Open letter to the Editor of The Lancet from the Swiss Association of Homoeopathic Physicians (SVHA)

Homeopathic Remedies in Psychiatric Disorders: A Meta-analysis of Randomized Controlled Trials

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 insufficient to support their use in clinical practice.

Development of a whole plant bioassay to test effects of potentized calcium carbonate in pillule formulation

OBJECTIVES

From a pharmaceutical point of view, we see a need to develop stable preclinical test systems to identify and investigate effects of potentized remedies as used in Anthroposophic Medicine and Homeopathy. We evaluated a plant bioassay regarding its capacity to distinguish homeopathic remedies from placebo, applied as sucrose pillules.

METHODS

Pea seed (Pisum sativum L) was soaked for 24 hours in water with dissolved homeopathic or placebo pillules, or in water only. Shoot length was measured 14 days after planting and treatment groups were compared by analysis of variance (ANOVA). The stability of the system was validated by systematic negative control experiments.

RESULTS

The system is suitable to test a common application form - sucrose pillules - of a potentized preparation without influence of the pharmaceutical carrier substance. A screening of 13 potentized preparations revealed Calcium carbonicum to affect pea shoot growth (p < 0.05). Three independent series of main experiments were performed with potentized Calcium carbonicum to assess reproducibility. Meta-analysis of all data revealed significant effects of Calcium carbonicum 12c and 30c on pea shoot growth (p < 0.05), which were however dependent on the date of experiment and/or the experimental series.

CONCLUSIONS

Potentized Calcium carbonicum, applied as sucrose pillules, influenced pea shoot growth in the assay investigated. However, due to the small effect size and due to the modulation of the effects by still unknown external factors, further optimization of this bioassay is necessary to be used in pharmaceutical quality control or in investigating the biological or pharmaceutical mode of action of potentized preparations.

Patient satisfaction with primary care: a comparison between conventional care and traditional Chinese medicine

OBJECTIVES

The evaluation of patient satisfaction with traditional Chinese medicine (TCM) versus conventional medicine (COM) in Swiss primary care.

DESIGN

A cross-sectional study was performed with questionnaires aimed at fulfilment of expectations, perceived treatment effects, and patient satisfaction.

SETTING

Participants were 51 certificated TCM physicians, 71 COM physicians, and 2530 adult patients.

RESULTS

Among patients seeking primary care in Switzerland, those who choose a conventional physician with additional certification in TCM have a higher chance of being completely satisfied with their treatment than patients who choose a physician educated only in COM.

CONCLUSIONS

Physicians who supply TCM in addition to COM are able to satisfy the needs of their patients more completely than solely COM-practicing physicians. Explanations for this difference include less frequent side effects in TCM, better TCM physician-patient interaction with longer duration of consultation, and different treatment expectations of patients seeking TCM.