Is it safe to take herbal supplements for a patient with psychological disorders?

From the Guidelines

It is not safe to take herbal supplements without medical supervision if you have psychological disorders. Consult with your healthcare provider before starting any herbal supplement, as many can interact with psychiatric medications and potentially worsen symptoms. Common supplements like St. John's Wort can cause dangerous interactions with antidepressants, potentially leading to serotonin syndrome, as noted in studies 1. Kava may worsen depression and can cause liver damage. Valerian and melatonin might interact with anxiety medications or sedatives. Even seemingly harmless supplements can affect how your prescribed medications work or directly impact your mental health condition. Many herbal products lack standardization and rigorous testing, making their effects unpredictable, as highlighted in a study from the American College of Physicians 1.

Key Considerations

• St. John's Wort is associated with important drug–drug interactions and is known to induce cytochrome P450 isoenzyme 3A4, which may reduce the bioavailability or efficacy of some drugs, such as oral contraceptives and immunosuppressants 1.
• The American College of Physicians recommends that clinicians select between either cognitive behavioral therapy or second-generation antidepressants to treat patients with major depressive disorder after discussing treatment effects, adverse effect profiles, cost, accessibility, and preferences with the patient 1.
• If you're interested in complementary approaches, discuss this with your psychiatrist or primary care doctor who can help determine which options might be safe given your specific diagnosis, medication regimen, and health history. They may recommend evidence-based alternatives like specific dietary changes, exercise, or mind-body practices that have better safety profiles for people with psychological disorders.

Safety and Efficacy

The safety and efficacy of herbal supplements for patients with psychological disorders are not well established, and the potential for adverse interactions with prescribed medications is a significant concern. Therefore, it is crucial to consult with a healthcare provider before taking any herbal supplements. The provider can help weigh the potential benefits against the risks and recommend safer alternative treatments, as suggested by studies 1.

From the FDA Drug Label

Warning: Do not give to children under twelve except under the advice and supervision of a doctor. If you are pregnant or nursing a baby seek the advice of a health professional before using this product. Do not exceed recommended dosage. Consult a doctor if symptoms are more than mild or if they persist. The answer to the question of whether it is safe to take herbal supplements for a patient dealing with psychological disorders is not directly addressed in the provided drug label for valerian root 2.

• The label provides warnings for specific populations such as children under twelve, pregnant women, and nursing mothers.
• It advises consulting a doctor if symptoms are more than mild or if they persist, but it does not explicitly mention psychological disorders. Therefore, based on the information provided in the label, no conclusion can be drawn regarding the safety of taking herbal supplements for patients with psychological disorders.

From the Research

Safety of Herbal Supplements for Patients with Psychological Disorders

• The use of herbal supplements for patients dealing with psychological disorders is a concern due to potential health risks, including misbranded toxic ingredients, contaminants, adulterants, and herb-drug interactions (HDI) with co-administered drugs 3.
• Herbal supplements are not regulated by the US Food and Drug Administration (FDA) for premarketing purity and potency, which can lead to deleterious health effects, including deranged lab results, allergic reactions, genotoxicity, carcinogenicity, teratogenicity, organ damage, and even fatality 3, 4.
• Patients with psychological disorders may be at higher risk due to potential interactions between herbal supplements and psychiatric medications, highlighting the need for careful monitoring and disclosure of supplement use 5, 6.

Efficacy and Safety of Nutrient Supplements

• Some nutrient supplements, such as polyunsaturated fatty acids (PUFAs), vitamins, minerals, antioxidants, amino acids, and pre/probiotic supplements, have shown promise in the treatment of mental disorders, including depression and attention-deficit/hyperactivity disorder 7.
• The strongest evidence was found for PUFAs, particularly as eicosapentaenoic acid, as an adjunctive treatment for depression, with good safety profiles and no evidence of serious adverse effects or contraindications with psychiatric medications 7.
• Clinicians should be informed of the nutrient supplements with established efficacy for certain conditions and made aware of those currently lacking evidentiary support to provide informed guidance to patients 7.

Precautions and Safe Use

• Patients should be encouraged to disclose their use of herbal supplements to healthcare providers, and providers should employ HDI screening tools and report adverse reactions to the FDA to minimize health risks 3, 4.
• Resources for consumers and healthcare professionals are available to provide information and precautions for common herbal supplements, including St. John's wort, ginseng, echinacea, and ginkgo 4, 6.