An epidemiological study on herbal product self-medication practice among psychotic outpatients from Serbia: A cross-sectional study

Global perspectives on the traditional approaches used in the treatment of schizophrenia: A systematic review

BACKGROUND

Traditional healing considers a holistic approach when diagnosing and treating patients for mental ailments, and is the preferred approach globally.

OBJECTIVE

This review documented traditional healing approaches for treatment of schizophrenia used in different regions globally.

METHODS

PICO framework was used to facilitate literature search from Google Scholar, PubMed, Medline, Cochrane, Scopus, APA PsycINFO, and Web search. Studies documenting methods of treatment from the perspective of traditional healers, patients and/or caregivers were included and also studies which investigated herbal plants used in traditional healing in vitro and in vivo were included. Review articles, magazine/newspaper articles, editorials, letters, comments/opinion articles, and articles with inaccessible full text were excluded. The risk of bias was assessed using MMAT and SYRCLE tools. University Capacity Development Programme funded this review.

RESULTS

74 articles were included, these documented traditional healing practices used in Africa, Asia, America, Europe, and Oceania. Common approach globally was herbal medicine. Other reported methods included faith-based healing, consultation with the ancestors, performing rituals, acupuncture, and music and yoga therapies. Inhumane approaches included starving, beating, cutting and confining patients. In some cases, traditional healing was used as adjunctive treatment. The overall risk of bias for studies in this review was low.

CONCLUSION

Traditional healing contributes in bridging the treatment gap for schizophrenia in developing countries. However, there is a lack of standardisation of the approaches employed in the different regions, and the safety and effectiveness of some of these approaches remain questionable.

The Effect of Oral Chamomile on Anxiety: A Systematic Review of Clinical Trials

Anxiety disorder is a prevalent psychiatric issue that affects 4.05% of the global population. As complementary and alternative medicine gains popularity, many individuals with anxiety symptoms seek herbal remedies. This systematic review aims to explore the sedative efficacy of chamomile as an herbal medicine for anxiety treatment. Our search was conducted in PubMed, Google Scholar, and Scopus databases until August 2023. Among 389 papers found, after removing duplicates and irrelevant papers, 10 clinical trials investigating the effect of oral consumption of chamomile on anxiety were included. Two researchers independently completed all steps, including the screening process and data extraction. Out of the 10 articles selected, 9 studies have concluded that chamomile is effective in reducing anxiety. Even though, the exact mechanism of chamomile's anxiolytic action is not well understood, evidence suggests that its active compounds, including apigenin, may modulate the function of the hypothalamic-pituitary-adrenocortical axis by affecting neurotransmitter pathways. This systematic review showed that chamomile potentially has an anxiolytic effect. In addition, due to the side effects of drugs used to treat anxiety disorders, the use of chamomile seems to be effective and less dangerous.

Herb-drug interactions: A short review on central and peripheral nervous system drugs

Herbal medicines are widely perceived as natural and safe remedies. However, their concomitant use with prescribed drugs is a common practice, often undertaken without full awareness of the potential risks and frequently without medical supervision. This practice introduces a tangible risk of herb-drug interactions, which can manifest as a spectrum of consequences, ranging from acute, self-limited reactions to unpredictable and potentially lethal scenarios. This review offers a comprehensive overview of herb-drug interactions, with a specific focus on medications targeting the Central and Peripheral Nervous Systems. Our work draws upon a broad range of evidence, encompassing preclinical data, animal studies, and clinical case reports. We delve into the intricate pharmacodynamics and pharmacokinetics underpinning each interaction, elucidating the mechanisms through which these interactions occur. One pressing issue that emerges from this analysis is the need for updated guidelines and sustained pharmacovigilance efforts. The topic of herb-drug interactions often escapes the attention of both consumers and healthcare professionals. To ensure patient safety and informed decision-making, it is imperative that we address this knowledge gap and establish a framework for continued monitoring and education. In conclusion, the use of herbal remedies alongside conventional medications is a practice replete with potential hazards. This review not only underscores the real and significant risks associated with herb-drug interactions but also underscores the necessity for greater awareness, research, and vigilant oversight in this often-overlooked domain of healthcare.

Prevalence of self-medication among the elderly: A systematic review and meta-analysis

BACKGROUND

Self-medication is the use of unprescribed drugs to treat a disease. Elderly self-medication can be more dangerous compared to other age groups because of changes in organ functions that occur due to senescence. This study aimed to estimate the prevalence of self-medication in the elderly, its related factors, and common drugs used in this regard.

MATERIALS AND METHODS

Electronic databases such as PubMed, Scopus, and Web of Science were searched between January 2016 and June 2021. The search strategy was built on two core concepts: "self-medication" and "aged". The search was limited to original articles in the English language. A random effect model was used to estimate the pooled prevalence of self-medication. Heterogeneity among studies was assessed using both the I² statistic and the χ ² test. Also, a meta-regression model was used to investigate the potential sources of heterogeneity of the studies.

RESULTS

Out of 520 non-duplicate studies, 38 were included in the meta-analysis. Self-medication in the elderly ranged from 0.3% to 82%. The pooled proportion of self-medication was 36% (95% CI: 27%-45%). The result of the χ ² test and the I² index (P < 0.001, I²= 99.90%) revealed notable heterogeneity among the included studies in the meta-analysis. The meta-regression showed a significant association between the sample size (adjusted β = -0.01; P = 0.043) and the pooled proportion of self-medication.

CONCLUSION

The prevalence of self-medication in the elderly is high. Education through mass media to raise awareness about the dangers of self-medication can help solve this problem.

Lemon Balm (Melissa officinalis) Essential Oil Moderately Affects Strychnine-Induced and Pentylenetetrazol-Induced Convulsions —In Silico and In Vivo Studies

Epileptic seizures are a consequence of uncontrolled neuronal discharge and demand urgent and prolonged treatment. Due to a lack of potent and low-risk drugs that could prevent seizures, efforts are underway to discover new drugs, and plant metabolites are often considered valuable candidates in this search. Lemon balm ( Melissa officinalis L., Lamiaceae) is a world-renowned medicinal plant affecting central nervous system function. In this study, we aimed to examine whether the results from in silico modeling of the interactions of major lemon balm essential oil constituents with GABAA and glycine receptors correspond to in vivo results of the convulsions in mice induced by the application of either pentylenetetrazol (GABAA antagonistic) or strychnine (glycine receptor antagonist). While molecular docking experiments of essential oil constituents to the two receptors demonstrated the possibility of ligand–receptor interactions, no binding poses were scored highly, and as the in vivo effect of the essential oil on convulsions seems to be only moderate, the results of the in silico study seem not to contradict results obtained by in vivo models. Thus, we can say that molecular docking might be a useful tool in initial screening for active constituents of natural product mixtures and the potential prediction of their activity in models in vivo.

Paeoniflorin Rescued MK-801-Induced Schizophrenia-Like Behaviors in Mice via Oxidative Stress Pathway

Schizophrenia (SCZ) affects approximately 1% population worldwide, and the first-line antipsychotics have partial reactivity or non-reactivity with side effects. Therefore, there is an urgent need to find more effective drugs. Paeoniflorin (PF) is the main effective component of traditional Chinese medicine from white peony, red peony and peony bark, which acts as a neuroprotective agent. The purpose of this study was to investigate whether PF can rescue MK-801 induced schizophrenia-like behavior in mice. Our results demonstrated that intragastric administration of PF ameliorated MK-801 induced schizophrenia–like behaviors in mice as demonstrated by prepulse inhibition of acoustic startle response, fear conditioning test for memory and open field test for activity. In contrast, the first-line antipsychotics-olanzapine reversed the prepulse inhibition deficits and hyperactivities, but not memory deficits, in the model mice. Further analysis showed that PF reduced oxidative stress in the MK-801-treated mice, as evidenced by the increased superoxide dismutase levels and decreased malondialdehyde levels in the blood of the model mice. In addition, PF treatment inhibited the expression of the apoptotic protein Bax and restored the expression of tyrosine hydroxylase in the brains of the model mice. in vitro data indicated that PF protected against oxidative stress induced neurotoxicity in the primary cultured hippocampal neurons. In conclusion, our results were the first to provide evidence that PF rescued schizophrenia-like behaviors (both positive symptoms and cognitive impairments) in rodents through oxidative stress pathway, and therefore provide a novel strategy for treatment of SCZ. However, more pre-clinical and clinical research are needed to translate the present findings into clinics for a treatment of schizophrenia.

Self-treatment and adverse reactions with herbal products for treating symptoms associated with anxiety and depression in adults from the central-western region of Mexico during the Covid-19 pandemic

ETHNOPHARMACOLOGICAL RELEVANCE

There are plant species used in the Mexican traditional medicine for the empirical treatment of anxiety and depression.

AIM OF THE STUDY

This work assessed the prevalence of self-medication with medicinal plants and the prevalence of the concomitant use of prescribed psychiatric drugs and medicinal plants for treating symptoms associated with anxiety and depression during the Covid-19 lockdown in Mexico.

MATERIALS AND METHODS

The suspected adverse reactions associated with drug-herb interactions were assessed. The factors associated with self-medication, the concomitant use of herb-drug combinations, and the presence of adverse reactions due their combined use is also reported. The study was descriptive and cross-sectional using an online questionnaire conducted among population with symptoms associated with anxiety and depression (n = 2100) from seven states of central-western Mexico.

RESULTS

The prevalence of the use of herbs (61.9%) and the concomitant use of drug-herb combinations (25.3%) were associated with being diagnosed with mental illness [OR:2.195 (1.655-2.912)] and the use of psychiatric medications [OR:307.994 (178.609-531.107)], respectively. The presence of adverse reactions (n = 104) by the concomitant use of drug-herb combinations was associated with being unemployed [p = 0.004, OR: 3.017 (1.404-6.486)].

CONCLUSION

Health professionals should be aware if their patients concomitantly use medicinal plants and psychiatric drugs. Public health campaigns should promote the possible adverse reactions that might produce the concomitant use of drug-herb combinations for mental illnesses.

Prevalence and Drivers of Self-Medication Practices among Savar Residents in Bangladesh: A Cross-Sectional Study

BACKGROUND

Self-medication practice (SMP) is widely adopted among residents of such countries as Bangladesh. However, the major determinants of SMP have only scarcely been evaluated. Therefore, this cross-sectional study aimed to fill this knowledge gap by assessing the prevalence and determining factors of SMP.

METHODS

A convenience sample of individuals residing in Savar (Dhaka, Bangladesh) >16 years of age and suffering from an illness >2 months underwent face-to-face interviews during January-February, 2019.

RESULTS

Among 520 interviewees fulfilling entry criteria, the prevalence of SMP was reported as 60.2%. Drug shops, previous knowledge or prescription, and consulting with peers (friends or relatives) were the most sought sources of SMP, whereas simple illness, higher consulting fees, unsatisfactory health-care services, and delayed access were reported as the motives. From the regression analysis, the sociodemographic risk factors of SMP were reported as being older (compared to <18 years), married, illiterate (compared to having higher education), having engaged in any occupation (ie, service, business, homemaker, and others compared to student), and suffering from chronic illness.

CONCLUSION

SMP is highly prevalent and exhibits significant socioeconomic determinants. Development of proper health care-access systems and public education should be implemented to reduce the rate of SMP.

Differences among health care students' attitudes, knowledge and use of dietary supplements: a cross-sectional study

OBJECTIVES

The objectives of this study were to evaluate the difference among pharmacy, dental and medical students' attitudes, knowledge and use of dietary supplements. Furthermore, factors likely to influence their personal use and willingness to recommend supplement to patient were investigated.

DESIGN

A cross-sectional survey study.

SETTING

The study was carried out at a single university.

MAIN OUTCOME MEASURES

Survey gathered socio-demographic data and questioned students' attitudes, knowledge and use of dietary supplements.

RESULTS

A total of 506 students were included in the study. Pharmacy students showed more positive attitudes about dietary supplements, and achieved higher knowledge scores when compared to dental or medical students (p < 0.001). Medical students were more likely to use evidence based sources of information about dietary supplements. There was no difference in supplements use across study programs (p = 0.177). As many as 59.7% of students that participated in the study reported using dietary supplements. Data analysis showed that the previous personal use supplements was a significant independent predictor whether students would recommend supplements to their patients (OR 27.03, 95% CI 14.08-50, p < 0.001).

CONCLUSIONS

Students' education did not influence their personal use of dietary supplements. However, their personal experience seems to influence their willingness to recommend supplements to patients. Pharmacy students showed greater knowledge about supplements than their dental or medical colleagues. In future practice, health care students could benefit from collaboration with pharmacists when they provide care to patients seeking advice about the use of dietary supplements.