By MD Barry S.Oken, Barry Oken
Drawing upon the information of professional participants, this booklet offers an advent to what CAM remedies are and the way a neurologist could use them. Divided into sections, it experiences the various types of treatments encompassed by means of the phrases "alternative" and "complementary" and offers readers an outline of primary treatments that experience a few medical foundation for his or her use. the second one part is an evidence-based assessment of the medical purposes of those treatments prepared via neurological illness. Written via physicians for physicians, this booklet is the 1st selection for info on substitute and complementary remedies in scientific neurology.
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Such interactions have been reported with cyclosporin, amitriptyline, digoxin, indinavir, warfarin, phenprocoumon and theophylline. Intermenstrual bleeding was reported in oral contraceptive users5,77. A systematic review93 of drug interactions with St John’s wort has identified clinically Complementary therapies in neurology 26 significant interactions with warfarin, phenprocoumon, cyclosporin, HIV protease inhibitors, theophylline, digoxin and oral contraceptives. In Sweden and the UK, the potential risks to patients were judged to be significant, and product information of the licensed medicines involved has been amended to reflect these concerns93.
G. g. analysis of only responders or compliant patients, or of an ‘eligible’ or ‘evaluable’ subset) A conduct of studies by groups with properly documented operating procedures and a history of implementing such procedures effectively Botanicals—quality, efficacy, safety and drug interactions 21 Table 5. Definitions of the levels of evidence of the safe and effective use of an herbal medicinal product. Based on the US Agency for Health Care Policy and Research and the WHO and references 28 and 29 Level Type of evidence Ia Evidence obtained from meta-analysis of randomized controlled trials Ib Evidence obtained from at least one randomized controlled trial IIa Evidence obtained from at least one well-randomization designed controlled study without IIb Evidence obtained from at least one other type of well-designed quasi-experimental study III Evidence obtained from well-designed non-experimental descriptive studies, such as comparative studies, correlation studies and case-control studies IV Evidence obtained from expert committee reports or opinions and/or clinical experience of respected authorities A 2002 Cochrane review35, while recognizing the need for more clinical trials, concluded that there was promising evidence of improvement in cognition and function associated with ginkgo, with no excess side-effects compared to placebo.
EMEA/HMPWG/23/99 draft. Ad hoc Working Group on Herbal Medicinal Products. Draft Points to Consider on the Evidence of Safety and Efficacy Required for Well-established Herbal Medicinal Products in Bibliographic Applications. London: The European Agency for the Evaluation of Medicinal Products, 1999:1–7 29. Forte JS, Raman A. Regulatory issues relating to herbal products. Part 2: Safety and toxicity. J Med Food 2000; 3:41–58 30. Ernst E, Pittler MH. Ginkgo biloba for dementia: a systematic review of double-blind placebocontrolled trials.
Complementary Therapies in Neurology by MD Barry S.Oken, Barry Oken