Current research on complementary and alternative medicine (CAM) in the treatment of depression: evidence-based review

Complementary and alternative medicine (CAM) refers to a range of treatments, therapies and practices that are not considered part of conventional medicine. CAM approaches are widely used, and depression has been identified as one of the most frequent indications for CAM use. Prevalence and patterns of use are highly variable across different countries but frequently involve self-diagnosis and self-treatment. A critical review of the evidence on efficacy of CAM treatments in depression indicates that the approaches that have generated the most research interest include acupuncture, Chinese herbs, hypericum (St John’s wort), mindfulness and omega-3 fatty acids. Based on a critical review of the evidence, it appears that the most promising evidence is for hypericum (but with concerns with adverse effects and interactions), mindfulness, relaxation and yoga. Many trials are small, comparison interventions are varied, and there is a lack of systematically collated data on adverse events or long-term effects. Even where there is a strong evidence base, there may be factors preventing wider adoption for clinical use, such as concerns related to interactions or lack of standardisation or regulation of the practice and practitioners. Challenges in developing a rigorous evidence base in this area are also briefly discussed.