Cited by 121Complementary and Alternative Medicine StudiesTreatment of Major DepressionMedicinal Plant Extracts Effects

Complementary and alternative therapies as add-on to pharmacotherapy for mood and anxiety disorders: A systematic review

Ravindran, Arun V., da Silva, Tricia L.·2013·Journal of Affective Disorders

Abstract

Background Depressed and anxious patients often combine complementary and alternative medicine (CAM) therapies with conventional pharmacotherapy to self-treat symptoms. The benefits and risks of such combination strategies have not been fully evaluated. This paper evaluates the risk-benefit profile of CAM augmentation to antidepressants in affective conditions.Methods PubMed was searched for all available clinical reports published in English up to December 2012. Data were evaluated based on graded levels of evidence for efficacy and safety.Results Generally, the evidence base is significantly larger for depression than for anxiety disorder. In unipolar depression, there is Level 2 evidence for adjunctive sleep deprivation (SD) and Free and Easy Wanderer Plus (FEWP), and Level 3 for exercise, yoga, light therapy (LT), omega-3 fatty acids, S-adenosylmethionine and tryptophan. In bipolar depression, there is Level 1 evidence for adjunctive omega-3s, Level 2 for SD, and Level 3 for LT and FEWP. In anxiety conditions, exercise augmentation has Level 3 support in generalized anxiety disorder and panic disorder. Though mostly well-tolerated, these therapies can only be recommended as third-line interventions due to the quality of available evidence.Limitations Overall, the literature is limited. Studies often had methodological weaknesses, with little information on long-term use and on potential drug-CAM interactions. Many CAM studies were not published in English.Conclusions While several CAM therapies show some evidence of benefit as augmentation in depressive disorders, such evidence is largely lacking in anxiety disorders. The general dearth of adequate safety and tolerability data encourages caution in clinical use.

Integrity signals

Registry

Crossref · 10.1016/j.jad.2013.05.042

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196 of 196 references verified0 citation errors · 0 not checkable

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  • The finding that Seduction of Spirit participants experienced a greater reduction in depressed mood compared to other courses supports previous data on the beneficial effects of meditation specifically on depression.

    “We found that participants in the Seduction of Spirit meditation course experienced a greater reduction in depressed mood scores compared to the other courses, which supports previous data on the beneficial effects of meditation specifically on depression.34”

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Authors
Ravindran, A. V., & da Silva, T. L.
Affiliations
Centre for Addiction and Mental Health (CA)
Corresponding author
Ravindran, Arun V.
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2013-09
Volume
150
Issue
3
Pages
707-719
ISSN
0165-0327 (ISSN-L)
OpenAlex
W1977854880
Cited by
121
References
201
Citations by year
2026: 2 · 2025: 3 · 2024: 7 · 2023: 3 · 2022: 5 · 2021: 9 · 2020: 12 · 2019: 10 · 2018: 9 · 2017: 14 · 2016: 18 · 2015: 18 · 2014: 7 · 2013: 4
FWCI
3.64
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Complementary and alternative medicine › Medicinal Plant Extracts Effects
Keywords
complementary and alternative medicine, adjunctive therapy, antidepressants, depression, anxiety disorders, bipolar depression, sleep deprivation, physical activity, yoga, phototherapy, omega-3 fatty acids, S-adenosylmethionine, tryptophan, generalized anxiety disorder, panic disorder, safety and tolerability
MeSH terms
Complementary Therapies, Anxiety Disorders, Combined Modality Therapy, Female, Humans, Male, Phototherapy, S-Adenosylmethionine, Tryptophan, Yoga, Fatty Acids, Omega-3, Meditation, Mood Disorders

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