Abstract
Objective To systematically review the research evidence on the effectiveness of homeopathy
for the treatment of depression and depressive disorders.
Methods A comprehensive search of major biomedical databases including MEDLINE, EMBASE, ClNAHL,
PsycINFO and the Cochrane Library was conducted. Specialist complementary and alternative
medicine (CAM) databases including AMED, CISCOM and Hom-Inform were also searched.
Additionally, efforts were made to identify unpublished and ongoing research using
relevant sources and experts in the field. Relevant research was categorised by study
type and appraised according to study design. Clinical commentaries were obtained
for studies reporting clinical outcomes.
Results Only two randomised controlled trials (RCTs) were identified. One of these, a feasibility
study, demonstrated problems with recruitment of patients in primary care. Several
uncontrolled and observational studies have reported positive results including high
levels of patient satisfaction but because of the lack of a control group, it is difficult
to assess the extent to which any response is due to specific effects of homeopathy.
Single-case reports/studies were the most frequently encountered clinical study type.
We also found surveys, but no relevant qualitative research studies were located.
Adverse effects reported appear limited to ‘remedy reactions’ (‘aggravations’) including
temporary worsening of symptoms, symptom shifts and reappearance of old symptoms.
These remedy reactions were generally transient but in one study, aggravation of symptoms
caused withdrawal of the treatment in one patient.
Conclusions A comprehensive search for published and unpublished studies has demonstrated that
the evidence for the effectiveness of homeopathy in depression is limited due to lack
of clinical trials of high quality. Further research is required, and should include
well-designed controlled studies with sufficient numbers of participants. Qualitative
studies aimed at overcoming recruitment and other problems should precede further
RCTs. Methodological options include the incorporation of preference arms or uncontrolled
observational studies. The highly individualised nature of much homeopathic treatment
and the specificity of response may require innovative methods of analysis of individual
treatment response.
Keywords homeopathy - depression - depressive disorder - systematic review
Abbrevations RCT - Randomised-controlled trial - CCT - Controlled clinical trial - UC - Uncontrolled
- DARE - Database of Abstracts of Reviews of Effects - H - Homeopathy - D - Diazepam
- HAMD - Hamilton Depression Scale - P - Placebo - F - Fluoxetine - CGI - Clinical
Global Impression - QoL - Quality of life - WSDS - Work and Social Disability Scale
- BSPS - Brief Social Phobia Scale - SCL-90 - Outpatient psychiatric rating scale
- HADS - Hospital Anxiety and Depression Scale - RSCL - Rotterdam Symptom Checklist
- EORTCQLQ-30 - European Organisation for Research and Treatment in Cancer—Quality
of Life Questionnaire—Core 30.
