October 7th 2009

The World Health Organisation estimates that 4.5% of the population worldwide experience depression at some point in their lifetime (WHO, 2007).  Depression was found to be the most frequently treated condition in a study of NHS homeopathic treatments (Mathie and Robinson, 2006). Depression treatment in homeopathy has been subject of two previous RCTs (Pilkington et al, 2005).

The recent randomized, double-blind trial performed by Adler et al investigated outcomes for 91 patients diagnosed with acute moderate to severe depression. Participants were assigned either fluoxetine or individualised homeopathic treatment.  The authors found that individualised homeopathic prescribing using Q (LM) potencies is as effective as fluoxetine in the treatment of patients suffering acute moderate to severe depression, based on a validated depression score. Response and remission rates as secondary efficacy outcomes showed no significant difference between the groups. No statistically significant differences in side effects were found between the groups but more patients in the fluoxetine arm of the study reported marked side effects and treatment interruption. More patients assigned to homeopathic prescriptions were excluded due to worsening symptoms.

Evidence from a recent large meta-analysis of antidepressant benefits (Kirsch et al, 2008) points to SSRIs, including fluoxetine, lacking effects over those expected from placebo. In this study, homeopathic treatment was shown to be not inferior to the placebo effect of fluoxetine.

The authors cautiously refer to a possible therapeutic effect of the
homeopathic consultation as a putative active agent in treatment. This study illustrates that a randomized controlled double-blind trial design for homeopathy in depression is feasible. While the authors recognize the need for further research, they show that in this study homeopathy performed no worse than fluoxetine in treating depression.

This is a synopsis of the paper by Adler UC, Paiva AT, Cesar AT, Adler MS, Molina A, Padula AE, Calil HM (2009) “Homeopathic Individualized Q-Potencies versus Fluoxetine for Moderate to Severe Depression: Double-blind, Randomized Non-inferiority trial” Evidence-Based Complementary and Alternative Medicine (eCAM) http://ecam.oxfordjournals.org/cgi/content/full/nep114

Suse Moebius BSc RSHom