Behavioral Science: CAM in Psychiatry Flashcards
1
Q
Why is there little research and evidence on CAM approaches?
A
- large studies are $$$
- FDA meds require 2 studies showing safety + efficacy over placebo, most CAM tx don’t have this evidence
- fear of running trials in case tx doesn’t work
- fewer resources available for CAM
2
Q
Diet
A
- increase fruit + veg
- low Vit D, B12, folate, and iron a/w psychiatric illness
3
Q
Exercise
A
- may reset circadian clock
- improve energy, concentration, depression
4
Q
1 Carbon Cycle
A
- increases serotonin, norepi, dopamine
- folate, B12, SAMe all implicated
- adding folate, l-methylfolate, SAMe all have low level RCT data to support effective depression tx
- defect in MTHFR gene means folate can’t convert to l-methylfolate (folate can’t cross BBB)
5
Q
Fatty Acids
A
- antiinflammatory
- patients may suffer psychiatrically d/t inflammatory processes
- evidence is equivocal in tx of bipolar and MDD
6
Q
St. John’s Wort
A
- many trials support its use
- RCT and meta analyses support it over placebo
- sometimes as effective as approved antidepressants
- German data is robust, US data equivocal
7
Q
Vitamin D
A
- Vit D deficiency a/w depression
- tx is equivocal but replacement therapy is helpful in ruling out a potential cause of depression
8
Q
Zinc, Calcium, Magnesium
A
- no real data
9
Q
Breathing, yoga, mindfulness
A
- Sudarshan Kriya yogic breathing has limited but reasonable evidence of lowering MDD and PTSD sx
- mindfulness meditation has reasonable data for anxiety
10
Q
Acupuncture
A
- open label trials show effectiveness in depression
- one meta analysis, 5 small RCT suggest effectiveness in depression
- for anxiety, there is too much variability to make a conclusion
11
Q
Light therapy
A
- super effective for seasonal depression
- 30 minutes daily
- 10000lux bright broad spectrum light
