Natural Medicines Comprehensive Database eUPDATE and eCE

Natural Medicines Comprehensive Database eUPDATE and eCE

Here are just a few of the hundreds of updates we've made to Natural
Medicines Comprehensive Database this month. You can learn more about
these and thousands of other natural medicines by accessing the
Database. Plus you can get fully accredited continuing education
credits.

• SAMe (S-adenosyl methionine) is getting renewed attention as an
option for patients with mild-to-moderate major depression. New
guidelines from the American Psychiatric Association now suggest SAMe
as an alternative to conventional antidepressants (e.g., paroxetine,
venlafaxine, etc) for patients interested in alternative therapies.
New research also shows that SAMe might be effective for
treatment-resistant depression. Adding SAMe (SAMe Complete 400 mg,
Nature Made) 400 mg twice daily to conventional treatment in
nonresponders increased remission rates by about 14% after 6 weeks of
treatment. About 7 patients need to be treated with SAMe for 6 weeks
for one additional patient to have remission. Explain to patients that
SAMe is an option worth considering. Keep in mind that SAMe isn't
covered by insurance. It can be expensive - $65 or more for a month's
supply.

• Clotamin is a new supplement promoted for patients taking the blood
thinner, warfarin (Coumadin). This product is similar to a typical
multiple vitamin, but it does not contain vitamin K. It also contains
lower amounts of some ingredients including vitamin C, vitamin D, and
vitamin E, to prevent potential interactions with warfarin. But it
contains substantially more B vitamins and biotin to prevent potential
warfarin side effects, such as fatigue and hair loss. Explain to
patients that there is no reliable evidence that taking this product
can prevent warfarin-related side effects. Remind patients that
consistency is key. Most common multiple vitamin products are OK to
take while on warfarin therapy, if they are taken consistently.

• St. John's wort is commonly used to improve mood and treat
depression. St. John's wort affects neurotransmitters similar to
conventional antidepressants. It also affects serotonin receptors in
the gut, similar to irritable bowel syndrome (IBS) drugs such as
alosetron (Lotronex). Many IBS patients are now trying St. John's
wort. But new research is discouraging. It shows that taking a
specific St. John's wort extract (St. John's Wort Extract Extra
Strength, Enzymatic Therapy) 450 mg twice daily is no more effective
than placebo for reducing symptoms after 12 weeks of treatment. In
fact, some patients did worse on St. John's wort compared to placebo.
For now, explain to IBS patients that St. John's wort doesn't appear
to be a good choice.