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Canadian Network for Mood and Anxiety Treatments (CANMAT) Clinical guidelines for the management of major depressive disorder in adults. V. Complementary and alternative medicine treatments.
J Affect Disord. 2009 Oct; 117 Suppl 1:S54-64.JA

Abstract

BACKGROUND

In 2001, the Canadian Psychiatric Association and the Canadian Network for Mood and Anxiety Treatments (CANMAT) partnered to produce evidence-based clinical guidelines for the treatment of depressive disorders. A revision of these guidelines was undertaken by CANMAT in 2008-2009 to reflect advances in the field. There is widespread interest in complementary and alternative medicine (CAM) therapies in the treatment of major depressive disorder (MDD).

METHODS

The CANMAT guidelines are based on a question-answer format to enhance accessibility to clinicians. An evidence-based format was used with updated systematic reviews of the literature and recommendations were graded according to Level of Evidence using pre-defined criteria. Lines of Treatment were identified based on criteria that included evidence and expert clinical support. This section on "Complementary and Alternative Medicine Treatments" is one of 5 guideline articles.

RESULTS

There is Level 1 evidence to support light therapy in seasonal MDD and St. John's wort in mild to moderate MDD. There is also some evidence for the use of exercise, yoga and sleep deprivation, as well as for omega-3 fatty acids and SAM-e . Support for other natural health products and therapies is still limited.

LIMITATIONS

The evidence base remains limited and studies often have methodological problems, including small samples, variability in dose, short duration of treatment, unknown quality of the agent and limited long-term data. Safety data are also sparse with little information about drug interactions.

CONCLUSIONS

Some CAM treatments have evidence of benefit in MDD. However, problems with standardization and safety concerns may limit their applicability in clinical practice.

Authors+Show Affiliations

University of Toronto, Canada. arun_ravindran@camh.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Practice Guideline
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19666194

Citation

Ravindran, Arun V., et al. "Canadian Network for Mood and Anxiety Treatments (CANMAT) Clinical Guidelines for the Management of Major Depressive Disorder in Adults. V. Complementary and Alternative Medicine Treatments." Journal of Affective Disorders, vol. 117 Suppl 1, 2009, pp. S54-64.
Ravindran AV, Lam RW, Filteau MJ, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) Clinical guidelines for the management of major depressive disorder in adults. V. Complementary and alternative medicine treatments. J Affect Disord. 2009;117 Suppl 1:S54-64.
Ravindran, A. V., Lam, R. W., Filteau, M. J., Lespérance, F., Kennedy, S. H., Parikh, S. V., & Patten, S. B. (2009). Canadian Network for Mood and Anxiety Treatments (CANMAT) Clinical guidelines for the management of major depressive disorder in adults. V. Complementary and alternative medicine treatments. Journal of Affective Disorders, 117 Suppl 1, S54-64. https://doi.org/10.1016/j.jad.2009.06.040
Ravindran AV, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) Clinical Guidelines for the Management of Major Depressive Disorder in Adults. V. Complementary and Alternative Medicine Treatments. J Affect Disord. 2009;117 Suppl 1:S54-64. PubMed PMID: 19666194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Canadian Network for Mood and Anxiety Treatments (CANMAT) Clinical guidelines for the management of major depressive disorder in adults. V. Complementary and alternative medicine treatments. AU - Ravindran,Arun V, AU - Lam,Raymond W, AU - Filteau,Marie J, AU - Lespérance,François, AU - Kennedy,Sidney H, AU - Parikh,Sagar V, AU - Patten,Scott B, AU - ,, Y1 - 2009/08/08/ PY - 2009/05/01/received PY - 2009/06/23/accepted PY - 2009/8/12/entrez PY - 2009/8/12/pubmed PY - 2009/12/16/medline SP - S54 EP - 64 JF - Journal of affective disorders JO - J Affect Disord VL - 117 Suppl 1 N2 - BACKGROUND: In 2001, the Canadian Psychiatric Association and the Canadian Network for Mood and Anxiety Treatments (CANMAT) partnered to produce evidence-based clinical guidelines for the treatment of depressive disorders. A revision of these guidelines was undertaken by CANMAT in 2008-2009 to reflect advances in the field. There is widespread interest in complementary and alternative medicine (CAM) therapies in the treatment of major depressive disorder (MDD). METHODS: The CANMAT guidelines are based on a question-answer format to enhance accessibility to clinicians. An evidence-based format was used with updated systematic reviews of the literature and recommendations were graded according to Level of Evidence using pre-defined criteria. Lines of Treatment were identified based on criteria that included evidence and expert clinical support. This section on "Complementary and Alternative Medicine Treatments" is one of 5 guideline articles. RESULTS: There is Level 1 evidence to support light therapy in seasonal MDD and St. John's wort in mild to moderate MDD. There is also some evidence for the use of exercise, yoga and sleep deprivation, as well as for omega-3 fatty acids and SAM-e . Support for other natural health products and therapies is still limited. LIMITATIONS: The evidence base remains limited and studies often have methodological problems, including small samples, variability in dose, short duration of treatment, unknown quality of the agent and limited long-term data. Safety data are also sparse with little information about drug interactions. CONCLUSIONS: Some CAM treatments have evidence of benefit in MDD. However, problems with standardization and safety concerns may limit their applicability in clinical practice. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/19666194/Canadian_Network_for_Mood_and_Anxiety_Treatments__CANMAT__Clinical_guidelines_for_the_management_of_major_depressive_disorder_in_adults__V__Complementary_and_alternative_medicine_treatments_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(09)00331-0 DB - PRIME DP - Unbound Medicine ER -