RCP – Combining traditional Chinese herbal medicine with Western antipsychotic medication is beneficial in the treatment of schizophrenia, a systematic review of randomised trials has found.
Chinese herbal medicine has been used to treat millions of people with schizophrenia for over 2000 years. Although antipsychotic drugs are the mainstay of treatment both in China and in the West, they have serious side effects, and about one fifth of people do not respond adequately to treatment.
The 7 studies reviewed were identified from the Cochrane Schizophrenia Group’s register of trials, as well as a range of Chinese databases. Most studies evaluated Chinese herbal medicine in combination with Western antipsychotic drugs.
The results, published in the May issue of the British Journal of Psychiatry, tended to favour combination treatment compared with antipsychotic treatment alone.
The authors of the study comment that the results are broadly encouraging. They suggest that combination treatment might be beneficial in terms of certain measures of improvement in schizophrenia, although results are based on only 2 small studies of a total of 103 people.
Medium-term data on the negative symptoms of schizophrenia, such as withdrawal, were more robust, with 3 studies of a total of 741 people favouring the herbal plus antipsychotic combination group.
The researchers conclude that there is some evidence that Chinese herbal medicines, combined with antipsychotics and given in a way that is not in keeping with their normal use within traditional Chinese medicine, may be beneficial for people with schizophrenia across a range of outcomes.
If these medicines are used within their usual context, which differentiates cases of schizophrenia into syndromes, the positive effects could be greater, they say. Even the gains seen in this review would still be important for the millions for whom these treatments are used.
Both West and East need well-reported randomised trials that are adequately powered, blinded and of sufficient length for researchers to detect meaningful treatment effects.
[Rathbone J, Zhang L, Zhang M, Xia J, Liu X, Yang Y and Adams CE (2007) Chinese herbal medicine for schizophrenia: Cochrane systematic review of randomised trials. British Journal of Psychiatry, 190, 379-384.]