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Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 5. Complementary and Alternative Medicine Treatments.
- Source :
- Canadian Journal of Psychiatry; Sep2016, Vol. 61 Issue 9, p576-587, 12p, 3 Charts
- Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals.<bold>Methods: </bold>Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. "Complementary and Alternative Medicine Treatments" is the fifth of six sections of the 2016 guidelines.<bold>Results: </bold>Evidence-informed responses were developed for 12 questions for 2 broad categories of complementary and alternative medicine (CAM) interventions: 1) physical and meditative treatments (light therapy, sleep deprivation, exercise, yoga, and acupuncture) and 2) natural health products (St. John's wort, omega-3 fatty acids; S-adenosyl-L-methionine [SAM-e], dehydroepiandrosterone, folate, Crocus sativus, and others). Recommendations were based on available data on efficacy, tolerability, and safety.<bold>Conclusions: </bold>For MDD of mild to moderate severity, exercise, light therapy, St. John's wort, omega-3 fatty acids, SAM-e, and yoga are recommended as first- or second-line treatments. Adjunctive exercise and adjunctive St. John's wort are second-line recommendations for moderate to severe MDD. Other physical treatments and natural health products have less evidence but may be considered as third-line treatments. CAM treatments are generally well tolerated. Caveats include methodological limitations of studies and paucity of data on long-term outcomes and drug interactions. [ABSTRACT FROM AUTHOR]
- Subjects :
- MENTAL depression
THERAPEUTICS
ALTERNATIVE medicine
THERAPEUTIC use of meditation
EVIDENCE-based medicine
PHOTOTHERAPY
SLEEP deprivation
EXERCISE therapy
BIOTHERAPY
ACUPUNCTURE
COMPARATIVE studies
RESEARCH methodology
MEDICAL cooperation
MEDICAL protocols
META-analysis
RESEARCH
SYSTEMATIC reviews
EVALUATION research
STANDARDS
Subjects
Details
- Language :
- English
- ISSN :
- 07067437
- Volume :
- 61
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Canadian Journal of Psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 117537438
- Full Text :
- https://doi.org/10.1177/0706743716660290