Aust N Z J Psychiatry. 1999 Aug; 33(4): 482-9; discussion 490-3.

The relevance of herbal treatments for psychiatric practice.

Walter G, Rey JM.

Department of Psychological Medicine, University of Sydney, New South Wales, Australia. gwalter@mail.usyd.edu.au

OBJECTIVE: The aim of this paper is to inform psychiatrists about the basic principles, terminology, schools of thought, efficacy, safety and regulatory issues regarding herbal treatments for mental illness. METHOD: Information was obtained by computerised and manual searching of medical and botanical data bases, and by discussions with experts in herbal medicine and regulatory aspects of the pharmaceutical industry. RESULTS: Herbal medicines are commonly used in developed and developing countries for psychiatric illness. The main schools of herbal medicine in Australia are Western herbal medicine, traditional Chinese medicine and 'Ayurveda' (Indian herbal medicine). Herbs used for psychiatric or neurological disorders are termed 'nervines'. Three nervines which have attracted considerable attention recently are St John's Wort, Gingko biloba and Valeriana officinalis. In Australia, most herbal drugs are classed as 'listed drugs' which are required to satisfy less rigorous safety and efficacy criteria than 'registered drugs'. The popularity of herbal remedies has a number of clinical and research implications for psychiatry. CONCLUSIONS: Psychiatrists should not endorse treatments that are unsupported by sound research, nor remain ignorant about alternative approaches to mental illness. The extent of use of herbal treatments for mental illness suggests that psychiatrists should become more knowledgeable about developments in this area.