Complementary Medicine and Natural Medications in Psychiatry: A Guide for the Consultation-Liaison Psychiatrist

BACKGROUND:Complementary and Alternative Medicine (CAM) is commonly and increasingly used in America and worldwide and can include both pharmacologic (e.g., vitamins and supplements) and nonpharmacologic (e.g., yoga) interventions. These therapies may be of interest to patients who desire "natural" alternatives or complements to standard treatments. CAM may be used by patients, with or without supervision from a licensed medical professional, to treat psychiatric conditions. OBJECTIVE:To provide an overview of more commonly used CAM interventions that have relevance to mental health care providers, particularly consultation-liaison psychiatrists, and to describe the indications, safety, and dosing of these treatments. METHODS:We searched PubMed to identify articles that described the uses, safety, mechanisms, and recommendations for CAM therapies in relation to the treatment of psychiatric conditions. Articles most relevant to this review were included, with a preferential focus on meta-analyses and systematic reviews. RESULTS:We summarized common CAM therapies that have shown efficacy for the treatment of psychiatric conditions. These therapies include natural medications, nutritional psychiatry, light therapy, yoga, and exercise. CONCLUSIONS:Certain CAM interventions may be effective as monotherapies and/or as adjunctive treatments for psychiatric conditions. However, they may also have safety risks, contraindications, and/or interactions with medications. It is therefore important for physicians and other mental health care professionals to inquire about patient use of CAM and to understand the indications, safety, and dosing of these therapies.