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CAM's Slow (and Somewhat Reluctant) Acceptance by Conventional Medicine Practitioners

The FasTrak HerbClip included in this bin (HC 060551-281) is a commentary on St. John's wort related to the March 15th, 2005 FasTrak HerbClip (HC 030155-278; Szegedi A, Kohnene R, Dienel A, Kieser M. Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St. John's wort): randomised controlled double blind non-inferiority trial versus paroxetine. Brit Med J. 2005;330: 503-506.)

Although 71% of acute major depression subjects in the Szegedi et al trial's SJW group responded to treatment (compared to 60% in the paroxetine group), 50% of the SJW group were considered in remission (compared to 35% in the paroxetine group) and the incidence of adverse events was only 0.035 per day in the SJW group (compared to 0.060 in the paroxetine), the authors believe that SJW should not be a first or second choice for patients with moderate to severe depression. The reasons they give for their belief is that they think that evidence of SJW's efficacy in major depression is inconsistent and that the quality of over-the-counter products is questionable. To their credit, the authors do state that SJW is a reasonable option for persons experiencing minor depression as long as they can obtain quality preparations.

This commentary is just one example of how conventional medicine and its practitioners are (sometimes slowly and reluctantly) beginning to give at least some credence to Complementary and Alternative Medicine (CAM). Recently, the University of Pennsylvania (UPenn) announced that they are working with Tai Sophia Institute in Maryland to establish a program that will teach medical students about herbal therapies, meditation, and other forms of CAM beginning in August. In the RedNova report on this venture, Aviad Haramati, a professor at Georgetown University's medical school, states that "Universities nationwide, in response to the burgeoning numbers [of Americans who practice some form of CAM], are increasingly focusing on complementary medicine (used along with conventional treatment) and alternative medicine (used instead of conventional treatment). Some are creating their own programs and others are working with alternative medicine practitioners."

While the authors of the SJW commentary are certainly not effusive in their support of SJW, they at least show an openness to the benefits that the herb can provide people who suffer from depression. It's a beginning and certainly more encouraging than some of the other articles by conventional medicine practitioners. Perhaps with more programs such as UPenn's, a greater number of conventional medicine practitioners will develop a more sophisticated understanding of CAM.

Lori Glenn, Coordinator