Section V. Complimetary & Alternative Medicine Treatments

Question 1

What are the 2 forms of complementary & alternative medicine (CAM)?

Answer 1

1. Physical & meditative treatments
2. Natural health medicine

Question 2

What % of people with mental illness use CAM?

Answer 2

16 to 44%

Question 3

For light/ photo therapy - what is the standard protocol intensity and frequency?

Answer 3

10,000 lux light intensity for 30 minutes daily in the mornings for UP TO 6 weeks

Question 4

How long does it typically take to see response to light therapy for MDD?

Answer 4

1 - 2 weeks

Question 5

What is the MOA for light therapy?

Answer 5

• alteration of circadian rhythm
• modulation of serotonin catecholamine system

Question 6

Light therapy is ____ line monotherapy for seasonal affective disorder.

Answer 6

first line

Question 7

Light therapy is ____ line monotherapy or adjunct therapy for mild to moderate MDD (without seasonal features)

Answer 7

2nd line

Question 8

What are the risks/ adverse effects of sleep deprivation therapy?

Answer 8

• relapse after discontinuation is rapid
• daytime sleepiness
• recurrence of panic attacks

Question 9

What are the CIs for sleep deprivation?

Answer 9

epilepsy (high risk of seizure induction with sleep loss)

Question 10

What is the overall recommendation for exercise to treat MDD?

Answer 10

for mild to mod MDD, exercise as monotherapy is 1st line (level 1 evidence)

for mod to severe MDD, exercise as adjunctive therapy is 2nd line (level 1 evidence)

Question 11

What are the recommendations for yoga to treat MDD?

Answer 11

for mild to mod MDD, yoga is 2nd line (level 2 evidence) as an adjunctive therapy

Question 12

What is the dose range for St. John’s Wort?

Answer 12

500-1800 mg/d

Question 13

What is the suggested MOA of St. John’s Wort?

Answer 13

• direct effect on serotonin Rc
• monoamine inhibition
• neuroendocrine and ion channel modulation

Question 14

What are the SEs of St. John’s Wort?

Answer 14

• GI upset
• headaches
• skin irriatation
• photosensitivity
• dry mouth

Question 15

What are the overall recommendations for St. John’s Wort for MDD treatment?

Answer 15

for mild to mod MDD, 1st line (level 1 evidence) as monotherapy for MDD

for mod to severe MDD, 2nd line (level 2 evidence) as adjunctive therapy

Question 16

What are the overall recommendations for omega fatty acids?

Answer 16

for mild to mod MDD, 2nd line (level 1 evidence) as monotherapy or adjunctive

for mod to severe, 2nd line (level 2 evidence) as adjunctive

Question 17

What are the overall recommendations for SAM-e?