To systematically review placebo-controlled randomized trials of homeopathy for psychiatric conditions.
Eligible studies were identified using the following databases from database inception to April 2010: PubMed, CINAHL, PsycINFO, Hom-Inform, Cochrane CENTRAL, National Center for Complementary and Alternative Medicine grantee publications database, and ClinicalTrials.gov. Gray literature was also searched using Google, Google Scholar, the European Committee for Homeopathy, inquiries with homeopathic experts and manufacturers, and the bibliographic lists of included published studies and reviews. Search terms were as follows: (homeopath* or homoeopath*) and (placebo or sham) and (anxiety or panic or phobia or post-traumatic stress or PTSD or obsessive-compulsive disorder or fear or depress* or dysthym* or attention deficit hyperactivity or premenstrual syndrome or premenstrual disorder or premenstrual dysphoric disorder or traumatic brain injury or fibromyalgia or chronic fatigue syndrome or myalgic encephalitis or insomnia or sleep disturbance). Searches included only English-language literature that reported randomized controlled trials in humans.
Trials were included if they met 7 criteria and were assessed for possible bias using the Scottish Intercollegiate Guidelines Network (SIGN) 50 guidelines. Overall assessments were made using the Grading of Recommendations Assessment, Development and Evaluation procedure. Identified studies were grouped into anxiety or stress, sleep or circadian rhythm complaints, premenstrual problems, attention-deficit/hyperactivity disorder, mild traumatic brain injury, and functional somatic syndromes.
Twenty-five eligible studies were identified from an initial pool of 1,431. Study quality according to SIGN 50 criteria varied, with 6 assessed as good, 9 as fair, and 10 as poor. Outcome was unrelated to SIGN quality. Effect size could be calculated in 16 studies, and number needed to treat, in 10 studies. Efficacy was found for the functional somatic syndromes group (fibromyalgia and chronic fatigue syndrome), but not for anxiety or stress. For other disorders, homeopathy produced mixed effects. No placebo-controlled studies of depression were identified. Meaningful safety data were lacking in the reports, but the superficial findings suggested good tolerability of homeopathy. A funnel plot in 13 studies did not support publication bias (χ(>2)>(1) = 1.923, P = .166).
The database on studies of homeopathy and placebo in psychiatry is very limited, but results do not preclude the possibility of some benefit.
© Copyright 2011 Physicians Postgraduate Press, Inc.
For more information visit http://www.ncbi.nlm.nih.gov/pubmed/21733480
A gentle miracle post by David.
New research suggests water remembers what has been dissolved in it, even after dilution beyond the point where no molecule of the original substances could remain. Dr. Mae-Wan Ho reports.
For more than a century, practitioners of homeopathy have used highly diluted solutions of medicinal substances to treat diseases. Some substances are diluted way beyond the point at which no trace of the original substances could remain. It is as though the water has retained memory of the departed molecules. This has aroused a great deal of scepticism within the conventional medical and scientific community. To this day, ‘homeopathic’ is used as a term of derision, to indicate something imagined that has no reality.
But a series of recent discoveries in the conventional scientific community is making people think again.
First, there were the South Korean chemists who discovered two years ago that molecules dissolved in water clump together as they get more diluted (see SiS 15), which was totally unexpected; and further more, the size of the clumps depends on the history of dilution, making a mockery of the ‘laws of chemistry’.
Now, physicist Louis Rey in Lausanne, Switzerland, has published a paper in the mainstream journal, Physica A, describing experiments that suggest water does have a memory of molecules that have been diluted away, as can be demonstrated by a relatively new physical technique that measures thermoluminescence.
In this technique, the material is ‘activated’ by irradiation at low temperature, with UV, X-rays, electron beams, or other high-energy sub-atomic particles. This causes electrons to come loose from the atoms and molecules, creating ‘electron-hole pairs’ that become separated and trapped at different energy levels.
Then, when the irradiated material is warmed up, it releases the absorbed energy and the trapped electrons and holes come together and recombine. This causes the release of a characteristic glow of light, peaking at different temperatures depending on the magnitude of the separation between electron and hole.
As a general rule, the phenomenon is observed in crystals with an ordered arrangement of atoms and molecules, but it is also seen in disordered materials such as glasses. In this mechanism, imperfections in the atomic/molecular lattice are considered to be the sites at which luminescence appears.
Rey decided to use the technique to investigate water, starting with heavy water or deuterium oxide that’s been frozen into ice at a temperature of 77K. The absolute temperature scale (degree K, after Lord Kelvin) is used in science. (The zero degree K is equivalent to –273 C, and deuterium is an isotope of hydrogen which is twice as heavy as hydrogen).
As the ice warms up, a first peak of luminescence appears near 120K, and a second peak near 166 K. Heavy water gives a much stronger signal than water. In both cases, samples that were not irradiated gave no signals at all.
For both water and heavy water, the relative intensity of the thermoluminescence depends on the irradiation dose. There has been a suggestion that peak 2 comes from the hydrogen-bonded network within ice, whereas peak 1 comes from the individual molecules. This was confirmed by looking at a totally different material that is known to present strong hydrogen bonds, which showed a similar glow in the peak 2 region, but nothing in peak 1.
Rey then investigated what would happen when he dissolved some chemicals in the water and diluted it in steps of one hundred fold with vigorous stirring (as in the preparation of homeopathic remedies), until he reached a concentration of 10 to the power -30 g per centilitre, and compare that to the control that has not had any chemical dissolved in it and diluted in the same way.
The samples were frozen and activated with irradiation as usual.
Much to his surprise, when lithium chloride, LiCl, a chemical that would be expected to break hydrogen bonds between water molecules was added, and then diluted away, the thermoluminescent glow became reduced, but the reduction of peak 2 was greater relative to peak 1. Sodium chloride, NaCl, had the same effect albeit to a lesser degree.
It appears, therefore, that substances like LiCl and NaCl can modify the hydrogen-bonded network of water, and that this modification remains even when the molecules have been diluted away.
The fact that this ‘memory’ remains, in spite of, or because of vigorous stirring or shaking at successive dilutions, indicates that the ‘memory’ is by no means static, but depends on a dynamic process, perhaps a collective quantum excitation of water molecules that has a high degree of stability (see “The strangeness of water and homeopathic memory”, SiS 15).
Rey L. Thermoluminescence of ultra-high dilutions of lithium chloride and sodium chloride. Physica A 2003, 323, 67-74.
A gentle miracle post by David.
Getting an NHS referral for homeopathy
Asking to be referred
If there is a homeopathic GP in your area, you may be able to register with them – use our practitioner search to find out if there is one near you. Otherwise, you will need to ask your current doctor or specialist for a referral to one of the homeopathic hospitals or clinics, or to a homeopathic GP who takes NHS referrals. Your doctor can either use the choose and book system or apply directly to the Primary Care Trust (PCT) or Local Health Board (LHB) on your behalf.
Your GP must take your request seriously
Under the terms of his/her contract, your GP is obliged to refer you for other NHS services if you ask for them. Referral to doctors working at the homeopathic hospitals, clinics and in private practice fulfills this responsibility.
Your GP will want to be satisfied that the treatment you request meets your needs and he/she may want to know if there is evidence to back it up. You can use our two page summary of evidence to show your doctor that there is a good body of positive research in homeopathy. We can also provide you with information on your specific condition in some cases – call us on 01582 408675 to find out.
If your GP decides that homeopathic treatment is not appropriate, he or she should discuss this with you. If you do not feel that your GP has given you a satisfactory explanation there are other things you can do:
1. Contact the BHA – we can help you make a good case for asking your GP to re-consider their decision.
2. Request a second opinion from another doctor at the practice.
3. Register with another GP in your area who is open to referring patients for homeopathy.
Got a referral but there’s no local funding?
It is likely that your referral to a homeopathic hospital or clinic will be funded by your PCT in England or LHB in Scotland, Wales and Northern Ireland. However some GPs might not know about the funding arrangements for NHS homeopathy, in which case the homeopathic hospital where the referral is being requested can usually advise.
There are some PCTs/LHBs that restrict access to homeopathic treatment and who will only fund GPs to refer patients in exceptional cases. If this is the case where you live, your referral will go to a panel of doctors and managers who will decide whether your treatment can be funded. The PCT/LHB must ensure that your request is considered on its individual merits.
If funding for homeopathy is refused
If you still cannot get the initial referral from your GP or specialist, of if you have the referral but the funding is refused, you may like to make a formal complaint. If you live in England and want to take your case further, contact the Patient Advice and Liaison Service (PALS). To find your nearest PALS contact, telephone NHS Direct on 0845 4647 or visit http://www.pals.nhs.uk/.
If you live in Wales, your local Community Health Council can point you in the right direction. In Scotland, the Scottish Health Council can help you and in Northern Ireland, the local Health Council can guide you. These bodies will help you to liaise with the practice, PCT or LHB making the decision.
A gentle miracle post by David.
Gießen / Baden-Baden (Germany) – How does medicine affect our brain? Prof. Dr. Wilfried Dimpfel from the Justus Liebig University in Gießen, Germany, uses electricity to come up with the answer. He measures brain waves with the help of an electroencephalogram (EEG) to characterize the impact of pharmaceuticals. Using one of the homeopathic medications produced by the pharmaceutical company Heel as an example, he examined its effects, compared it to other medications and created a differentiated profile.
The electroencephalogram (EEG) is an approved standard method in medical diagnostics. It measures the electric signals that nerve cells in the brain use to communicate. Based on the region of the brain and the frequency of these electrical activities, the psycho-pharmacological effect of medication can be described, among other information. Each drug produces an individual reaction pattern.
The pharmacologist Prof. Dr. Wilfried Dimpfel examined the effect of a medication that contains several natural active pharmaceutical ingredients in homeopathic dilution, including passion flower and oats. Within an hour after taking the drug, the brain activity in certain regions already becomes more intense. It then reaches its peak after two to three hours and gradually decreases.
“Although the active pharmaceutical ingredients in the homeopathic preparation are highly diluted, the brain shows a strong reaction,” Dimpfel says. “The low dosage possibly even has a higher impact: In pre-clinical experiments, the brain”s response was even stronger if the dose was half of a pill per kilogram of body weight instead of a whole pill,” he adds.
The electrical activity was measured in four brain regions: the hippocampus and the frontal cortex, in which memories and emotions are processed, as well as the striatum and the formatio reticularis that controls conscious and unconscious brain functions via messenger substances.
“The pattern of brain activities implies a relaxing effect of this medication,” explains Dr. Bernd Seilheimer, Head of Bioregulatory Research at the pharmaceutical company Heel in Baden-Baden, Germany. “The EEG has verified the results of previous observational studies. It shows a great similarity to the effect of chemical tranquilizers. Hence, we can assume that the mechanisms of action are similar. Due to its good tolerability, the homeopathic medication is particularly well-suited for stress therapies,” Seilheimer adds.
Through its studies on the effectiveness of homeopathic medications based on proven scientific standards, the pharmaceutical manufacturer Heel builds the bridge between homeopathy and conventional medicine. The pre-clinical study conducted by Prof. Dr. Wilfried Dimpfel, University of Gießen, was presented on December 3, 2010, at the European Congress for Integrative Medicine in Berlin and published in the European Journal of Integrative Medicine (issue 2, volume 4, pages 227 – 228).
Heel is a pioneer in the field of research on natural medicine on the basis of scientific standards. At Heel, a worldwide team of experts continuously works on expanding the scientific basis for its own products, but also on examining the underlying bioregulatory processes. The company spends a double-digit million Euro amount on scientific medical research each year. Its current activities include 50 research projects involving renowned international experts, institutes and universities from twelve countries.
Heel is a pharmaceutical company that develops, manufactures and distributes medications based on natural substances. Being the global leader in homeopathic combination preparations, the company is also a pioneer in the field of scientific research in natural healthcare. In cooperation with academic institutions, Heel actively fosters the concept of Integrative Medicine and is striving to build the bridge between homeopathy and conventional medicine to improve patient care and healing. The “Biologische Heilmittel Heel GmbH” with its corporate headquarters located in Baden-Baden/Germany and a staff of 1,300, achieved an annual turnover of 184 million Euros in 2010 – more than 70 percent of it outside of Germany. Heel medications are available through subsidiaries and distribution partners in over 50 countries around the world. http://www.heel.com
A gentle miracle post by David.
The Research Evidence Base for Homeopathy
Systematic reviews of randomised controlled trials (RCTs) of homeopathy
• Four of five major comprehensive reviews of RCTs in homeopathy have reached broadly
positive conclusions. 1,2,3,4 Based on a smaller selection of trials, a fifth review came to a
negative conclusion about homeopathy. 5
• Positive conclusions have been reported in 9 of 23 reviews of RCTs in specific categories of
medical condition (the other 14 are largely inconclusive):
•allergies and upper respiratory tract infections 6
•childhood diarrhoea 7
•influenza treatment 8
•post-operative ileus 9
•rheumatic diseases 10
•seasonal allergic rhinitis 11,12,13
RCTs of homeopathy – the original peer-reviewed research literature
• Up to the end of 2009, 142 RCTs had been published: 63 positive; 11 negative; 68 not
statistically conclusive. In addition to the above seven conditions, there is positive evidence
from two or more RCTs in each of the following three areas:
There is evidence from single RCTs (not refuted elsewhere) in favour of homeopathy for a
number of other conditions, including: acute otitis media, 22 ankle sprain, 23 bronchitis,24 chronic fatigue,25 premenstrual syndrome. 26
Cost effectiveness of homeopathy
Integration of homeopathy with conventional treatment is associated with better clinical
outcomes for similar or lower costs. 27,28,29
Clinical observational studies
70.7% of 6,544 follow-up patients, treated at Bristol Homeopathic Hospital for a wide range of
chronic medical complaints, reported positive health changes. 30
Many patients attending the Royal London Homoeopathic Hospital were able to reduce or stop
conventional medication following homeopathic treatment.
Laboratory research has obtained evidence that water may retain information about homeopathically-prepared solutes. 32,33,34
1.Kleijnen J, Knipschild P, ter Riet G. Clinical trials of homeopathy.20. Friese K-H, Zabalotnyi DI. Homeopathy in acute rhinosinusitis.
Br Med J 1991; 302: 316–23.A double-blind, placebo controlled study shows the effectiveness
and tolerability of a homeopathic combination remedy.
2.Linde K, Clausius N, Ramirez G, et al. Are the clinical effects
HNO 2007; 55: 271–7.
of homoeopathy placebo effects? A meta-analysis of
placebo-controlled trials. Lancet 1997; 350: 834–43.21. Zabolotnyi DI, Kneis KC, Richardson A, et al. Efficacy of a
complex homeopathic medication (Sinfrontal) in patients with
3.Linde K, Scholz M, Ramirez G, et al. Impact of study quality
acute maxillary sinusitis: a prospective, randomized, double-
on outcome in placebo controlled trials of homeopathy.
blind, placebo-controlled, multicenter clinical trial. Explore (NY)
J Clin Epidemiol 1999; 52: 631–6.
2007; 3: 98–109.
4.Cucherat M, Haugh MC, Gooch M, Boissel JP. Evidence of
22. Jacobs J, Springer DA, Crothers D. Homeopathic treatment
clinical efficacy of homeopathy – A meta-analysis of clinical trials.
of acute otitis media in children: a preliminary randomized
Eur J Clin Pharmacol 2000; 56: 27–33.
placebo-controlled trial. Pediatr Infect Dis J 2001; 20:
5.Shang A, Huwiler-Muntener K, Nartey L, et al. Are the clinical177–83.
effects of homoeopathy placebo effects? Comparative study of
23. Zell J, Connert WD, Mau J, Feuerstake G. Treatment of acute
placebo-controlled trials of homoeopathy and allopathy.
sprains of the ankle. Controlled double-blind trial to test the
Lancet 2005; 366: 726–32.
effectiveness of a homeopathic ointment. Fortschr Med 1988;
6.Bornhöft G, Wolf U, Ammon K, et al. Effectiveness, safety 106: 96–100.
and cost-effectiveness of homeopathy in general practice –
24. Diefenbach M, Schilken J, Steiner G, Becker HJ. Homeopathic
summarized health technology assessment. Forsch
therapy in respiratory tract diseases. Evaluation of a clinical
Komplementärmed 2006; 13 Suppl 2: 19–29.
study in 258 patients. Z Allgemeinmed 1997; 73: 308–14.
7.Jacobs J, Jonas WB, Jimenez-Perez M, Crothers D.
Homeopathy for childhood diarrhea: combined results and25. Weatherley-Jones E, Nicholl JP, Thomas KJ, et al. A randomized,
controlled, triple-blind trial of the efficacy of homeopathic
metaanalysis from three randomized, controlled clinical trials.
Pediatr Infect Dis J 2003; 22: 229–34.treatment for chronic fatigue syndrome. J Psychosom Res 2004;
8.Vickers A, Smith C. Homoeopathic Oscillococcinum for
preventing and treating influenza and influenza-like syndromes 26. Yakir M, Kreitler S, Brzezinski A, et al. Effects of homeopathic
(Cochrane Review). In: The Cochrane Library. Chichester, UK:treatment in women with premenstrual syndrome: a pilot study.
John Wiley & Sons, Ltd. 2006; CD001957. Br Homeopath J 2001; 90: 148–53.
9.Barnes J, Resch K-L, Ernst E. Homeopathy for postoperative27. Witt C, Keil T, Selim D, et al. Outcome and costs of homeopathic
ileus? A meta-analysis. J Clin Gastroenterol 1997; 25: 628–33.and conventional treatment strategies: a comparative cohort
study in patients with chronic disorders. Complement Ther
10. Jonas WB, Linde K, Ramirez G. Homeopathy and rheumatic
Med 2005; 13: 79–86.
disease – Complementary and alternative therapies for rheumatic
diseases II. Rheum Dis Clin North Am 2000; 26: 117–23.28. Witt CM, Lüdtke R, Baur R, Willich SN. Homeopathic medical
practice: long-term results of a cohort study with 3,981 patients.
11. Wiesenauer M, Lüdtke R. A meta-analysis of the homeopathic
BMC Public Health 2005; 5: 115.
treatment of pollinosis with Galphimia glauca. Forsch
Komplementärmed Klass Naturheilkd 1996; 3: 230–6.
29. Trichard M, Chaufferin G Nicoloyannis N. Pharmacoeconomic
comparison between homeopathic and antibiotic treatment
12. Taylor MA, Reilly D, Llewellyn-Jones RH, et al. Randomised
strategies in recurrent acute rhinopharyngitis in children.
controlled trials of homoeopathy versus placebo in perennial
Homeopathy 2005; 94: 3–9.
allergic rhinitis with overview of four trial series.
Br Med J 2000; 321: 471–6.
30. Spence D, Thompson E, Barron S. Homeopathic treatment
for chronic disease: a 6-year university hospital based
13. Bellavite P, Ortolani R, Pontarollo F, et al. Immunology and
outpatient observational study. J Altern Complement Med 2005;
homeopathy. 4. Clinical studies – Part 2. eCAM 2006;
31. Sharples F, van Haselen R, Fisher P. NHS patients’ perspective
14. Schneider B, Klein P, Weiser M. Treatment of vertigo with a
on complementary medicine. Complement Ther Med 2003;
homeopathic complex remedy compared with usual treatments:
a meta-analysis of clinical trials. Arzneimittelforschung 2005;
32. Rey L. Thermoluminescence of ultra-high dilutions of lithium
15. Fisher P. An experimental double-blind clinical trial method inchloride and sodium chloride, Physica (A) 2003; 323: 67–74.
homoeopathy. Use of a limited range of remedies to treat
33. Bell IR, Lewis DA, Brooks AJ, et al. Gas discharge visualisation
fibrositis. BrHomeopath J 1986; 75: 142–7.
evaluation of ultramolecular doses of homeopathic medicines
16. Bell I, Lewis D, Brooks A, et al. Improved clinical status inunder blinded, controlled conditions. J Altern Complement Med
fibromyalgia patients treated with individualized homeopathic2003; 9: 25–38.
remedies versus placebo. Rheumatology 2004; 43: 577–82.
34. Elia V, Niccoli M. Thermodynamics of extremely diluted aqueous
17. Relton C, Smith C, Raw J, et al. Healthcare provided by asolutions. Ann N Y Acad Sci 1999; 879: 241–8.
homeopath as an adjunct to usual care for fibromyalgia (FMS):
35. Linde K, Jonas WB, Melchart D, et al. Critical review and
results of a pilot randomised controlled trial. Homeopathy 2009;
meta-analysis of serial agitated dilutions in experimental
toxicology. Hum Exp Toxicol 1994; 13: 481–92.
18. Shealy CN, Thomlinson RP, Cox RH, Borgmeyer RN.
Osteoarthritic pain: a comparison of homeopathy and36. Belon P, Cumps J, Ennis M, et al. Histamine dilutions modulate
A gentle miracle post by David.