Herbal Medications for Common Ailments in the Elderly

Author: Ernst E. Source: Drugs & Aging, Volume 15, Number 6, December 1999 , pp. 423-428(6) Publisher: Adis International Abstract: The popularity of herbal medicine is at an all time peak. This article provides an overview of systematic reviews of herbal treatments for conditions common in elderly individuals. According to this evidence, there is little doubt that Hypericum perforatum (St John's Wort) is well tolerated and effective for mild to moderate depression. Although widely used, Valeriana officinalis (valerian) has not been shown beyond reasonable doubt to be effective for insomnia. There is relatively compelling evidence that Ginkgo biloba (ginkgo) is effective in delaying the clinical course of dementias. It has been well documented thatAesculus hippocastanum (horse chestnut) seed extracts alleviate the subjective symptoms and reduce the objective signs of chronic venous insufficiency. Serenoa repens (saw palmetto) is effective in improving the symptoms of benign prostatic hyperplasia. Finally, yohimbine has been shown to be effective for erectile dysfunction. It is concluded that several plant-based medicines can be useful additions to our therapeutic repertoire for treating common conditions in the elderly. However, several uncertainties remain and, at present, prevent unreserved recommendations.

http://www.ingentaconnect.com/content/adis/dag/1999/00000015/00000006/art00002
Herbal Remedies, Dietary Supplements, and Seizures
Alok Tyagi, Norman Delanty Article first published online: 6 FEB 2003 DOI: 10.1046/j.1528-1157.2003.19902.x
Summary: The use of herbal remedies and dietary supplements is widespread throughout the world, and use may be increasing. These are taken for a wide range of perceived benefits, such as energy and memory enhancement and treatment of specific conditions. Individuals with and without epilepsy may use these substances and may not inform their treating physician unless specifically asked. Inquiry about herbal medicine and dietary supplement intake should now be part of routine clinical history taking. Anecdotal accounts suggest that some herbal substances may have anticonvulsant effect, but randomised double-blind controlled trails are lacking. Alternatively many herbals and dietary supplements may predispose to seizures in individuals without epilepsy and worsen seizure control in those with epilepsy. In this article, we review the potential anticonvulsant and proconvulsant effects of herbal remedies and dietary supplements and discuss the potential interaction between these herbal substances and conventional anticonvulsant medications.

http://onlinelibrary.wiley.com/doi/10.1046/j.1528-1157.2003.19902.x/full
Review article: herbal treatment in gastrointestinal and liver diseasebenefits and dangers
L. Langmead, D. S. Rampton Article first published online: 20 DEC 2001 DOI: 10.1046/j.1365-2036.2001.01053.x Herbal medicines are now used by up to 50% of the Western population, in a substantial minority of instances for the treatment or prevention of digestive disorders. Although most indications for the use of such remedies are anecdotally or traditionally derived, controlled trials suggest some benefits for ginger in nausea and vomiting, liquorice extracts in peptic ulceration, Chinese herbal medicine in irritable bowel syndrome, opium derivatives in diarrhoea and senna, ispaghula and sterculia in constipation. Herbal preparations contain many bioactive compounds with potentially deleterious as well as beneficial effects.

There is clearly a need for greater education of patients and doctors about herbal therapy, for legislation to control the quality of herbal preparations, and in particular for further randomized controlled trials to establish the value and safety of such preparations in digestive and other disorders.

http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2036.2001.01053.x/abstract

One out of three Americans uses herbal therapies. Yet, less than one out of 3,000 scientific studies focuses on this increasingly popular therapy. Investigators at the Tang Center are changing that. Researchers at the Tang Center continue the long tradition of academic medicine at the University of Chicago, a place that has produced more than 80 Nobel laureates. Led by world-renowned University of Chicago researchers, the Tang Center is applying advanced science to uncover the advantages and possible dangers of herbal therapies.

http://tangcenter.uchicago.edu/

Complementary and Alternative Medicine

Haile T. Debas, Ramanan Laxminarayan, and Stephen E. Straus. The objective of medicine is to address people's unavoidable needs for emotional and physical healing. The discipline has evolved over millennia by drawing on the religious beliefs and social structures of numerous indigenous peoples, by exploiting natural products in their environments, and more recently by developing and validating therapeutic and preventive approaches using the scientific method. Public health and medical practices have now advanced to a point at which people can anticipateand even feel entitled tolives that are longer and of better quality than ever before in human history. Yet despite the pervasiveness, power, and promise of contemporary medical science, large segments of humanity either cannot access its benefits or choose not to do so. More than 80 percent of people in developing nations can barely afford the most basic medical procedures, drugs, and vaccines. In the industrial nations, a surprisingly large

proportion of people opt for practices and products for which proof as to their safety and efficacy is modest at best, practices that in the aggregate are known as complementary and alternative medicine (CAM) or as traditional medicine (TM).
http://www.ncbi.nlm.nih.gov/books/NBK11796/

Attitude and use of herbal medicines among pregnant women in Nigeria

Titilayo O Fakeye1 , Rasaq Adisa1 and Ismail E Musa2
*

BMC Complementary and Alternative Medicine 2009, 9:53 doi:10.1186/1472-6882-9-53

background
Herbal medicines can be purchased in bulk in the crude form or as refined pharmaceutical dosage forms such as capsules, tablets, concentrated extracts, teas, tinctures and decoctions. The use of herbal medicines play significant roles in the management of both minor and major illnesses and has been influenced by patients' dissatisfaction with conventional allopathic medicines in terms of effectiveness and/or safety, satisfaction with therapeutic outcome , and the perception that herbal medicines are inherently safe. Some of the more complex reasons for preference of herbal medicines are associated with cultural and personal beliefs, philosophical views on life and health, as well as comparison of experiences between conventional healthcare professionals and complementary medicine practitioners by patients. The use of herbal medicine has been on increase in many developing and industrialized countries. It is known that between 65 and 80% of the world's population use herbal medicines as their primary form of health care . Patients who are likely to be at risk from adverse effects of herbal medicines include those who are already prone to difficulties from regularly prescribed medications namely fetus, infants and older children, the elderly, as well as pregnant and lactating women. In developing nations most especially, regulation of sales, importation and manufacturing of herbal medicines are not subject to rigorous scrutiny in terms of safety and efficacy as is the case for conventional western/allopathic medicines . Few studies on the pattern of use of herbal medicines during pregnancy showed that more than 10% of pregnant women reported the use of herbal medicinal products in Finland, Australia, and United States . To our knowledge, only one study has been carried out in Nigeria to evaluate the use of herbal medicines among pregnant women . Despite the fact that knowledge of potential side effects of many herbal medicines in pregnancy is limited , and that some herbal products may be teratogenic in human and animal models , data on the extent of women's use of herbal medicines during pregnancy is scanty especially in sub-Sahara Africa, where the legislation for distribution and purchase of herbal medicines is not as stringent as it is for conventional medicines. This study was aimed at determining the proportion, prevalence of use, attitude and knowledge base of pregnant women in Nigeria vis a vis use of herbal medicines and potential effects of herbal remedies on the fetus. Opinion of pregnant women on the potential benefits or harms of combining herbal remedies with conventional therapies were also obtained.

Conclusions
The use of herbal medicines by pregnant women in Nigeria was seen to be quite high. Many patients have confidence in the efficacy of herbal remedies and found them helpful as a cost effective and accessible alternative treatment. Health care providers, especially those that are involved in ante-natal, pre-natal and post partum care should therefore be aware of evidence regarding potential benefits or harm of herbal medicinal agents when used by pregnant women, since many of these herbal remedies are self -prescribed based on the women's own information or belief.

http://www.biomedcentral.com/1472-6882/9/53

High Cost of Medical Care Prompts Consumers to Seek Alternatives

Data Bulletin No. 28 December 2004 Ha T. Tu, J. Lee Hargraves early 6 million American adults turned to complementary and alternative medicine (CAM) to treat specific health conditions, such as depression and chronic pain, in the past year because conventional medical treatment was too expensive, according to the 2002 National Health Interview Survey. Compared with the 38 million adults who used CAM to treat specific health conditions but did not cite cost of conventional medicine as a reason for doing so, people using CAM because of cost concerns were four times as likely to be uninsured (see Table 1). And they were almost twice as likely to have low incomesdefined as below 200 percent of the federal poverty level, or $36,200 for a family of four in 2002. Also, people using CAM because of cost concerns were much more likely to report fair or poor health status and lack a usual place to go to receive medical care. The financial barriers to conventional medical care reported by this group were striking: They were much more likely to report overall unmet medical needsand unmet mental health and prescription drug needs because of costs.

http://www.hschange.com/CONTENT/722/