Alternative Treatments for Depression: Empirical Support and Relevance to Women.[CME]
J Clin Psychiatry 2002;63:628-640
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: This article is a critical
review of the efficacy of selected alternative
treatments for unipolar depression including exercise,
stress management techniques, acupuncture, St.
John's wort, bright light, and sleep deprivation.
Issues related to women across the life span,
including pregnancy and lactation, are
Data Sources: Evidence of efficacy is
based on randomized controlled trials. A distinction
is made between studies that address depressive symptoms and studies that address
depressive disorders. The review emphasizes issues
related to effectiveness, such as treatment
availability, acceptability, safety, and cost and issues
relevant to women.
Data Synthesis: Exercise, stress
reduction methods, bright light exposure, and sleep
deprivation hold greater promise as adjuncts to
conventional treatment than as monotherapies for
major depression. The evidence to date is not
sufficiently compelling to suggest the use of St.
John's wort in favor of or as an alternative to
existing U.S. Food and Drug
Administration-regulated compounds. Initial evidence suggests that
acupuncture might be an effective alternative monotherapy for major depression, single episode.
Conclusion: This review indicates that
some unconventional treatments hold promise as
alternative or complementary treatments for
unipolar depression in women and have the potential
to contribute to its long-term management. Additional research is needed before further
recommendations can be made, and there is an
urgent need to carefully document and report the
frequency of minor and major side effects.