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While I have a conservative practice in Psychiatry including psychopharmacology and psychodynamic psychotherapy, as a physician I also encourage my patients to maintain and optimize their overall health. This concept is not new and dates back to the ancient Greek saying "ΝΟΥΣ ΥΓΙΗΣ ΕΝ ΣΩΜΑΤΙ ΥΓΙΕΙ (Healthy Mind in Healthy Body)." In 21st century medicine this is now better known as a concept in Integrative Psychiatry. Integrative Psychiatry consists of psychiatric practice which encompasses both mainstream psychiatry and selective components of "complementary and alternative medicine." Integrative psychiatry includes viewing the patient holistically, with consideration of "mind-body" issues along with spiritual values. Focus is on the treatment along with prevention of illness by paying attention to factors such as general health, nutrition, exercise, lifestyle, and stress reduction. In my practice I have increasingly found that many patients are using supplements including vitamins and herbs. The use of such products is also considered under the domain of Integrative Psychiatry. Unfortunately, such products can have serious side effects that patients are unaware of, often because of the misconception that only prescription medicines can have such side effects. Nevertheless as scientific evidence mounts, it seems that supplements, vitamins, and herbs may help with several conditions including depression, anxiety, insomnia, cognitive impairment, and recovery from addiction, and as a psychiatrist I find it my responibility to have a familiarity with such products, and be able to appropriately educate my patients. I emphasize that this approach be used with caution because in general supplements, vitamins, and herbs have not been subjected to the scientific scrutiny which FDA approved treatments have undergone. Modern technology brings with it treatments like Cranial Electrotherapy Stimulation, Bright Light Therapy, and Biofeedback. These are often useful as complementary treatments, but like other complementary and alternative treatments in psychiatry they have associated risks (and with the exception of some specific devices used for Cranial Electrotherapy Stimulation, do not carry any sort of FDA approval). On this website I attempt to present information to help make informed decisions. The treatments and supplements including vitamins, and herbs discussed are not exhaustive in scope, but rather focus in on what I have found to be practical, supported by research, and generally accepted by the scientific community as having some validity. Such treatments and products should only be taken under the supervision of a licensed health care provider, and used to complement traditional treatments utilized in modern psychiatric practice. The focus of this website is on mild cases of anxiety, depression, insomnia, cognitive decline, and early dementia. Complementary and alternative therapies should never be used as a first line of treatment in serious conditions involving severe impairment, psychosis, mania, or suicidal thinking. Robert Homer, M.D., Ph.D. Boca Raton, FL April 3, 2008 Diplomate in Psychiatry, American Board of Psychiatry and Neurology
Some products discussed and linked to may not have been evaluated by the Food and Drug Administration and none of these products are approved to diagnose, treat, cure or prevent disease. The information provided on this site is for informational purposes only and is not intended as a substitute for advice from your physician or other health care professional or any information contained on or in any product label or packaging. Some information may be accidently incorrect or unintentionally misleading. I do not recommend the use of any of the products and take no responsibility for any consequences. In particular I recommend that supplements if they are taken or other alternatives if chosen, be taken or used with caution because they are not tested for safety or regulated or approved by the FDA like prescription medications, yet they can also have serious side effects, become toxic, cause allergic reactions, cause birth defects, get into breast milk, thin blood-increasing the risk for bleeding especially with surgery, cause sedation and impairment leading to accidents, and interact with other medications and supplements potentially changing their levels in dangerous ways (among other potential complications). Like medications, several supplements may be dangerous if combined with alcohol. In addition if a supplement or other alternative therapy is self-prescribed, one may misdiagnose their condition and could be putting themselves in jeopardy of worsening symptoms. Furthermore, even if a supplement seems to be well tolerated, and seems to have a good safety record, complications may arise with high doses or prolonged use. Thus, I believe supplements are best utilized when recommended by a doctor who is familiar with their use and who has diagnosed the condition for which they are intended, and who can monitor for safety and progress. |
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