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Alternative and Complementary Treatments for Anxiety Disorders

Complementary/Alternative Medicine for Anxiety

David Slawson, MD
Excerpt from a systematic review
American Family Physician, 2/01/2005

Bottom Line: The majority of complementary and alternative medicines lack valid evidence of effectiveness in the treatment of anxiety disorders. Some supporting evidence has been found for inositol, acupuncture, massage (only in children), autogenic therapy, bibliotherapy, dance/movement therapy, exercise, meditation, music, and relaxation therapy. Many common herbal and homeopathy treatments lack any evidence of effectiveness.

A Meta-analysis of Massage Therapy Research

Moyer, CA, Rounds, J & Hannum, JW.
Psychological Bulletin, 2004 Jan;130(1):3-18.

This positive review was published by a particularly rigorous journal:

Massage therapy (MT) is an ancient form of treatment that is now gaining popularity as part of the complementary and alternative medical therapy movement. A meta-analysis was conducted of studies that used random assignment to test the effectiveness of MT. Mean effect sizes were calculated from 37 studies for 9 dependent variables. Single applications of MT reduced state anxiety, blood pressure, and heart rate but not negative mood, immediate assessment of pain, and cortisol level. Multiple applications reduced delayed assessment of pain. Reductions of trait anxiety and depression were MT's largest effects, with a course of treatment providing benefits similar in magnitude to those of psychotherapy. No moderators were statistically significant, though continued testing is needed. The limitations of a medical model of MT are discussed, and it is proposed that new MT theories and research use a psychotherapy perspective.

Effectiveness of complementary and self-help treatments for anxiety disorders.
Jorm AF, Christensen H, Griffiths KM, Parslow RA, Rodgers B, Blewitt KA.
Medical Journal of Australia, 2004 Oct 4;181(7 Suppl):S29-46.

OBJECTIVES: To review the evidence for the effectiveness of complementary and self-help treatments for anxiety disorders. DATA SOURCES: Systematic literature search using PubMed, PsycLit, and the Cochrane Library. DATA SYNTHESIS: 108 treatments were identified and grouped under the categories of medicines and homoeopathic remedies, physical treatments, lifestyle, and dietary changes. We give a description of the 34 treatments (for which evidence was found in the literature searched), the rationale behind the treatments, a review of studies on effectiveness, and the level of evidence for the effectiveness studies. CONCLUSIONS: The treatments with the best evidence of effectiveness are kava (for generalised anxiety), exercise (for generalised anxiety), relaxation training (for generalised anxiety, panic disorder, dental phobia and test anxiety) and bibliotherapy (for specific phobias). There is more limited evidence to support the effectiveness of acupuncture, music, autogenic training and meditation for generalised anxiety; for inositol in the treatment of panic disorder and obsessive-compulsive disorder; and for alcohol avoidance by people with alcohol-use disorders to reduce a range of anxiety disorders. Link: Jorm, et al.
(ASDI note: Liver damage has subsequently been linked to kava use.)

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