Information Survey on the Use of Complementary and Alternative Medicine

Background and Objectives: Complementary and alternative medicines (CAMs) are generally considered non-scientific and poor effective therapies. Nevertheless, CAMs are extensively used in common clinical practice in Western countries. We decided to promote a Delphi consensus to intercept the opinion of Italian physicians on CAM use in clinical practice. Materials and Methods: We run a Delphi-based consensus, interviewing anonymously 97 physicians. Of these, only 78 participate to the questionnaire. Results: Consensus about agreement and disagreement have been reached in several topics, including indication, as well as safety issues concerning CAMs. Conclusions: The use of CAMs in clinical practice still lacks evidence. Experts agree about the possibility to safely use CAMs in combination with conventional medicines to treat non-critical medical conditions.

Transdermal Nutraceuticals Delivery System for CNS Disease

Herbal medicines are being used by humans since the oldest civilizations and have been an integral part of traditional and alternative medicines. In recent times, pharmaceutical and biomedical scientists are taking interest in developing nutraceutical-based medicines to overcome the side effects and adverse drug reactions caused by allopathic medicines. Nutraceuticals have started occupying the global market. Nutraceuticals have gained widespread acceptance due to their efficacy in treating difficult to treat diseases, low toxicity, low cost, easy accessibility, etc. Safety and efficacy are other important factors in the commercialization process of nutraceuticals. Different novel advanced drug delivery systems have been constantly studied to improve the efficacy and bioavailability of medicines obtained from herbal sources. The transdermal drug delivery system provides a potent alternative to the conventional method of using nutraceuticals. The development of transdermal system-based nutraceuticals could provide the advantage of enhanced bioavailability, improved solubility, bypass the first-pass metabolism, and targeted delivery of drugs in brain-related disorders. It additionally provides the advantage of being non-invasive. This article reviews the potential effects of various nutraceuticals, in brain-related disorders as well as trends in transdermal nano-systems to deliver such nutraceuticals. We would also focus on advantages, application as well as recent United States-based patents which emphasized emerging interest towards transdermal nutraceuticals in brain disorders.

Herbal Drug Interactions

Use of complementary and alternative medicines (CAM) for preventive and therapeutic purposes has increased tremendously in the last two decades internationally. The manufacturers of these products are not required to submit proof of safety or efficacy to the Food and Drug Administration. As a result, the adverse effects and drug interactions associated with them are largely unknown. In this chapter, the author presents interactions of herbal medicines with other medicines (herbal or non-herbal). A large number of herbal drugs, including from single drug to a variety of mixtures have been used to treat kidney disorders. Herb-herb or herb drug interaction has been reported intensively during last decade, therefore it becomes important to keep an eye on the use of combination herbal therapy in order to avoid serious results because of interactions with each other. Due to the growing awareness about the interactions and side effects of herbal drugs/supplements over the past few years, regulatory bodies are working on these issues and pharmacopoeias are being developed for reference.

Homeopathy as an alternative for asthma treatment

Background: Asthma is a chronic inflammatory disease characterized by a reversible obstruction and hyperactivity of inferior aerial treat [1]. It is responsible for lifestyle modification and, considering its high frequency, it became an important issue in the budget of health services around the world. Aspects like the lack of definitive results and presence of adverse effects, observed for traditional therapy, as well as the search for better quality of life have increased patients’ interest for complementary and alternative medicines (CAM), being homeopathy one of the most cited [2]. In 2001, asthma was between the 10 diagnostics most treated by homeopaths in USA [3]. Aims: In this work, a qualitative research was made focusing the evaluation of the real contribution that homeopathy can represent for asthma patients and the role of pharmacist in this therapy. Methodology: databases such as Medline, Sciencedirect and Bireme were used to find scientific articles, applying the expressions “asthma”, “homeopathy” and “complementary and alternative medicine”. Results: At least six works demonstrate successful applications of homeopathic treatment in children or adults with asthma. The main benefits cited are the decrease of frequency and gravity of the crises, besides of some cure cases. Conclusions: Data available are still scanty about asthma homeopathic treatment. The few works found showed this kind of therapy is very adequate, mainly because of the emotional component of the disease, but also because it represents to be away from the adverse effects commonly related to the traditional therapy (e. g. corticoids). To ensure a correct therapy is being made, the pharmacist must be present and active in the patients’ identification and documentation, giving them right orientations about the use and storage of homeopathic medicines, besides of stimulating a close and confidence relationship with the homeopath. Also, the manufacturing of remedies must be according to the official guidelines in order to guarantee their quality.

Australian Community and Health Professionals Perceptions of Equine-Assisted Psychotherapy

Mental health conditions are increasingly prevalent in the Australian population, and despite the large evidence-based support for contemporary treatments, there are barriers which inhibit their efficacy. Thus, there is a perceived need for therapists to consider other therapeutic options which have potential to enhance treatment outcomes. There is increasing acceptance for complementary and alternative medicines (CAM) among general practitioners and clients/general community. Specifically, more than 70% of Australians utilize CAM. Equine-assisted psychotherapy (EAP) is an underutilized, culturally sensitive, complementary therapy, which has the potential to mitigate barriers of conventional therapy. The present study aimed to determine the level of knowledge about and general acceptance of EAP as a treatment for general psychopathology symptomology within community members and health professionals. The current sample included 144 community members and 55 health professionals, all with Australian citizenship. Data analysis comprised the independent t-test and two hierarchical multiple regressions. Results indicated that community members are significantly more accepting of EAP as a treatment compared to health professionals. Of the predictors tested, higher social support and openness within community members were significant predictors of accepting perceptions, and rural location was the only significant predictor for health professional’s accepting perceptions of EAP. This is one of the first studies to investigate perceptions of EAP outside the EAP field and through comparison between community members and health professionals. The current study identifies the need for future research to further investigate perceptions of EAP among Australian health professionals.

Talking about Complimentary and Alternative Medicine: A Conversation Analysis Study

Multiple Myeloma (MM) is a clonal plasma cell malignancy characterized by low blood counts and increased risk of infection, and primarily afflicts older adults. Although MM is incurable, advances in treatment, including autologous stem cell transplant (ASCT) has improved the lifespan of patients. MM patients commonly use over-the-counter complementary and alternative medicines (CAM) alongside conventional cancer therapies which, often without recognition by health care practitioners, may impact their treatment. Using data from an 18-month ethnographic study, we applied conversation analysis to examine 1180 minutes of audio-recordings to describe how patients and nurses interacted about CAM during ASCT education visits. Patients (n=12) had a median age of 62 years (IQR= 54-73), were mostly white (n=12, 75%), male (n=9, 56%), and had a moderate score on the FACT-G7 of 15 (IQR= 10-20). All patients had a caregiver present during their visit. Nurses (n=3) were aged 39 (IQR= 29-49) all with at least five years providing care to patients with blood cancers. Results suggested that nurses rarely provided direct feedback about CAM modalities, instead providing brief responses, and moving on to other topics. Excerpts were categorized into three groups, (1) demonstration of implicit epistemic authority, (2) demonstration of deferred epistemic authority in patient-initiated conversations, and (3) demonstration of deferred epistemic authority in nurse-initiated conversations. Understanding how conversations surrounding CAM are navigated can provide insights into patient-communication in general, and methods for improving ASCT education.

Bioactive Essential Oils from Cuban Plants: An Inspiration to Drug Development

Aromatic plants and essential oils are important agents as complementary and alternative medicines in many cultures and geographical locations. In this review, a literature search on essential oils from Cuba, their chemical compositions, and their pharmacological properties was carried out. Out of 171 published scientific articles on essential oils of Cuban plants, a total of 31 documents, focused on both chemical composition and pharmacological properties, were considered for this review. In general, an increase in articles published in the last decade was noted, particularly in recognized international journals in English. Myrtaceae and Piperaceae were the most representative families collected in the occidental area of the country. Leaves and aerial parts were predominantly used, while a wide and variable number of components were identified, including terpenes, aliphatic derivatives, sulfur-containing compounds, phenylpropanoids, alkaloids and amine-type compounds. Finally, different biological activities were reported such as antiprotozoal, antibacterial, antifungal, cytotoxic, anthelmintic, larvicidal and insecticidal. In conclusion, we encourage further studies that would promote the use of essential oils from Cuban plants in new pharmaceutical products.

Medicinal Plants Used in the Management of Psychosis

Substantial number of studies has been conducted to find alternatives or treatments for psychosis. Psychosis represents a variety of mental disorders characterized by the presence of delusions, hallucinations and grossly disorganized thinking in a clear sensorium. Psychosis is burdensome and difficult to treat given the inability of the typical and atypical antipsychotics to adequately manage it, accompanied by numerous disturbing adverse effects. Therefore, many with chronic mental health problems justifiably feel disappointed by the apparent ineffectiveness of conventional treatment and naturally search for a more holistic approach to treatment and alternative medicines having less or no side-effects. Plants are rich in secondary metabolites which have the ability to interact with the Central nervous system (CNS) to produce effects that can be beneficial for the management of psychosis, these phytochemicals are believed to have minimal adverse effects. A review of some of the medicinal plants used as antipsychotics, indicated that many medicinal plants possess antipsychotic effects that can improve the treatment of psychosis. Apparently, further studies are necessary in order to isolate the active constituents, ascertain their molecular mechanisms and safety, and also to test them in clinical studies for the development of new pharmacotherapies for psychosis.

Media and Science Policy: Who Influences Whom Regarding Complementary and Alternative Medicines Regulation

This paper analyses the synergies between press and politics in the debate on the regulation of complementary and alternative medicines (CAM) in Spain between 1979 and 2018. We argue that longitudinal analysis and comparison of this interaction and synergy reveal how the mainstream discourse has shifted. We use a dataset of news ( N = 2,059), a news sample ( n = 325) and a dataset of parliamentary records ( N = 86). Using both quantitative and qualitative approaches, the dynamics of the interaction between the different institutions and actors involved is assessed. Specifically, the study analyses the media and parliamentary attention to CAM issues (agenda setting), how CAM is addressed (framing), and the actors who have a voice in the discourse (costructuring of power relations). The results indicate that relevant changes in the public debate on CAM have only occurred over the last few years, corresponding to three overlapping dynamics of influence of the media on politics: amplification, framing, and costructuring of power relations. This recent period has seen convergence in the discussion and narratives/frames used, which also corresponds to more widespread skepticism regarding CAM.