The article by Niv et al. (2010) sought to examine the characteristics that people with mental illness would exhibit when subjected to herbal medication and dietary supplement (HMDS). The study was necessitated by the fact that the number of people in the US using complementary and alternative medicine (CAM) has been on the rise. The authors also argued that there is little research documenting the usage of HMDS among mentally ill persons. The goal of the study was to observe the differences between HMDS users and non-users concerning mental well-being. The study also aimed to determine the prevalence of HMDS among patients with psychiatric problems. The study use data collected in a nationwide telephone survey between 1997 and 1998 by the Healthcare for Communities (HCC). The sample consisted of 9,585 individuals who completed the survey. The data was then analyzed with SUDAAN software, which applies Taylor series linearization. The study found that HMDS use was higher in persons who perceived mental health needs. In relations to prevalence, the study found that use of psychoactive HMDS rose with growing family income, age, and dissatisfaction with healthcare. In its conclusion, the study finds that persons with a psychiatric disorder were more likely to use HMDS, especially melatonin and St John's Wort. The study argues that past reviews have found St John’s Wort effective than placebo as an antidepressant while melatonin is effective in improving depressive symptoms.
I would recommend supplements o my patients. NIHM (2007) found that most American citizens are turning to CAM treatments, 38 percent of adults and 12 percent of children with 16.5 percent using supplements for mental health care. It is likely that the patient will use the CAM treatment without consulting practitioners, and hence engaging him on the topic is necessary. The study by Niv et al. (2010) is supported by Wong, Smith, and Boon (1998) who not only identified St John’s Wort as a helpful herb for psychiatry use but extended the list and their potential benefits. Some of the other herbs identified in their research include black cohosh, German chamomile, Ginkgo, and Evening primrose, among others. Helping my patients select from these lists is helpful to avoid complications that may arise. One of the potential effects of self-treating includes using the supplements alongside antidepressant, risking adverse herb/drug interaction. Engaging a patient early on supplements helps alleviate the misconception that herbs are generally safe. For example, St John's Wort is known to interact with SSRIs based on cases reported of drowsiness o serotonin syndrome. Doctors who avail themselves to advise on the use of supplements can pursue intensive research and establish the efficacy of the supplements. This may also help uncover the effects of these herbs as novel treatments or yield fresh insight into their basic mechanism. I would put into consideration the assertion by Niv et al. (2010) that mentally ill patients were considering HMDS since they were dissatisfied with healthcare. Advising on the use of supplements ensures patients have information and are cautious even as they resort to supplements. Furthermore, when considering which herbal product to prescribe for my patients, I would consider the body of literature supporting its use. I would consider whether the results are valid, what the results were, and whether they will help me care for my patient.
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Use and research on supplements are associated with challenges. Identifying supplements safety is challenging. Herbs may appear comparatively safe under controlled environments with limited exposure to a small group of people with a thin band of characteristics (Gardner, 2002). However, once these controlled environments are lifted, the exposure is huge. Unlike in pharmaceuticals, where control is maintained through prescription herbal products have no control. The lack of control, coupled with self-treatments increases the risk of adverse interaction and reaction between supplements and pharmaceutical drugs (Gardner, 2002). The drug interaction may increase the risk of bleeding, affect the anticoagulation status, and may induce maniac like symptoms such as headache. Indirectly, the interaction may prolong hospitalization and may increase the cost of treatment. When researching on herbal products, product formulation and dosage preparation may yield different results as they affect the activity of the product. Lack of detailed preparation process leads to the dosage that is not standardized. Additionally, the herbs do not indicate the manufacturer or the constituents of the product. These factors often curtail the generalizability of the research on supplements. The composition of the herbal product also renders research difficult since chemical composition varies depending on several factors such as botanical species, anatomical part of the part, region and growth conditions as well as storage of the product. The variations can lead to differences in pharmacology activity. The herbal medicines are also associated with toxic side-effects and can have adverse reactions such as liver and kidney failure.
Based on the finding of Niv et al. (2010), evidence of positive outcomes and the growing popularity, I would recommend the use of supplements. However, patients would have to avoid herb-drug interaction to avoid side-effects. For professionals willing to prescribe the herbal products or supplements, using the appropriate body of literature would improve the efficacy of herbal product use.
References
Gardner. (2002). Evidence-based decisions about herbal products for treating mental disorders. Journal of Psychiatry and Neuroscience , 27 (5), 324–333.
NIHM. (2007). NIMH » Statistics. Retrieved from https://www.nimh.nih.gov/health/statistics/index.shtml
Niv, N., Shatkin, J. P., Hamilton, A. B., Unützer, J., Klap, R., & Young, A. S. (2009). The Use of Herbal Medications and Dietary Supplements by People with Mental Illness. Community Mental Health Journal , 46 (6), 563-569. doi:10.1007/s10597-009-9235-2
Wong, A. H., Smith, M., & Boon, H. S. (1998). Herbal Remedies in Psychiatric Practice. Archives of General Psychiatry , 55 (11), 1033. doi:10.1001/archpsyc.55.11.1033
