Phytotherapie bei psychischen Erkrankungen in medizinischen Leitlinien

Zusammenfassung

Hintergrund Phytotherapeutika werden aufgrund ihrer Beliebtheit bei PatientInnen und ihrer langen traditionellen Verwendung zunehmend in medizinische Leitlinien aufgenommen.

Methode Die vorliegende Übersichtsarbeit gibt einen systematischen Überblick über phytotherapeutische Empfehlungen und Inhalte in deutschen (AWMF) und internationalen (WFSBP, CANMAT) medizinischen Leitlinien für psychische Erkrankungen.

Ergebnisse Phytotherapeutika können bei leichten bis mittelschweren psychischen Störungen wie folgt empfohlen werden: Depressionen [(+++): Johanniskraut (Hypericum perforatum L.), (++ ): Safran (Crocus sativus L.) und Curcuma (Curcuma longa L.), (+): Lavendel (Lavandula angustifolia Mill.) und (+/–): Rosenwurz (Rhodiola rosea L.)], Angststörungen [(++ ): Lavendel und Ashwagandha (Withania somnifera (L.) Dunal), (+): Galphimia (Galphimia glauca Cav.), (+/–): Kamille (Matricaria spp.); „nicht empfohlen“ (–) wird Kava-Kava (Piper methysticum G. Forst.) wegen möglicher Lebertoxizität], Schlafstörungen [(+/–): Baldrian (Valeriana officinalis L.)] und Demenz [(+++): Ginkgo (Ginkgo biloba L.) zur Verbesserung der Kognition]. Sicherheit und Verträglichkeit wurden überwiegend als sehr gut bis tolerabel bewertet.

Schlussfolgerung Internationale Leitlinien zeigen die mögliche Vielfalt an empfehlenswerten Phytotherapeutika für die Behandlung von psychischen Erkrankungen auf. Die derzeitige Überarbeitung einer Vielzahl nationaler Leitlinien zu psychischen Erkrankungen bietet die Chance, bestehende Empfehlungen für Phytotherapeutika systematisch zu aktualisieren und neue zu integrieren, um TherapeutInnen eine evidenzbasierte Nutzen-Risiko-Bewertung für ihre PatientInnen zu ermöglichen.

Abstract

Background Phytotherapeutics are increasingly included in medical guidelines due to their popularity with patients and their long traditional use.

Method This review provides a systematic overview of phytotherapeutical recommendations and contents in medical guidelines for psychiatric disorders in Germany (by AWMF) and internationally (by WFSBP, CANMAT).

Results Phytotherapeutics can be recommended for mild to moderate psychiatric disorders as follows: Depression [(+++): St. John’s wort (Hypericum perforatum L.), (++ ): Saffron (Crocus sativus L.) and Curcuma (Curcuma longa L.), (+): Lavender (Lavandula angustifolia Mill.) and (+/–): Roseroot (Rhodiola rosea L.)], anxiety disorders [(++ ): Lavender and Ashwagandha (Withania somnifera (L.) Dunal), (+): Galphimia (Galphimia glauca Cav.), (+/–): Chamomile (Matricaria spp.); “not recommended” (–) is Kava kava (Piper methysticum G. Forst.) due to potential liver toxicity], sleep disorders [(+/–): Valerian (Valeriana officinalis L.)], and dementia [(+++): Ginkgo (Ginkgo biloba L.) for improving cognition]. Safety and tolerability were predominantly rated robust to acceptable.

Conclusion International guidelines present a large variety of phytotherapeutics recommendable for the treatment of psychiatric disorders. The current revision of multiple national guidelines for psychiatric disorders offers the opportunity to systematically update existing and integrate new recommendations for phytotherapeutics, enabling therapists to perform an evidence-based risk-benefit assessment for their patients.

Schlüsselwörter

Leitlinien - psychische Erkrankungen - Psychiatrie - Psychosomatik - Phytotherapie - Phytopharmaka - pflanzliche Arzneimittel - Übersichtsarbeit - AWMF - WFSBP - CANMAT

Key words

guidelines - psychiatric disorders - psychiatry - phytotherapy - phytopharmaceuticals - herbal medicine - review - AWMF - WFSBP - CANMAT

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