In today’s 3 New Things series I talk about:
- A great resource for alternative medicine information
- A new St. John’s Wort and depression study
- A new “fad” diagnosis up for consideration in the Diagnostic and Statistical Manual of Mental Disorders Version V (DSM-V)
1. What I Don’t Like – Fad Diagnoses in the DSM
Psychosis Risk Syndrome (AKA attenuated psychotic symptoms) and Temper Dysregulation (AKA disruptive mood dysregulation)
See, I’m not a scientist, and I honestly can’t tell you with any degree of certainty these conditions don’t exist or that they shouldn’t be specifically diagnosed. I just don’t think so, particularly as they may be pediatric diagnoses. The concern expressed in the article* is that these diagnoses have little scientific backing and will lead to yet a further increase in prescriptions of antipsychotics to children (and others) – and that I can tell you with certainty, that I am against.
There are many issues with the new version of the DSM, due out 2013, some positive, some negative, but honestly, if I started writing about them it would take until 2013 to finish. Best to take a millimetre at a time, I say
2. What I Do Like – Alternative Medicine Index from the University of Maryland
From Wikipedia
I’m not a huge fan of alternative medicine, mostly because it, as a rule, doesn’t work. However, if you’re going to wander down that path, you need a reliable source of information and I believe the Alternative Medicine Index from the University of Maryland is it. Now, keep in mind, when you do a search for something you’re going to come up with multiple documents, and some of them are going to conflict, but nevertheless, it’s the best place I’ve found to look up the real information on alternative / supplement / herbal treatments.
3. What I Could Have Told You – St. John’s Wort Doesn’t Work for Depression
OK, technically St. John’s Wort doesn’t work better than a placebo in mild depression and earlier it was shown St. John’s Wort doesn’t work better than a placebo in moderately severe depression either. (There could be reasons for this, such as formulation and strength, but it’s what we know for now.)
Important – Please read the warning about using St. John’s Wort
(FYI, the studies were undertaken by the National Institute on Mental Health, a widely-regarded agency with (in my opinion) no conflict of interest here.) (Curious about mine?)
Until next week when I will learn more and try to do better.
* As always, the Psychiatric Times articles require a membership – but it’s free.
When it comes to medicine there are two people that I trust, my psychiatrist and my pharmacist. Both are far more knowledgable than I am and know the studies, especially my pharmacist. She’s recommended vitamin supplements and some other stuff that has a little empirical backing, but also just for proper nutrition while on these drugs. She’s also the one that tipped me off about not tolerating heat as effectively while on abilify. She also hates alternative treatments, even some natural medicines that are supposed to work. She knows the studies, and she doesn’t take them as being accurate. In my opinion, if she doesn’t ok it, I don’t take it. And she’s definitely told me not to take st. john’s wort while on any of my medications.
Hi James,
It’s interesting when people say they trust their pharmacist so much because in all the years I’ve been seeing one, they have never impressed me as much of anything. And I _wouldn’t_ trust them. I’m not likely to tell a pharmacist about the side effects of a medication but I will tell my doctor because we have an appointment for just such things. It’s odd to me that people think the pharmacist knows better than that.
(I’m not saying your pharmacist isn’t great. She might be. I just haven’t seen it personally.)
Regardless, it’s good you have someone who’s opinion you trust, because that’s important.
And she’s definitely right about St. John’s Wort – while taking antidepressants it’s _absolutely_ contraindicated. Because even if it doesn’t, statistically, work for depression, it does alter serotonin and you don’t want to be doing that in addition to whatever modifications your antidepressants are making.
– Natasha Tracy
Hi Natasha – will find a link but do know St John’s Wort has nasty interactions with some depression meds. Encountered this myself a while ago. So ineffective plus can be dangerous.
Hi Emma,
Absolutely. The FDA issued a Public Health Advisory on this matter as it doesn’t just interact with antidepressants, but also life-saving medications like HIV drugs. According to the National Institute of Mental Health:
“St. John’s wort can dangerously interact with other medications, including those used to control HIV. On February 10, 2000, the FDA issued a Public Health Advisory letter stating that the herb appears to interfere with certain medications used to treat heart disease, depression, seizures, certain cancers, and organ transplant rejection. Also, St. Johns wort may interfere with oral contraceptives.”
http://www.nimh.nih.gov/health/publications/mental-health-medications/what-medications-are-used-to-treat-depression.shtml
– Natasha Tracy