Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce

Sarris, Jerome; Ravindran, Arun; Yatham, Lakshmi N.; Marx, Wolfgang; Rucklidge, Julia J.; McIntyre, Roger S.; Akhondzadeh, Shahin; Benedetti, Francesco; Caneo, Constanza; Cramer, Holger; Cribb, Lachlan; Manincor, Michael J de; Dean, Olivia; Deslandes, Andréa Camaz; Freeman, Marlene P.; Gangadhar, Bangalore N.; Harvey, Brian H.; Kasper, Siegfried; Lake, James; Lopresti, Adrian L.; Lin, Li; Metri, Najwa‐Joelle; Mischoulon, David; Ng, Chee H.; Nishi, Daisuke; Rahimi, Roja; Seedat, Soraya; Sinclair, Justin; Su, Kuan‐Pin; Zhang, Zhangjin; Berk, Michael

doi:10.1080/15622975.2021.2013041

Cited by 101 publications

(98 citation statements)

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“…Der Blick in nationale wie internationale Leitlinienempfehlungen zeigt ein breites Spektrum an möglichen Phytotherapeutika mit guter Wirksamkeit sowie hoher Sicherheit und Verträglichkeit in der Therapie von leichten bis mittelschweren psychischen Erkrankungsformen wie Depression [8,9], Angst- [10], Zwangs- [11] und Schlafstörungen [12,13], Demenz [14], Schizophrenie und ADHS [5] Behandlungen mit Kamille ( + /-) hingegen wird aufgrund der unzureichenden Wirksamkeit derzeit nicht empfohlen, könnte aber in Form von Tee eine potenzielle kostengünstige ergänzende Selbsthilfe bei Angstsymptomen sein. Kava-Kava (-) wird aufgrund eines bestehenden Risikos für das Auftreten schwerer Leberreaktionen und mangelnder Wirksamkeit bei generalisierter Angststörung nicht empfohlen, könnte aber in der akuten oder kurzfristigen Behandlung von allgemeinen Angstsymptomen unterstützend wirken.…”

Section: Phytotherapeutika In Nationalen Und Internationalen Leitlini...unclassified

“…Die neue internationale Leitlinie der WFSBP und CANMAT (2022) 5 berücksichtigt den höchsten Evidenzlevel A (Vorliegen einer Metaanalyse oder≥2 qualitativ hochwertiger RCT). Sie spricht neben der Empfehlung für Johanniskraut (+++) auch eine vorläufige Empfehlung für die Therapie mit Safran (++ ), Curcuma (++ ) und eine schwache Empfehlung für Lavendel (+) aus.…”

Section: Depressionunclassified

“…Sie spricht neben der Empfehlung für Johanniskraut (+++) auch eine vorläufige Empfehlung für die Therapie mit Safran (++ ), Curcuma (++ ) und eine schwache Empfehlung für Lavendel (+) aus. Derzeit nicht empfohlen wird der Einsatz von Rosenwurz (+/–) 5 . Für Safran und Curcuma weisen Studien auf einen potenziellen Zusatznutzen bei komorbiden entzündlichen Erkrankungen hin.…”

Section: Depressionunclassified

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Phytotherapie bei psychischen Erkrankungen in medizinischen Leitlinien

Bittel

Rakoczy

Fröhlich

et al. 2022

Zeitschrift für Phytotherapie

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Zusammenfassung Hintergrund Phytotherapeutika werden aufgrund ihrer Beliebtheit bei PatientInnen und ihrer langen traditionellen Verwendung zunehmend in medizinische Leitlinien aufgenommen. Methode Die vorliegende Übersichtsarbeit gibt einen systematischen Überblick über phytotherapeutische Empfehlungen und Inhalte in deutschen (AWMF) und internationalen (WFSBP, CANMAT) medizinischen Leitlinien für psychische Erkrankungen. Ergebnisse Phytotherapeutika können bei leichten bis mittelschweren psychischen Störungen wie folgt empfohlen werden: Depressionen [(+++): Johanniskraut (Hypericum perforatum L.), (++ ): Safran (Crocus sativus L.) und Curcuma (Curcuma longa L.), (+): Lavendel (Lavandula angustifolia Mill.) und (+/–): Rosenwurz (Rhodiola rosea L.)], Angststörungen [(++ ): Lavendel und Ashwagandha (Withania somnifera (L.) Dunal), (+): Galphimia (Galphimia glauca Cav.), (+/–): Kamille (Matricaria spp.); „nicht empfohlen“ (–) wird Kava-Kava (Piper methysticum G. Forst.) wegen möglicher Lebertoxizität], Schlafstörungen [(+/–): Baldrian (Valeriana officinalis L.)] und Demenz [(+++): Ginkgo (Ginkgo biloba L.) zur Verbesserung der Kognition]. Sicherheit und Verträglichkeit wurden überwiegend als sehr gut bis tolerabel bewertet. Schlussfolgerung Internationale Leitlinien zeigen die mögliche Vielfalt an empfehlenswerten Phytotherapeutika für die Behandlung von psychischen Erkrankungen auf. Die derzeitige Überarbeitung einer Vielzahl nationaler Leitlinien zu psychischen Erkrankungen bietet die Chance, bestehende Empfehlungen für Phytotherapeutika systematisch zu aktualisieren und neue zu integrieren, um TherapeutInnen eine evidenzbasierte Nutzen-Risiko-Bewertung für ihre PatientInnen zu ermöglichen.

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Section: Phytotherapeutika In Nationalen Und Internationalen Leitlini...unclassified

Section: Depressionunclassified

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Phytotherapie bei psychischen Erkrankungen in medizinischen Leitlinien

Bittel

Rakoczy

Fröhlich

et al. 2022

Zeitschrift für Phytotherapie

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“…These findings support the importance of the interactions between the digestive system and the brain functions via the microbiota-gut-brain axis, thus indicating the significant role of the microbiota in the modulation of the central nervous system, including affective and cognitive functions [ 19 ]. Additionally, probiotics are among nutrients that are provisionally recommended for adjunctive use in mental disorders according to the World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Disorders (CANMAT) [ 23 ]. Some researchers refer to probiotics administered with the purpose of supporting mental health wellbeing as psychobiotics [ 24 , 25 , 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Direct or Indirect Use of Probiotics for the Improvement of Maternal Depression during Pregnancy and in the Postnatal Period: A Systematic Review and Meta-Analysis

et al. 2022

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The mother and infant form a unique bond, with maternal mental health affecting the interactions with the infant and infant behaviours impacting maternal mental health. One of the possible mechanisms influencing maternal mental health is the manipulation of the gut-brain axis by consuming probiotic supplements. Probiotics can also have an indirect influence on maternal mental health via the modulation of the infant microbiome and consequently improving the infant’s health and thus, indirectly leading to an improvement in maternal mood. This systematic review evaluated the efficacy of probiotics on maternal mental health by searching for randomised controlled trials via international databases: Cochrane Library, PubMed, Scopus, ScienceDirect, and Web of Science until January 2022. A meta-analysis was performed using the Cochrane Collaboration methodology where possible. We found seven clinical trials that included the word probiotics and addressed maternal depression and/or anxiety. Of these, five trials investigated the influence of maternal probiotic supplementation on the gut-brain axis. Two trials investigated the indirect influence of probiotics on maternal depression via supplementation of probiotics by infants and subsequent influence on the crying of colicky infants. Meta-analysis of two studies of pregnant and postnatal women and two studies of infants consuming probiotics on the outcome of the Edinburgh Postnatal Depression Scale for mothers showed no statistical difference. The findings indicate that maternal depression is very complex and is influenced by various bidirectional factors. One of the factors that can improve maternal mental health is probiotics, however, careful consideration must be given to correct strain selection as strain-specific effectiveness was observed. Further well-designed, robust clinical studies are warranted.

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Management of Depression in Adults

Simon,

Moise,

Mohr

2024

JAMA

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ImportanceApproximately 9% of US adults experience major depression each year, with a lifetime prevalence of approximately 17% for men and 30% for women.ObservationsMajor depression is defined by depressed mood, loss of interest in activities, and associated psychological and somatic symptoms lasting at least 2 weeks. Evaluation should include structured assessment of severity as well as risk of self-harm, suspected bipolar disorder, psychotic symptoms, substance use, and co-occurring anxiety disorder. First-line treatments include specific psychotherapies and antidepressant medications. A network meta-analysis of randomized clinical trials reported cognitive therapy, behavioral activation, problem-solving therapy, interpersonal therapy, brief psychodynamic therapy, and mindfulness-based psychotherapy all had at least medium-sized effects in symptom improvement over usual care without psychotherapy (standardized mean difference [SMD] ranging from 0.50 [95% CI, 0.20-0.81] to 0.73 [95% CI, 0.52-0.95]). A network meta-analysis of randomized clinical trials reported 21 antidepressant medications all had small- to medium-sized effects in symptom improvement over placebo (SMD ranging from 0.23 [95% CI, 0.19-0.28] for fluoxetine to 0.48 [95% CI, 0.41-0.55] for amitriptyline). Psychotherapy combined with antidepressant medication may be preferred, especially for more severe or chronic depression. A network meta-analysis of randomized clinical trials reported greater symptom improvement with combined treatment than with psychotherapy alone (SMD, 0.30 [95% CI, 0.14-0.45]) or medication alone (SMD, 0.33 [95% CI, 0.20-0.47]). When initial antidepressant medication is not effective, second-line medication treatment includes changing antidepressant medication, adding a second antidepressant, or augmenting with a nonantidepressant medication, which have approximately equal likelihood of success based on a network meta-analysis. Collaborative care programs, including systematic follow-up and outcome assessment, improve treatment effectiveness, with 1 meta-analysis reporting significantly greater symptom improvement compared with usual care (SMD, 0.42 [95% CI, 0.23-0.61]).Conclusions and RelevanceEffective first-line depression treatments include specific forms of psychotherapy and more than 20 antidepressant medications. Close monitoring significantly improves the likelihood of treatment success.

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Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce

Cited by 101 publications

References 130 publications

Phytotherapie bei psychischen Erkrankungen in medizinischen Leitlinien

Phytotherapie bei psychischen Erkrankungen in medizinischen Leitlinien

Efficacy of Direct or Indirect Use of Probiotics for the Improvement of Maternal Depression during Pregnancy and in the Postnatal Period: A Systematic Review and Meta-Analysis

Management of Depression in Adults

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