Recommendations for phytotherapy in mental illnesses

A publication in the World Journal of Biological Psychiatry proposes evidence-based guidelines for the use of nutraceuticals and herbal medicines for the treatment of common mental disorders.

The study seeks meaningful options for anxiety & depression

"Contrary to what some people may say or believe, there is a lot of high-quality evidence, and the purpose of these guidelines was to provide a synthesis of that evidence, as well as input from clinicians, to produce authoritative practice guidelines," explains working group leader Jerome Sarris, Professor of Integrative Mental Health at the NICM Research Institute, University of Western Sydney.2 This is the largest meta-synthesis in the world in this area, incorporating evidence from clinical trials and data from around the world from over 10,000 people treated.

Brief overview of Grade A recommendations for depression and anxiety:

Depression Anxiety disorders
Nutraceuticals Omega-3 fatty acids (especially eicosapentaenoic acid: EPA)
Vitamin D
N-acetylcysteine
Probiotics
Zinc
Folate compounds
S-adenosyl-methionine
Vitamin C
Tryptophan and 5-HTP
Creatine
Inositol
Magnesium 		N-acetylcysteine
Phytopharmaceuticals St. John's wort
Saffron
Curcumin
Rhodiola
Lavender 		Lavender
Kava (Piper methysticum)
Ashwagandha
Galphimia
Chamomile

* according to Tab. 31

Some of these are recommended as adjunctive therapy, others also as monotherapy. The compiled results in the area of micro- and macronutrients are further evidence of the importance of the gut-brain axis and nutritional approaches to mental health and support their integration into actually any treatment.

The document includes further recommendations for depression and anxiety disorders, as well as schizophrenia and ADHD. The exact recommendations with suggested dosages are freely available here.

Using natural agents therapeutically

Dr David Mischoulon, professor of psychiatry at the Harvard Medical School, director of the clinical research programme for depression at Massachusetts General Hospital, and co-author of the publication, believes it is very important for clinicians to be familiar with natural agents as well. "In my practice, I prescribe some of these therapies, including many people for whom approved treatments have not provided benefits. "2

Sources:
  1. Sarris, J. et al. 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. The World Journal of Biological Psychiatry 23, 424–455 (2022).
  2. Institute, N. H. R. & University, W. S. Global commission: New clinical guidelines for mental health and the use of nutraceuticals and medicinal plants.

    Last websites check: 17 June 2023