Most alternative therapies ineffective in elderly

Most alternative therapies ineffective in elderly
NEW YORK (Reuters Health) - While some alternative remediesshow promise for older adults' sleep problems, depression andanxiety, the jury is still out on most, according to a newresearch review.
In an analysis of 33 clinical trials, researchers foundthat two thirds of the studies showed benefits from variousalternative remedies used to treat depression, anxiety andsleep disturbances.
Particularly promising were certain "mind-body" approaches,such as tai chi and relaxation exercises, in the treatment ofsleep problems.
In general, however, many of the studies suffered fromflaws in their design, and this was particularly true of thosethat had positive results, the researchers report in theJournal of Clinical Psychiatry.
In particular, no "biologically based" therapy -- includingherbs, vitamins and hormones -- has been proven safe andeffective for any of these conditions in older adults, saidlead researcher Dr. Thomas W. Meeks, an assistant clinicalprofessor of psychiatry at the University of California, SanDiego.
More studies of alternative remedies, specifically focusingon older adults, are necessary, according to Meeks and hiscolleagues. The number of older Americans with mental healthconditions is "increasing exponentially," they note, as isconsumers' interest in alternatives to conventional medicine.
For their review, the researchers combed the medicalliterature for clinical trials testing various alternativetherapies for depression, anxiety and sleep disturbances. Theyfound 33 clinical trials that involved at least 30 patients andlasted at least 2 weeks.
Overall, 10 of 12 studies on mind-body therapies --including tai chi and relaxation exercises -- found benefits,particularly for insomnia.
Mind-body therapies are a "reasonable alternative" forolder adults with insomnia who cannot or don't want to takesedative medication, Meeks told Reuters Health. He noted thatcomponents of relaxation therapy are used in cognitivebehavioral therapy, a mainstream treatment for insomnia.
However, Meeks added, certain mind-body approaches, liketai chi and yoga, require physical exertion, so older adultsshould get an OK from their doctor before trying them.
Mind-body therapies also "hold promise" for depression andanxiety, according to Meeks, but more studies are necessary. Ofthe mind-body trials in his team's review, none focusedprimarily on treating older adults' anxiety symptoms.
When it came to herbal remedies and other supplements -such as St. John's wort for depression, and melatonin for sleepproblems -- the results were inconsistent. According to theresearchers, less than half of these trials yielded positiveresults.
Older adults who do want to try an alternative remedyshould first talk with their doctor, Meeks advised. Herbs andother biological therapies, for example, can potentiallyinteract with any medications a person may be taking.
Some doctors may not be knowledgeable about a givenalternative therapy, Meeks noted, but they should at least bewilling to have a conversation about it.
"Open, honest communication is key to a doctor-patientrelationship," he said.
SOURCE: Journal of Clinical Psychiatry, October 2007.