Complementary and Alternative Medicines 2
Under Review April 2018
This leaflet is for anyone who wants to know more about using
complementary and alternative medicines (CAMs) for mental
health problems. It covers:
Which CAMs can be used for mental health
Many treatments have been used, some more
successfully than others. Your choice should be guided by their
safety and effectiveness. If they are safe and do not interfere
with other treatments, then anything that makes you feel good can
How good are they?
Very little research has been done into these
treatments. Research is expensive and many of the studies are
too small to give a clear answer. Most research has been
done on treatments for depression, anxiety and insomnia.
Who can I speak to about CAMs?
Finding an expert can be difficult. Your
doctor, nurse or pharmacist can give you some guidance, or may
be able to suggest someone who knows more. It is best to choose a
CAM therapist with a recognised qualification, who is member of a
regulated society. See finding a
How to use CAMs safely?
- Keep an open mind about the
different options available.
- If in doubt, seek advice from your doctor,
nurse or pharmacist.
- Tell the therapist about any illness,
seizures or allergies, or if you plan to become pregnant or
- Discuss your concerns about conventional
- Ask about your therapist’s qualification and
- Ask about the side-effects of treatment.
- Seek medical advice if you experience unusual
- Make special time for your treatment
Acupuncture involves piercing the skin with
fine needles. There are two types:
Chinese acupuncture involves placing the needles along
assumed energy channels or ‘meridians’. This is done in order to
restore a disturbed energy balance which is theoretically
responsible for illness.
- The Western
medical approach uses similar techniques without using the
energy concept. In the West, acupuncture is mainly used as a
treatment for pain. Its use for mental health problems is still in
How is the strength of
The dose of acupuncture can be varied by the needle sites, the
depth and duration of insertion, the number of needles and the
number of sessions. The dose can also be increased by manual
stimulation of the needles, or electrical stimulation. This is
where the dose is increased by running a small electric
current through the needles. Moxibustion is when the needles are
heated by burning mugwort.
Which mental health problems can
be treated with acupuncture?
depression, stress and insomnia can all be treated. If you don’t
feel an improvement after several sessions, or your symptoms become
severe, you should seek medical help.
How well does it
Acupuncture seems to reduce anxiety. Most research has studied
its effect on conditions such as tooth extraction, withdrawal
from alcohol addiction, and diseases such as cancer. It can help
calm people down in these situations.
We don't really know whether it works, as only a few small
studies have been done and the results are conflicting. Acupuncture
could possibly be combined with antidepressants in some cases.
Electro-acupuncture may be the most effective method. This
seems to have a similar effect on muscles as exercise, which has been shown to
Anxiety, agitation and low mood may be
About 1 in 10 people feel tired after
acupuncture. It comes as no surprise that acupuncture has been
used to treat insomnia, and some studies suggest that it may work.
The main drawback is that the insomnia may come back once the
treatment is stopped.
What about addiction and acupuncture?
Acupuncture is used to treat withdrawal symptoms, but on its own
does not seem to help people overcome their addiction to smoking,
drinking or drugs. More research needs to be done to understand how
acupuncture could help people with addiction problems.
Side-effects of acupuncture
If you are sensitive to pain, or if you have fibromyalgia or
chronic fatigue with muscle pain, it may not help you. This is
because your pain sensitivity could make the treatment
uncomfortable or painful. However, one recent trial has shown that
it may reduce pain in fibromyalgia.
Most people get very few side-effects. Some needle points
require more caution than others, for instance, those in the chest.
Common side-effects include bruising, bleeding and pain. Some
people can faint which is why the first session should be conducted
lying down. Some people can also become very tired. If this happens
to you, then do not drive after the sessions. Similarly, you should
not drive to the first session in case this happens to you.
Infection can occur, but since acupuncture needles are only used
once, this is unlikely. Some people get anxious or have a strong
emotional reaction to the treatment. If this happens during the
session, it might be best to stop and discuss what happened.
Sometimes it can help to simply lower the dose. Tell your
acupuncturist if you may be pregnant.
Are there serious side-effects?
Acupuncture involves needles, so it is
possible to pierce organs, nerves and blood vessels. In the worst
case, needling over the chest or back could pierce the heart or
lungs. Skilled therapists would avoid such injuries. However, if
you get breathing difficulties after needling of the chest and
upper back, you should consult a doctor immediately and explain
that you had acupuncture.
Ear acupuncture, or auriculotherapy, involves inserting very
fine needles into the surface of the ears. The needles are never
inserted into the openings of the ear. Since ears are prone to
infections, the skin area should be cleaned and disinfected. Ear
acupuncture has been used to treat addiction and pain. Some people
use needles which stay in the ear, sometimes for up to two weeks.
These needles are more prone to infection, and people who suffer
from heart valve disease must never use them. People who are
treated with steroids, or have diabetes, also have a higher risk of
TENS is short for Transcutaneous Electrical Nerve Stimulation.
Electrodes are placed on the skin, so no needles are used. TENS is
mainly used as a treatment for pain.
This is based on the healing properties of plant oils. These
oils are diluted in a 'carrier oil'. The oils are commonly
used in oil burners, in bath water, or massaged into the
skin. The aroma of the essential oil evaporates and stimulates
the sense of smell. An aromatherapy massage is based on techniques
to relieve tension and improve circulation. Practitioners believe
this allows oil molecules to be absorbed into the blood stream
during massage, and then passed through the body to the
nervous system. People use aromatherapy for relaxation, sleep
improvement, pain relief and to help depression.
Its effects are weak, so it is best to use it
in conjunction with conventional treatments. Aromatherapy is
safe, but some oils should not be used if you are pregnant or
have epilepsy, or in babies and young children. Some oils can lead
to allergies or increased sensitivity to light.
Homeopathy uses the principle of 'like to cure like'. This
involves using extremely diluted substances to avoid toxicity. The
medicines may be so diluted that very few, or no, molecules of the
original substance are present in the tablets or solutions taken.
Homeopathic medicines are prepared from minerals, plants and animal
substances. The more diluted the solution, the stronger the
'claimed' effect. This is one of the most controversial aspects of
There is a lot of scepticism about the effectiveness of
homeopathy, and using it as a substitute for conventional
treatments is unwise. However, some people find it helps to combine
homeopathic and conventional medicines. Homeopathic remedies are
very safe because they are highly diluted.
Yoga is a technique which is more than 5000
years old. 'Yoga' means 'union' in Sanskrit. It uses spiritual and
physical exercises to heal mind and body. The exercises need to be
adapted to suit the person. Yoga can have a calming and relaxing
effect, and reduce agitation. It may be useful for anxiety and
stress. Yoga has also been tested as a treatment of depression and
epilepsy, but the findings are inconclusive.
Biofeedback is a technique where bodily
functions which are usually ignored, or perceived as automatic, are
monitored in order to control them. These functions include heart
or breathing rate, blood pressure, sweating and muscle tension.
Monitors are attached to measure and provide feedback of the chosen
function. It can be used for agitation, anxiety and stress, but it
is difficult to draw firm conclusions about its effectiveness. One
of the main criticisms is that it is costly and similar effects can
be achieved through meditation or relaxation.
Relaxation is usually used to reduce agitation
and arousal. One technique is progressive muscle relaxation. This
involves tensing and relaxing different muscle groups. It is useful
for problems associated with muscle tension, and can help in
anxiety and asthma. Sessions take about 20 minutes. The exercises
need to be done every day to work. Autogenic
training is another technique and involves autosuggestion
to control breathing, heart rate and muscle tone.
Spiritual techniques can help in a variety of
mental and physical health problems. Religious activity can improve
your health. However, meditation can affect your mental
health, and even cause psychotic episodes in vulnerable people.
People suffering from psychotic disorders should use these
techniques with caution.
Hypnosis involves the induction of a trance or
sleep-like state. Suggestions, targeting the problems, can then
be given to help with the healing. Hypnosis can be
tried for many different problems. However, it is important to
choose an experienced and well-trained hypnotherapist. Hypnosis can
be used alongside conventional medicine to treat schizophrenia, but people suffering from
psychosis should use these techniques with caution.
'Reiki' relates to spiritual life force
and energy. Reiki therapists claim to channel energy from their
hands to the client which leads to healing. Advanced reiki therapy
involves healing from a distance. Reiki therapy is controversial.
If reiki is not successful, some therapists may claim that this is
because the client was blocking the energy. This could result in
people wrongly blaming themselves for the therapy not working. The
evidence for reiki being effective is poor. Therapeutic touch is a
concept related to Reiki, but there is no distance healing.
This treatment works on the principle that
specific points in the feet, hands and ears represent certain body
systems or organs. Illness is seen as a sign that the person is out
of balance, and that energy flows are disturbed. By applying
pressure point massage, the energy flows and balance is
restored. Reflexology can give a sense of well-being and relaxation
and it may be help in stress, anxiety and poor sleep. If symptoms
are severe, reflexology may not work. In such cases, it still can
be a useful additional treament.
Finding a practitioner
Finding a well-trained practitioner can be
difficult. You can ask your doctor or mental health professional to
sugggest a qualified practioner.
Medical Acupuncture Society trains doctors and health
The British Acupuncture
Council represents non-medically qualified
practitioners trained in traditional Chinese acupuncture.
Council has a national register of
aromatherapists who meet the agreed national standards
for training, professional skills, behaviour and
has a register of
medically qualified homeopaths.
The Royal London Hospital for Integrated
Medicine, formerly The Royal London Homeopathic
Hospital, has been part of the NHS from its beginnings in 1949. The
hospital offer a whole range of other complementary and alternative
The National Council
for Hypnotherapy represents over
700 practitioners within the United Kingdom.
British Institute of Hypnotherapy is an association of
hypnotherapists, Psychotherapists, and neurolinguistic programming
General Hypnotherapy Register is the registering
agency for the General Hypnotherapy Registering Council.
All three organizations offer accreditation
and operate a code of practice as well as grievance and complaints
All members of the UK Reiki
Federation of practitioners and teachers, have
undersigned to the Federation’s code of ethics, have Reiki
insurance and hold Reiki certificates.
Forum is a national organisation that represents up to
80% of all the reflexologists in the UK. It has several member
organizations and currently develops a register of recognized
The British Wheel of
Yoga is recognized by the Sports Council as the
national governing body for yoga in Great Britain. It
represents the UK at the European Federation of National Yoga
Organisations and offers a training and accreditation programme for
professional qualifications. BWY also accredits other
organisations’ training programmes.
This is a website run by the US National
Institute of Health. The homepage has a search option allowing you
to type in different keywords, to enable you to retrieve the
information you want. Typing the keyword “alternative medicine” or
“drug information” will direct you to the relevant sites.
Navigating with the buttons on the top of the menu will help you to
find what you are looking for.
National Center for Complementary
Alternative Medicine / National Institutes of
This website from the US offers very
comprehensive information on complementary medicines. It is easy to
surf. Of particular interest is the clinical trial register, which
gives an overview of the evidence base collated in the US.
Obviously this needs to complemented with information from other
clinical trial databases, such as the Cochrane
collaboration www.cochrane.org. Click on “news and events” for
important safety updates.
Mayo Clinic: Consumer health: complementary and alternative
medicine: An American website that offers a wealth of
information on all sorts of complementary alternative medicines,
which is easy to serve.
NHS Choices: Complementary and alternative
medicine: This website is very
helpful to get information on all aspects of complementary and
alternative medicines, ranging from individual treatment to
regulation of medicines and how to find a practitioner.
“ a non-profit corporation whose purpose is to combat
health-related frauds, myths, fads, fallacies, and misconduct." Its
primary focus is on quackery-related
information that is difficult or impossible to get elsewhere. This
website can be very helpful to consult when rather unusual
treatments are suggested, particularly if high fees are to be paid
in advance. Some people may find the website too provocative and
over-sceptical towards complementary medicines. Click onto the
“cheers and jeers” section to get a flavour of the site.
This leaflet was produced by the Royal
College of Psychiatrists' Public Education Editorial Board.
This leaflet reflects the best available evidence at the time of
Under Review April 2018
Royal College of Psychiatrists. This leaflet may be
downloaded, printed out, photocopied and distributed free of charge
as long as the Royal College of Psychiatrists is properly credited
and no profit is gained from its use. Permission to reproduce it in
any other way must be obtained from firstname.lastname@example.org
The College does not allow reposting of its leaflets on other
sites, but allows them to be linked to directly.
For a catalogue of public education materials or copies of our
Royal College of Psychiatrists, 21 Prescot Street, London
E1 8BB. Telephone: 020 3701 2552.
Charity registration number in England (228636) and in