دانلود رایگان مقاله انگلیسی هومیوپاتی در درمان افسردگی: یک بررسی سیستماتیک - الزویر 2018

ABSTRACT

Introduction: Depression is a common reason for patients to consult homeopaths. This review aims to assess the efficacy, effectiveness and safety of homeopathy in depression. Methods: Thirty databases/sources used to identify studies reporting on homeopathy in depression, published between 1982 and 2016. Studies were assessed for their risk of bias, model validity, aspect of homeopathy and comparator. Results: Eighteen studies assessing homeopathy in depression were identified. Two double-blind placebo-controlled trials of homeopathic medicinal products (HMPs) for depression were identified. The first trial (N=91) with high risk of bias found HMPs were non-inferior to fluoxetine at 4 (p=0.654) and 8 weeks (p=0.965); whereas the second trial (N=133), with low risk of bias, found HMPs was comparable to fluoxetine (p=0.082) and superior to placebo (p<0.005) at 6 weeks. The remaining research had unclear/high risk of bias. A non-placebo-controlled RCT found standardised treatment by homeopaths comparable to fluvoxamine; a cohort study of patients receiving treatment provided by GPs practising homeopathy reported significantly lower consumption of psychotropic drugs and improved depression; and patient-reported outcomes showed at least moderate improvement in 10 of 12 uncontrolled studies. Fourteen titles provided safety data. All adverse events were mild or moderate, and transient. No evidence suggested treatment was unsafe. Conclusions: Limited evidence from two placebo-controlled double-blinded trials suggests HMPs might be comparable to antidepressants and superior to placebo in depression, and patients treated by homeopaths report improvement in depression. Overall, the evidence gives a potentially promising risk benefit ratio. There is a need for additional high quality studies.

CONCLUSIONS

The existing limited research evidence suggests that the effectiveness of homeopathic medicinal products for depressed patients is comparable to some antidepressants and superior to placebo, with clinically significant effects. A significant proportion of patients report improvements in depression following treatment provided by homeopaths in uncontrolled studies and surveys. No evidence suggested treatment was unsafe. However, further research is still needed to test the efficacy of homeopathic medicinal products, the effectiveness of treatment provided by homeopaths, and the safety of the intervention.