Complementary therapies adverse effects

Continuing in the tradition of the acclaimed first edition. Pharmacodynamic Basis of Herbal Medicine, Second Edition examines in extensive detail the physiologic effects of complementary and alternative therapies, foods, supplements, vitamins, and traditional herbal remedies. This encyclopedic volume considers the site, mode, and mechanism of action to explain the desired and adverse effects and interactions of each herb, drug, and food. 

However, this notion is dangerously misleading adverse effects have been associated with the use of complementary therapies (16). Furthermore, complementary therapies may not only be directly harmful (for example adverse effects of herbal formulations), but like other medical treatments have the potential to be indirectly harmful (for example through being applied incompetently, by delaying appropriate effective treatment, or by causing needless expense) (17). 

The efficacy of many complementary therapies is largely unknown, and more definitive evidence is urgently needed (18). Tike any other interventions, complementary therapies are associated with adverse effects, and for responsible therapeutic decision-making, the balance of benefits and harms must be considered (19). 

Most of the data on adverse effects associated with complementary therapies is anecdotal, and assessment and classification of causality is often not possible. Fikewise, there have been few attempts to determine systematically the incidence of adverse effects of nonorthodox therapies. 

It is a curious assumption, and illogical that a complementary therapy could have sufficient pharmacological activity to improve health (however imprecisely that may be defined), and yet these properties are automatically insufficient to cause harm. Part of the problem is that adverse reactions to natural therapies are not reported in the same way as for orthodox drugs (Barnes et al., 1998). Reporting bias also tends toward the association of adverse effects with the condition being treated rather than from the harmless over-the-counter or herbal remedy that has been administered. The only complementary therapies that are safe in overdose are those that are homeopathic, with even these carrying the clinical hazard of under-treatment. 

Little is known about the efficacy of herbal products in infants, children, and adolescents. Health care professionals must ask caregivers specifically about the use of complementary and alternative treatments to minimize the adverse effects and costs associated with ineffective therapies. 

Bielory L, Russin J, Zuckermen GB (2004) Clinical efiBcacy, mechanisms of action, and adverse effects of complementary and alternative medicine therapies for asthma. Allergy Asthma Proc 25 283-291... 

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