Meta-analysis: Insufficient evidence for homeopathic remedies in psychiatric disorders

Organisation: Position: Deadline Date: Location:

Available data on homeopathy in psychiatric disorders are insufficient to support their use in clinical practice, found an Italian systematic review of 212 randomised control trials.

Complementary and alternative medicine critic, Emeritus Professor Edzard Ernst notes on his blog:

“In their discussion section, they also add an interesting note of caution: Ethical considerations should therefore prevent clinicians from recommending HRs, which have a cost either for patients or for health care systems, until when a sufficient amount of solid evidence becomes available. In addition, systematic reviews of randomised trials, if unavailable, are advisable for all medical conditions for which homeopathy is currently prescribed.

“This is a rigorous, transparent and clear review which generates no surprises. Few critical thinkers would have expected a positive result. It also teaches us, I think, a valuable lesson about the difference between a rigorous and a flimsy review, between independent and biased research. “

Purpose/background: Homeopathy is a complementary and alternative medicine. Conclusive evidence on the plausibility, efficacy, and safety of these treatments is not currently available. Nonetheless, homeopathic remedies (HRs) are widespread throughout the world and especially in mental disorders. The aim is to assess the efficacy of HRs in the treatment of mental disorders.
Methods/procedures: We performed a Medline/Embase search for studies written in English and published from any date to October 23, 2018. All randomized controlled trials enrolling patients with any psychiatric disorder and comparing HR with placebo, no treatment, or other psychotropic drugs were included.
Findings/results: A total of 212 studies were screened, 9 met all selection criteria and reported data on major depressive disorder (MDD) (n = 4), generalized anxiety disorder (n = 1), attention-deficit/hyperactivity disorder (n = 2), and premenstrual syndrome/dysphoric disorder (n = 2). Eight of 9 randomized controlled trials showed high risk of bias. Homeopathy showed greater efficacy in MDD compared with fluoxetine, and in premenstrual syndrome/dysphoric disorder compared with placebo, whereas no difference emerged between homeopathy and placebo in MDD and attention deficit/hyperactivity disorder.
Implications/conclusions: Available data on homeopathy in psychiatric disorders are insufficien
t to support their use in clinical practice.

Authors
Francesco Rotella, Emanuele Cassioli, Andrea Falone, Valdo Ricca, Edoardo Mannucci

Journal of Clinical Psychopharmacology abstract

Edzard Ernst blog


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