--> Pizzorno was appointed by President Clinton in December 2000 to the White House Commission on complementary and alternative medicine Policy. President Bush’s administration appointed him to the Medicare Coverage Advisory Committee in February 2003. He is also the co-author of the “Textbook of Natural Medicine” and the “Handbook of Natural Medicine. |  Evaluation of randomised controlled trials on complementary and alternative medicine', International Journal of Technological Assessment of Health Care 16: 13-21.
Bowles, E. J. 2000, The Basic Chemistry of Aromatherapeutic Essential
Oils, E. J. Bowles, Sydney. Bruneton, J. 1995, Pharmacognosy Phytochemistry Medicinal Plants,
Lavoisier Pubs, Paris. Carey, F. A. 2000, Organic Chemistry, 4th ed., McGraw Hill, Boston. Cronquist, A. 1988, The Evolution and Classification of Flowering Plants,
2nd edn, New York Botanical Gardens. Duke, J. A. and Bogenschutz-Godwin, M. J. |  In late 1998 the Office of Alternative Medicine was elevated to the status of a National "Center" for complementary and alternative medicine (NCCAM) within the NIH. Its budget almost tripled to $68 million, with over $10 million allocated for actual alternative cancer research.36 The National Cancer Institute quickly funded a Division of complementary and alternative medicine with advisers including Ralph Moss. The White House added its own Commission on Complementary and Alternative Policy to study and make policy recommendations to Congress. | | Alternative medicine has become complementary and alternative medicine (capitals intentional), or CAM for short; however, the question is often asked: 'Is there any scientific evidence that proves any of these therapies work?'.
Of all the various complementary therapies, perhaps medical herbalism can be made to fit the orthodox model most easily. Given that many of the pharmaceutical drugs in use are derived from plants directly or indirectly, it is obvious that at least some plants contain compounds with pharmacological activity that can be harnessed as medicinal agents. |  For example, a week-long course on "Botanical Medicine in Modern Clinical Practice" has been offered by the Rosenthal Center for complementary and alternative medicine at the Columbia University College of Physicians and Surgeons (www.rosenthal.hs.columbia.edu) since 1996.
Previous reports suggest that people who have used complementary medicine do not tell their physicians, as they are often concerned that the physician may either not understand or will criticize them; some of this is borne out in a recent survey summarized in Table 3 (Eisenberg et ai, 2001). | | Nearly two-thirds (64%) of the nation's medical schools now have courses on complementary and alternative medicine (CAM); many designed to help physicians answer patients' questions (Wetzel et ai, 1998; Stolberg, 2000). Of the 123 CAM courses reported in a survey, 68% were stand-alone electives and 31% were part of required curriculum (Wetzel et ai, 1998). Herbal medicine is usually included in the complementary medicine courses in these curricula, but the herb information is often relegated to cursory reviews and basic but incomplete information on only the most popular herbs in the market. | | Courses involving complementary and alternative medicine at U.S. medical schools. JAMA 1998;240:784-787.
Wilt J, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia: a systematic review. JAMA 1998;280( 18): 1604-9.
Zollman C, Vickers A. Complementary medicine and the doctor. British Medical Journal 1999;319:1558-1561.
Clinical Overviews, Patient Information Sheets, and Single Herb Monographs
Echinacea Illustration © 2003 Peggy Duke
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Bilberry
Vacciniutn myrtillus L.
[Fam. | | The
Photo © 2003 stevenfostercom
National Institutes of Health's (NIH) National Center for complementary and alternative medicine (NCCAM) recently sponsored a three-year, multi-center trial comparing the effects of a standardized extract of SJW and the selective serotonin reuptake inhibitor (SSRI) sertraline (Hypericum Depression Trial Study Group, 2002). Since 1979, there have been more than 35 controlled clinical studies of SJW extracts for the treatment of mild to moderate depression (Blumenthal et ai, 2000). | | A notable exception was a recent trial on a Chinese herbal formula to treat irritable bowel syndrome (IBS), published in a special complementary and alternative medicine edition of the Journal of the American Medical Association (Bensoussan et al, 1998). In this three-arm trial, patients received either a standardized formula, a customized formula prepared for each subject based on the concept of differential diagnosis, or placebo. The results suggested that the Chinese herbs were significantly better than placebo in providing relief from the symptoms of IBS, as measured in the trial. |  All of these approaches are encompassed by the general term complementary and alternative medicine (CAM). CAM and other terms, such as complementary medicine, alternative medicine, complementary therapies and complementary healthcare, are used interchangeably to describe many different diagnostic and treatment approaches which, generally, lie outside mainstream pharmacy and medicine. In addition to the therapies listed above, CAM includes acupuncture, chiropractic, massage, osteopathy, reflexology and other therapies. | | British Homeopathic Journal 89(suppl 1):S35-S38
Department of Health 2001 Government response to the House of Lords Select Committee on Science and Technology's report on complementary and alternative medicine. The Stationery Office, London
Eldin S, Dunford A 1999 Herbal medicine in primary care.
Butterworth-Heinemann, Oxford Ernst E, Hahn EG (eds) 1998 Homoeopathy. A critical appraisal.
Butterworth-Heinemann, Oxford Evans WC 2002 Trease and Evans' pharmacognosy, 15th edn.
Bailliere Tindall. London Fulder S 1996 The handbook of alternative and complementary medicine, 3rd edn. | | Oxford University Press, Oxford House of Lords Select Committee on Science and Technology
2000 Session 1999-2000, 6th report. complementary and alternative medicine. The Stationery Office, London Kayne S 1997 Homoeopathic pharmacy. An introduction and handbook. Churchill Livingstone, Edinburgh
PART B
IMPORTANT NATURAL PRODUCTS AND PHYTOMEDICINES USED IN PHARMACY AND MEDICINE
This part is devoted to plant-derived medicines arranged in therapeutic categories in a manner analogous to that of the British National Formulary (BNF). | | Herbal medicines are often considered to be part of complementary and alternative medicine (CAM), and the use of HMPs has increased alongside the increasing utilization of CAM across the developed world.
Natural products, or compounds isolated from nature
These are pure chemical entities, often used in the form of licensed medicines. They are sometimes produced synthetically and referred to as 'nature identical' (if that is the case), but were originally discovered from plant drugs. Examples include:
• Morphine, from opium poppy (Papaver somniferum), used as an analgesic. | | Preliminary results indicate that HIV+ men and women who use complementary and alternative medicine exclusively do not fare as well over 6 months as those who utilize both conventional drug therapy and complementary and alternative medicine. | | Additional meta-analyses are being continually produced by the Cochrane Collaboration, an international group of reviewers from various medical centers who have been conducting evidence-based reviews on many of the more well-researched herbs and phytomedicines (as well as reviews on other modalities used in both conventional and complementary and alternative medicine ). |  The NCI's Office of Cancer complementary and alternative medicine (OCCAM) initially was responsible for the review of 714X. After that, it was supposed to go to the Cancer Advisory Panel for Complementary Alternative Medicine (CAPCAM). At this point in time, it is unclear as to what the results of the NCI investigation have been.
714X is extremely inexpensive compared to conventional cancer approaches and costs about 300 U.S. dollars per 21-day cycle. |  Kronenberg F, Fugh-Berman A. complementary and alternative medicine for menopausal symptoms: A review of randomized, controlled trials. Annals of Internal Medicine. 2002; 137(10): 805-814.
Lauritzen CH, Reuter HD, Repges R, Bohnert KJ, Schmidt U (1997) Treatment of premenstrual tension syndrome with Vitex agnus castus. Controlled, double-blind study versus pyridoxine. Phytomedicine 4:183-189.
Lehmann-Willenbrock E, Riedel HH (1988) Klinische und endokrinologische Untersuchungen zur Therapie ovarieller Ausfallserscheinungen nach Hysterektomie unter Belassung der Adnexe. |  Sphere: Physical Page: 000 Action rating: Moderate
Booster 41: Consider Complementary and Alternative Medicine
Impact **
Amplifier Chronic or acute disease
One of the most controversial topics today between physicians and patients Is the role of complementary and alternative medicine. Though consumer-driven and rarely scientifically based, it has a role. Unfortunately, as with standard medicine, promises do not always meet expectations. |  The Desktop Guide to Complementary and Alternative Medicine: An Evidence-Based Approach. St. Louis, MO: Mosby, 2001.
A well-organized and well-documented resource for the clinical applications and side effects of commonly used herbs.
Robbers, James, and Varro Tyler. Tyler's Herbs of Choice. Binghamton, NY: Hawthorne Herbal Press, 1999.
An excellent, consumer-friendly review of common herbal remedies for various medical conditions.
Web Sites www.artofliving. |  Wayne Jonas, former director of the National
Center for complementary and alternative medicine at the National Institutes of Health, reports, "More than 80 percent of those who used unconventional practices in 1990 combined these practices with conventional medicine. Patients who use cam [complementary and alternative medicine] do not harbor antiscientific or anticonventional medicine sentiments, nor do they represent a disproportionate number of the uneducated, poor, seriously ill, or neurotic. | | Call the toll-free number for the NCCAM Clearinghouse, which can answer questions about complementary and alternative medicine.)
Natural Medicines Comprehensive Database
209-472-2244 www.naturaldatabase.com
Covers all of the common and many of the less well-known herbs. Includes information on side effects and potential drug interactions.
Print Resources
Brown, Richard P., Patricia L. Gerbarg, and Phillip R. Muskin. "Complementary and Alternative Treatments in Psychiatry." In Psychiatry 2nd edition. Edited by Allan Tasman, Jerald Kay, and Jeffrey Lieberman. Hoboken, NJ: Wiley, 2003. | | Fortunately, many medical centers are helping to bridge this research gap by establishing departments of complementary and alternative medicine. At the Rosenthal Center of Columbia University, for example, scientists are conducting studies of black cohosh and other phytoestrogens.
Confirming the Safety of Rhodiola rosea
Pat: We are aware of populations—mainly villagers in the mountains of Siberia and the Republic of Georgia—who take Rhodiola rosea every day throughout their lives without any increase in their risk of cancer. | | Preliminary results indicate that HIV+ men and women who use complementary and alternative medicine exclusively do not fare as well over 6 months as those who utilize both conventional drug therapy and complementary and alternative medicine. |  Note: The National Center for complementary and alternative medicine and the National Heart, Lung, and Blood Institute have launched the first large-scale clinical trial to determine the safety and efficacy of EDTA chelation therapy in individuals with confirmed coronary artery disease. Plans for the 5-year study, involving over 2300 patients at more than 100 research sites across the countty, are currently being finalized.
Coronary Gene Therapy
Coronary gene therapy is another alternative to either angioplasty or coronary artery bypass surgery for high risk patients. | | These findings sparked interest in the compound as a potential anticancer agent (National Center for complementary and alternative medicine 2001). Cellular and animal studies have found evidence that CoQiq stimulates the immune system and can increase resistance to illness (Bliznakov et al. 1970; Hogenauer et al. 1981; NCCAM 2000).
CoQiq nas demonstrated promise in treating breast cancer. Although there are only a few studies, the safe nature of CoQiq coupled with this promising research suggests that breast cancer patients should take 100 mg 3 times a day. |  Largely as a result of such misleading suggestions, the National Center for complementary and alternative medicine informs visitors to its Web site that no herbal or vitamin products can protect against bioterrorism, and the Federal Trade Commission sends warning letters to Web sites that make unsupportable claims that products such as oregano oil, coconut oil, or zinc mineral water protect against bioweapons. | | He refers to his treatment modality as "Complementary and Alternative Medicine," or CAM, and one of the most powerful tools he uses is Laetrile.
Primary to Dr. Brodie's approach is the administration of intensive intravenous treatments. These usually involve each patient spending three to four hours a day in his clinic Monday through Friday for an initial two to three-week period. After that, the patient can usually go home with a diet and supplement plan and return to the clinic at varying intervals for follow-up treatments. | | This approach is currently being evaluated in a large-scale study, funded by the National Institutes of Health's National Center for complementary and alternative medicine with collaboration from the National Cancet Institute. A key component of this program is the ingestion of large quantities of potk pancreas enzymes throughout the day.
How To Implement:
• You can enroll as a patient of Dr. Nicholas Gonzalez who practices in New York City. For information, contact Michelle Gabay, R.N., at (212) 305-9468 or visit the Gonzalez Web site at http://www.dr-gonzalez.com/. | | As a result of the pilot study, the National Cancer Institute (NCI) and the National Center for complementary and alternative medicine approved funding for a large-scale clinical trial comparing Dr. Gonzalez's nutritional therapy against gemcitabine in the treatment of inoperable pancreatic cancer. This study has full FDA approval and is being conducted under the Department of Oncology and the Department of Surgical Oncology at Columbia Presbyterian Medical Center in New York. To learn more about the study and its objectives, call Michelle Gabay, R.N., in the office of John Chabot, M.D. | | Ernst E, Pittler MH, Stevinson C, White A (2001) The Desktop Guide to complementary and alternative medicine, an Evidence-Based Approach. Mosby, Edinburgh London New York 2001.
ESCOP (2003) Monographs on the medicinal uses of plant drugs. Thieme Stuttgart New York, 2003
Europaisches Arzneibuch, Amtliche Deutsche Ausgabe 1997. Deutscher Apotheker Verlag - Govi
Verlag, Stuttgart - Eschborn, 1997. European Pharmacopeia (2002) Extracts. 4th edition. Suppl 4.3 : 2937-8. | |
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