Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 5. Complementary and Alternative Medicine Treatments
Language: 
English
Short Title: 
Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder
Abstract: 

BACKGROUND: The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. METHODS: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. "Complementary and Alternative Medicine Treatments" is the fifth of six sections of the 2016 guidelines. RESULTS: Evidence-informed responses were developed for 12 questions for 2 broad categories of complementary and alternative medicine (CAM) interventions: 1) physical and meditative treatments (light therapy, sleep deprivation, exercise, yoga, and acupuncture) and 2) natural health products (St. John's wort, omega-3 fatty acids; S-adenosyl-L-methionine [SAM-e], dehydroepiandrosterone, folate, Crocus sativus, and others). Recommendations were based on available data on efficacy, tolerability, and safety. CONCLUSIONS: For MDD of mild to moderate severity, exercise, light therapy, St. John's wort, omega-3 fatty acids, SAM-e, and yoga are recommended as first- or second-line treatments. Adjunctive exercise and adjunctive St. John's wort are second-line recommendations for moderate to severe MDD. Other physical treatments and natural health products have less evidence but may be considered as third-line treatments. CAM treatments are generally well tolerated. Caveats include methodological limitations of studies and paucity of data on long-term outcomes and drug interactions.

Author(s): 
Ravindran, Arun V.
Balneaves, Lynda G.
Faulkner, Guy
Ortiz, Abigail
McIntosh, Diane
Morehouse, Rachel L.
Ravindran, Lakshmi
Yatham, Lakshmi N.
Kennedy, Sidney H.
Lam, Raymond W.
MacQueen, Glenda M.
Milev, Roumen V.
Parikh, Sagar V.
CANMAT Depression Work Group
Item Type: 
Journal Article
Publication Title: 
Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
Journal Abbreviation: 
Can J Psychiatry
Publication Date: 
2016-09
Publication Year: 
2016
Pages: 
576-587
Volume: 
61
Issue: 
9
ISSN: 
1497-0015
DOI: 
10.1177/0706743716660290
Library Catalog: 
PubMed
Extra: 
PMID: 27486153 PMCID: PMC4994794

Turabian/Chicago Citation

Arun V. Ravindran, Lynda G. Balneaves, Guy Faulkner, Abigail Ortiz, Diane McIntosh, Rachel L. Morehouse, Lakshmi Ravindran, Lakshmi N. Yatham, Sidney H. Kennedy, Raymond W. Lam, Glenda M. MacQueen, Roumen V. Milev, Sagar V. Parikh and CANMAT Depression Work Group. 2016-09. "Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 5. Complementary and Alternative Medicine Treatments." Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie 61: 9: 576-587. 10.1177/0706743716660290.

Wikipedia Citation

<ref> {{Cite journal | doi = 10.1177/0706743716660290 | issn = 1497-0015 | volume = 61 | pages = 576-587 | last = Ravindran | first = Arun V. | coauthors = Balneaves, Lynda G., Faulkner, Guy, Ortiz, Abigail, McIntosh, Diane, Morehouse, Rachel L., Ravindran, Lakshmi, Yatham, Lakshmi N., Kennedy, Sidney H., Lam, Raymond W., MacQueen, Glenda M., Milev, Roumen V., Parikh, Sagar V., CANMAT Depression Work Group | title = Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 5. Complementary and Alternative Medicine Treatments | journal = Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie | date = 2016-09 | pmid = | pmc = }} </ref>