MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

The aim of this systematic review was to assess the efficacy of homeopathic remedies (HRs) in the treatment of mental disorders.

Italian psychiatrists performed a Medline/Embase search for studies written in English and published from any date to October 23, 2018. All randomized controlled trials enrolling patients with any psychiatric disorder and comparing HR with placebo, no treatment, or other psychotropic drugs were included.

A total of 212 studies were screened, 9 met all selection criteria and reported data on major depressive disorder (MDD) (n = 4), generalized anxiety disorder (n = 1), attention-deficit/hyperactivity disorder (n = 2), and premenstrual syndrome/dysphoric disorder (n = 2). Eight of 9 randomized controlled trials showed high risk of bias. Homeopathy showed greater efficacy in MDD compared with fluoxetine, and in premenstrual syndrome/dysphoric disorder compared with placebo, whereas no difference emerged between homeopathy and placebo in MDD and attention deficit/hyperactivity disorder.

The authors concluded that the available data on homeopathy in psychiatric disorders are insufficient to support their use in clinical practice.

In their discussion section, they also add an interesting note of caution: Ethical considerations should therefore prevent clinicians from recommending HRs, which have a cost either for patients or for health care systems, until when a sufficient amount of solid evidence becomes available. In addition, systematic reviews of randomized trials, if unavailable, are advisable for all medical conditions for which homeopathy is currently prescribed.

This is a rigorous, transparent and clear review which generates no surprises. Few critical thinkers would have expected a positive result. It also teaches us, I think, a valuable lesson about the difference between a rigorous and a flimsy review, between independent and biased research. In 2011, evidently pro-homeopathy authors published a paper of the latter kind. Here is its abstract:

Objective: To systematically review placebo-controlled randomized trials of homeopathy for psychiatric conditions.

Data sources: 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.

Study selection: 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.

Results: 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).

Conclusions: The database on studies of homeopathy and placebo in psychiatry is very limited, but results do not preclude the possibility of some benefit.

The two conclusions speak for themselves, I think. They should remind us that, although systematic reviews are in principle the most reliable source of evidence, it is still necessary to check the quality of the work and the independence of the worker.

19 Responses to Homeopathy is not effective for psychiatric disorders – a new systematic review and meta-analysis

  • the study with the largest effect size from the review has been retracted, as previously reported:
    https://pubmed.ncbi.nlm.nih.gov/25768800/

  • It shouldn’t come as a surprise to anybody, because neither is SBM much use to psychotic patients. Please don’t tell me I don’t know because I do. I’ve participated in NAMI for 14 years now, since the time my son was diagnosed with schizo. The majority of schizo patients (90%) can not function in society without help…. with our without meds.

    The good news is, homeopathy does less harm than SBM to psychotic patients.
    Thumbs-up to homeopathy

  • Is it a bit ODD that you claim that there is “no evidence” that homeopathic medicines are effective in psychiatric disorders, but you didn’t seem to read your own article (or the published article), which clearly asserts:

    “Homeopathy showed greater efficacy in MDD compared with fluoxetine, and in premenstrual syndrome/dysphoric disorder compared with placebo.”

    And because the authors of this study actually recommend that clinicians should not prescribe homeopathic remedies, they are PROVING their own biases. I say biases because psychiatry is FULL of medications and therapies that also have not been “proven” by the highest standard of randomized double-blind and placebo controlled trials.

    Hypocrisy reigns in your mind and in the minds of these authors…but I am not surprised.

    • the fluoxetine vs homeopathy trial has been withdrawn.
      and in any case, one study is not enough for a recommendation; an independent confirmation would be required.
      this is why responsible experts are cautious.
      keep up Dana

      • Out of curiosity, did you read WHY the trial in Plos One was retracted…and do you think that these reasons are legitimate?

        If you think that they are legiimate, how many other studies from this same journal should also be retracted?

        • thank you for the red herring
          fact is, you are promoting info that has been retracted – quack seem to do that, you know?

          • Actually, when an article gets retracted for political, economic, or philosophical reasons, not medical or scientific ones, I don’t respect the retraction.

            The data is still the data! And there was NO question on the data itself.

          • oh Dana!
            “questions were raised about the study design and reporting that prompted a full reassessment of the article… The Editors determined that the additional information provided did not fully address the above concerns, which call into question the reproducibility of the study, the scientific validity and rigor of the study design, and whether conclusions are adequately supported by the results…”

        • It was retracted because it was rubbish, Dana. If other studies are subsequently similarly found to be rubbish then they too are retracted. That’s how it works. If they’re still there, it means they’re fine.

          • Lenny… you WIN for being one of the BEST black-and-white thinkers in the world! There are NO other colors to you only black and white. My most sincere condolences to you and your family (if anyone can stand to live with you).

            Those randomized double-blind and placebo controlled trials really piss you off…especially when you don’t like the results.

          • Oh dear, Dana. Having a little tantrum and throwing your toys out of the pram because the nasty men said a study which you liked wasn’t worth the paper it was written on are we? We know the truth hurts but one day you’ll get used to it. There there. Let me give you back your colouring book and crayons.

            As ever, your posts demonstrate only the limitations of intellect and truncated powers of reasoning which characterize the warped thought-processes of the homeopathy freak. Science and medicine will continue to regard you and your beliefs as inconsequential objects of ridicule.

          • So typical ad hom attack without a scintilla of information about WHY this article was retracted.

          • OH DANA
            I even copied you key sentences from the retraction notice.
            the study was shit

          • Oh come on, Edzard. You don’t expect Dana to actually read any of the posts he’s responding to do you? They contain nasty things like facts and evidence. Dana doesn’t understand them or respond to them. Watch him bluster, bluff, shift, deny and ignore.

            Come on Dana. Hit us with what you believe to be some unarguable facts. We’ll wait.

            Why not unblock us all on Twitter as well?

    • Oh dear, Dana. We know you’ve been triumphantly waving this study around. Had no-one told you about it being retracted? We know your reading and comprehension skills aren’t all that great so do you want any of us to explain to you what “being retracted” means? Let’s spell it out, shall we?

      “In academic publishing, a retraction is a statement published in an academic journal stating that a peer-reviewed article previously published in the journal should be considered invalid as a source of knowledge.”

      It means the paper is rubbish, Dana. Garbage. That the conclusions it makes are not valid. That homeopathy is not more effective than fluoxetine.

      Which comes as a great surprise to no one apart from the ideological fools who continue to espouse magic shaken water and sugar pills as an effective therapy for anything.

  • I’d say that homeopathy definitely has an effect on one psychiatric condition: pathological gullibility.

    Unfortunately, the effect is that it aggravates the condition, instead of alleviating or curing it.

    But hey, it is an effect!

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