Nutraceuticals in Psychiatric Practice

Abstract

Nutraceuticals can be defined as food components or active principles present in aliments which have positive effects for health and quality of life, including preventing or treating disorders. Herbal and "natural" food supplements are increasingly used to treat different psychiatric disorders, often as "self-prescribed" therapies. With factors such as chronic illness, poor health, emotional distress, and quality of life influencing the desire for complementary medicine, patients with comorbid medical and psychiatric problems seem likely to turn to this approach. We reviewed the most commonly used herbal and dietary supplements for which a certain efficacy on psychiatric symptoms or disorders has been claimed, checking current Pubmed-indexed literature (the most important being St. John's wort, Omega-3 fatty acids, valerian, Kava, Ginkgo, folate, B vitamins, S-Adenosylmethionine, inositol, alfa-lactoalbumin and passionflower). There is evidence of efficacy for some of these herbs an supplements, proved also by Cochrane's meta-analysis. However many different areas (including efficacy, tolerability, optimal dosing, adequate shelf life, drug and non-pharmacological interactions) need to be thoroughly studied; moreover political decisions need to be scientifically guided in order to best serve psychiatric patients' interests and to prevent using of expensive and sometimes un-useful therapies. This implies that a scientific strategy is needed to rule out any third-part economical interest which could in any way influence therapeutic choices. The article presents some promising patents on nutraceuticals in psychiatric practice.

Complementary and Alternative…but Please Not Secret

“…The second relevant point is that a significant number of caregivers decided not to discuss the use of complementary and alternative medicine interventions with their doctor, despite a diffuse feeling that there would have been an open-minded approach to this kind of interventions. We agree with Dr Patel and colleagues that the 42% in their study population is much lower than the 80% reported by Kompoliti et al 7 ; however, as Dr Patel and colleagues mention in their article, these interventions pose significant concerns in terms of safety 8 and interactions 9 with other treatments. Moreover, 17% of caregivers reported significant side effects, whose management could have been difficult without knowing about the complementary and alternative medicine interventions used.…”

Poly-Unsaturated Fatty Acids in ADHD and in Other Neuropsychiatric Conditions: A Multiple Case Presentation

“…Given that PUFA administration is a highly safe intervention, it is important for the general pediatrician, to be aware of this option, of its possible use, of the differences existing between different products in order to best serve the interest of the patient and of his/her family, considering the increasing use of nutraceuticals in psychiatric e neuropsychiatric disorders [17]. It is also important to consider PUFAs as part of a more comprehensive approach towards neurodevelopmental difficulties, as evidenced by the clinical vignettes described.…”

Perspective Chapter: Nutraceuticals as a Therapeutic Promise in Healthy Aging and Neurocognitive Disorders

“…The gut microbiota is a collection of colonies of multiple microbes that reside in the body and live in a symbiotic relationship with their host [63]. The brain-gutmicrobiota axis comprises a part of this microbiota that is an extensive communication network between the brain [64] and gut.…”

“…This axis plays an important role in the emotional and cognitive development of an individual, and any dysbiosis in this axis will lead to the occurrence of neuropsychiatric illnesses [65,66]. Recent studies have shown the interaction between hypothalamo-pituitary-adrenal (HPA) axis and braingut-microbiota axis in the causation of psychiatric disorders [63].…”

“…Probiotics are various bacterial strains that exert beneficial effects through the number of ways such as antimicrobial effects, modulating the host's immune response, enhancing the functioning of epithelial barrier [63,67]. The recent studies at the preliminary stage have shown that nutraceuticals, including prebiotics (fructooligosaccharides, xylo-oligosaccharides, and inulins), anthraquinones, phytoestrogens, polyphenols, amino acids, vitamins, and omega-3 fatty acids, can interact with…”