Elsevier

General Hospital Psychiatry

Volume 25, Issue 1, January–February 2003, Pages 24-26
General Hospital Psychiatry

Commentary and perspective
Use of herbal medications among 200 psychiatric outpatients: prevalence, patterns of use, and potential dangers

https://doi.org/10.1016/S0163-8343(02)00237-2Get rights and content

Abstract

We documented the use rates of herbal medication among a population of psychiatric outpatients to identify patients at risk for drug-herb interactions. Data were collected on 200 patients who, as part of their routine evaluation, provided information regarding their use of herbs. Fifteen percent of patients were currently taking herbs, the majority for treatment of psychiatric symptoms. There were no significant differences in use patterns across gender or between age groups. None of the current users charts, including the “high risk” patients, indicated that treating physicians were aware of potentially dangerous drug-herb combinations. Use of herbal medication was common among this sample of psychiatric outpatients. These data are consistent with reports from other patient populations. It is important for psychiatrists to ask all patients about their use of herbs and provide education about potentially dangerous drug-herb interactions.

Introduction

Herbal medicines are readily available and commonly used in the United States [1], [2]. As over the counter preparations, herbal medicines are generally considered safe by the general population, and are commonly used for the treatment of psychiatric symptoms [2], [3]. St John’s wort (Hypericum perforatum) is commonly taken to treat depression, kava kava (Piper methysticum) for anxiolysis, Valerian (usually Valeriana officialis) to improve sleep, and Ginkgo biloba to improve memory [1], [2].

Herbal preparations contain one or more biologically active components, each with a unique side effect profile. When used in a knowledgeable fashion by individuals trained in their appropriate use and obtained from reliable producers, herbs are relatively safe. However, there have been several reports of clinically significant interactions between herbs and medications [4]. The use of herbs concurrently with a prescribed medication is extremely common. A survey conducted in the US reported that among adults taking a prescribed medicine, 18.4% were also taking at least one herbal compound. In addition, among those who used alternative therapies, 61.5% had not discussed this with their physician [5]. With the above points in mind, we examined patterns of herb use among a population of psychiatric outpatients.

Section snippets

Materials and methods

This was a retrospective chart analysis, conducted with the approval of the UCSD Human Research Protection Program, which did not use consented subjects. Information, provided by psychiatric outpatients regarding their use of herbs, was retrospectively reviewed and characterized. As part of their routine evaluation, patients at UCSD Outpatient Psychiatric Services were asked about their use of herbal medications. While several different psychiatrists provided mental health care services, all

Results

Of the 200 patients, 106 (53%) were female and 94 (47%) male. Twenty-nine (15%) were current users, 94 (47%) previous users, and 77 (38%) nonusers. Among current users; 17 (59%) took herbal products to improve overall mental health, 7 (24%) took herbs to improve overall physical health, and five (17%) indicated other reasons for taking herbs (such as prevention of a future illness). Of the 29 current users, 19 (66%) were age 21–50, 10 (44%) were age 51 or older, 17 (59%) were male, and 12 (41%)

Discussion

Herbs are used for a variety of conditions, and prior studies indicate that one-third to one-half of all Americans has used herbs. We report similar results among a population of psychiatric outpatients. Specifically, almost two-thirds of surveyed patients reported they had taken or were currently using herbal remedies. Current use of herbal medications was not specific to any gender or age group.

Among a population of psychiatric outpatients, it is not surprising that most patients reported

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There was no pharmaceutical company support or grant funding for this study.

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