BACKGROUND:
Ayurvedic medicine has been
used to treat mental health
problems since 1000 BC. OBJECTIVES:
To review effects of Ayurvedic
medicine or treatments for schizophrenia.
SEARCH STRATEGY: We searched
the Cochrane Schizophrenia Group
Trials Register (March 2007)
and AMED (March 2007), inspected
references of all identified
studies and contacted the first
author of each included study.
SELECTION CRITERIA:
We included all clinical randomized
trials comparing Ayurvedic medicine
or treatments with placebo,
typical or atypical antipsychotic
drugs for schizophrenia and
schizophrenia-like psychoses.
DATA COLLECTION AND
ANALYSIS: We independently
extracted data and calculated
random effects, relative risk
(RR), 95% confidence intervals
(CI) and, where appropriate,
numbers needed to treat/harm
(NNT/H) on an intention-to-treat
basis. For continuous data,
we calculated weighted mean
differences (WMD).
MAIN RESULTS:
From the three small (total
n=250) short included studies,
we were unable to extract any
data on many broad clinically
important outcomes such as global
state, use of services, and
satisfaction with treatment.
When Ayurvedic herbs were compared
with placebo, about 20% of people
left the studies early (n=120,
2 RCTs, RR 0.77 CI 0.37 to 1.62).
Mental state ratings were mostly
equivocal with the exception
of the brahmyadiyoga group using
Ayurvedic assessment (n=68,
1 RCT, RR not improved 0.56
CI 0.36 to 0.88, NNT 4 CI 3
to 12). Behavior seemed unchanged
(n=43, 1 RCT, WMD Fergus Falls
Behavior Rating 1.14 CI -1.63
to 3.91). Nausea and vomiting
were common in the brahmyadiyoga
group (n=43, RR 13.13 CI 0.80
to 216.30). When the Ayurvedic
herbs were compared with antipsychotic
drugs (chlorpromazine), again,
equal numbers left the study
early (n=120, 2 RCTs, RR for
brahmyadiyoga 0.91 CI 0.42 to
1.97) but people allocated herbs
were at greater risk of no improvement
in mental state compared to
those allocated chlorpromazine
(n=45, RR 1.82 CI 1.11 to 2.98).
Again, nausea and vomiting were
found with use of brahmyadiyoga
(n=45, 1 RCT, RR 20.45 CI 1.09
to 383.97, NNH 2 CI 2 to 38).
Finally, when Ayurvedic treatment,
in this case a complex mixture
of many herbs, is compared with
chlorpromazine in acutely ill
people with schizophrenia, it
is equally ( 10% attrition,
n=36, RR 0.67 CI 0.13 to 3.53),
but skewed data does seem to
favor the chlorpromazine group.
AUTHORS'
CONCLUSIONS:
Ayurvedic medication may have
some effects for treatment of
schizophrenia, but has been
evaluated only in a few small
pioneering trials.
