

The Menninger Clinic is world-renowned as one of the leading mental health centers for research and treatment. Most people don't know it, but the founder of the Menninger Clinic, Charles Frederick Menninger, MD, was originally a homeopathic physician. He was even the head of his local homeopathic medicine society and was so frequently impressed with the results that he got from homeopathic medicines, he once said, "Homeopathy is wholly capable of satisfying the therapeutic demands of this age better than any other system or school of medicine." (5)

Numerous studies have shown benefits in using the herb, St. Johns wort, to treat mild to moderate depression. However, homeopaths generally find that it is preferable to prescribe individualized homeopathic remedies to each patient to attain better long-term sustained results without having to take continual doses of any medicine (natural or otherwise). In fact, a recent study published in a medical journal published by Oxford University Press found that individualized homeopathic treatment is as effective and is safer than Prozac in the treatment of people with moderate or severe depression.(6)

This study included 91 outpatients with moderate to severe depression who received an individually chosen homeopathic medicine or fluoxetine (Prozac) 20 mg/day (up to 40 mg/day) in a prospective, randomized, double-blind double-dummy eight week trial. The primary efficacy measure was the mean change in MADRS depression scores (MADRS is a commonly used observer rated depression scale, with a score of 32 representing the "severe depression"). The average MADRS of patients in this study was 29.

The mean MADRS scores differences were not significant on the fourth (p=0.654) and eigth weeks (p=0.965) of treatment, which suggests that the two methods are treatment are equally effective. There were also no significant differences between the percentages of response or remission rates in both groups. The study also found a higher but non-significant percentage of patients treated with Prozac reported troublesome side effects, and there was a trend toward greater treatment interruption for adverse effects in the Prozac group.

Those people who claim to be "skeptics" of homeopathy will be surprised and impressed to know that two specialty medical journals published a double-blind and placebo controlled study on mice and found that one of the medicines in the above study, Gelsemium sempervirens, had anxiety-related effects.(7)(8)

Jonathan Davidson, MD, a professor of psychiatry at Duke University, conducted a small study of adults with major depression, social phobia, or panic disorder. He found that 60 percent of the patients responded favorably to homeopathic treatment.(9) When one recognizes the considerable safety of homeopathic medicines and the benefits that some patients get from this safer method of treatment, it is remarkable that the majority of psychiatrists and psychologists do not yet refer appropriate patients to homeopaths prior to prescribing powerful conventional drugs for them.

A clinical outcome study of interest involved 14 physicians of the United Kingdom's Faculty of Homeopathy (13 NHS GPs and 3 private practitioners) who treated a wide variety of people with chronic ailments.(10) The outcome scores from 958 individual patient conditions having two or more appointments found that 75.9 percent experienced a "positive outcome," 14.7 percent had no change, and 4.6 percent experienced deterioration in health. Patients with the highest positive scores (over 50 percent of patients who self-scored a +2 or +3 on a 7 point Likert scale from -3 to +3) were achieved in the treatment of anxiety, catarrh, colic, cystitis, depression, eczema, irritable bowel syndrome, and PMS. A total of 63.6 percent of patients with depression self-scored a +2 or +3 result from homeopathic treatment.

More information on the homeopathic treatment of mental illness and more scientific evidence verifying its efficacy is contained in a newly published textbook on the subject, Homeopathy and Mental Health Care: Integrative Practice, Principles, and Research .


How NOT to Use Homeopathy for Depression

In early 2010, Alexa Ray Joel, the daughter of singer Billy Joel and actress/model Christy Brinkley, supposedly tried to kill herself by taking a homeopathic medicine, called Traumeel. Anyone with the simply elementary knowledge of homeopathy knows that one cannot commit suicide taking homeopathic medicines due to the extremely small doses in these medicines. Even homeopathy's most ardent skeptics must have had a good laugh at this media report.

After the initial media report about Alexa Ray Joel's suicide attempt, she went public with the fact that she suffered from depression as a result of a break-up in a relationship. And yet, Ms. Joel did not correct the misunderstanding of homeopathic medicine or the assertions made claiming that she (or anyone) could kill themselves with a homeopathic remedy. Sympathy is certainly appropriate for anyone who experiences such emotional trauma from the break-up of a love relationship to consider suicide. However, we should be wary of actions that inappropriately seek to tarnish the reputation of good companies or safe medicines.



Why Homeopathy Makes Sense for Depression

Homeopathic medicines are not prescribed based on the person's diagnosed disease but on the unique way the person experiences his or her disease. In other words, homeopathic medicines are prescribed based on the SYNDROME of various physical and psychological symptoms, not just a single symptom or disease label. Although the selection of the correct homeopathic prescribing is more complex than the use of conventional drugs or even many herbal preparations, the system of prescribing that is individualized to the whole person is intellectually sound... and its results are often significant if not substantial.

The premise behind homeopathy is that symptoms of illness are not just something "wrong" with the person but are actually efforts of their bodymind to fight infection and/or to adapt to stress. Instead of using large doses of pharmacological agents to inhibit or suppress symptoms, very small and specially prepared doses of medicinal substances are individually prescribed to a person for their unique ability to cause in overdose the similar symptoms that the sick person is having. By finding a medicine that matches the symptoms of the sick person, the medicine supports and augments the body's defenses. Ultimately, homeopathy is what Stewart Brand, founder of the Whole Earth Catalog, called "medical aikido" because it goes with, rather than against, the force of the disease. It is also a type of "medical biomimicry."

There is, indeed, much more that could be said about the sophisticated system of healing that homeopathy embodies and on the historical and scientific evidence that verifies its safety and efficacy, but the above information and insights provide a good introduction to why people with mild to moderate depression might be consider seeking professional homeopathic care.



REFERENCES:

(1) Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, et al. (2008) Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration. PLoS Med 5(2): e45. doi:10.1371/journal.pmed.0050045 http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050045

(2) Fournier JC, DeRubeis RJ, Hollon SD, Dimidjian S, Amsterdam JD, Shelton RC, Fawcett J. Antidepressant Drug Effects and Depression Severity: A Patient-Level Meta-analysis. JAMA. 2010;303(1):47-53. http://jama.ama-assn.org/cgi/content/short/303/1/47?home

(3) Fontanella CA, Bridge JA, Campo JV. Psychotropic medication changes, polypharmacy, and the risk of early readmission in suicidal adolescent inpatients. Ann Pharmacother. 2009 Dec;43(12):1939-47.
(4) Mojtabai R, Olfson M. National Trends in Psychotropic Medication Polypharmacy in Office-Based Psychiatry. Arch Gen Psychiatry. 2010;67:26-36.

(5) Menninger, C. F. The Application as Well as the Similar, Transactions of the American Institute of Homeopathy, 1896, pp. 317-324.

(6) Adler UC, Paiva NMP, Cesar AT, Adler MS, Molina A, Padula AE, Calil HM. Homeopathic individualized Q-potencies versus fluoxetine for moderate to severe depression: double-blind, randomized non-inferiority trial. Evid Based Complement Alternat Med. 2009 Aug 17. http://ecam.oxfordjournals.org/cgi/content/full/nep114v1

(7) Bellavite P, Magnani P, Zanolin E, Conforti A. Homeopathic Doses of Gelsemium sempervirens Improve the Behavior of Mice in Response to Novel Environments. Evid Based Complement Alternat Med. 2009 Sep 14. http://www.ncbi.nlm.nih.gov/pubmed/19752165?dopt=Abstract

(8) Magnani P, Conforti A, Zanolin E, Marzotto M, Bellavite P. Dose-effect study of Gelsemium sempervirens in high dilutions on anxiety-related responses in mice. Psychopharmacology (Berl). 2010 Apr 20.

(9) Davidson, J, Morrison, R, Shore, J, et al., Homeopathic Treatment of Depression and Anxiety," Alternative Therapies, January, 1997,3,1:46-49.

(10) Mathie, RT, Robinson, TW. Outcomes from Homeopathic Practice in Medical Practice: A Prospective, Research-Tarageted, Pilot Study, Homeopathy. 2006,95:199-205.

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