Complementary and alternative medicine in epilepsy: A global survey of physicians' opinions
Ali A Asadi-Pooya 1, Francesco Brigo 2, Simona Lattanzi 3, Ioannis Karakis 4, Marjan Asadollahi 5, Eugen Trinka 6, Lobna Talaat El Ghoneimy 7, Chrisma Pretorius 8, Guilca Contreras 9, Anilu Daza-Restrepo 10, Kette Valente 11, Luciana D'Alessio 12, Saule T Turuspekova 13, Ghaieb Aljandeel 14, Samson Khachatryan 15, Abdulaziz Ashkanani 16, Torbjörn Tomson 17, Mansur Kutlubaev 18, Alla Guekht 19, Taoufik Alsaadi 20, Yamile Calle-Lopez 21, Boulenouar Mesraoua 22, Loreto Ríos-Pohl 23, Abdullah Al-Asmi 24, Vicente Villanueva 25, Stanley C Igwe 26, Najib Kissani 27, Asel Jusupova 28
Affiliations
Affiliations
- 1Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: aliasadipooya@yahoo.com.
- 2Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano-Meran, Italy.
- 3Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.
- 4Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
- 5Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- 6Department of Neurology, Christian-Doppler Medical Centre, Paracelsus Medical University, 5020 Salzburg, Austria; Institute of Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria; Centre for Cognitive Neuroscience, 5020 Salzburg, Austria, Associated Member of the European Reference Network EpiCARE.
- 7Cairo University Epilepsy Unit (CUEU), Cairo University, Cairo, Egypt.
- 8Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.
- 9Department of Pediatric Neurology, Hospital Metropolitano, Quito, Ecuador.
- 10Epilepsy Unit. La Trinidad Medical Center, Caracas, Venezuela.
- 11Laboratory of Clinical Neurophysiology, Deparment of Psychiatry, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, Brazil.
- 12Buenos Aires University, Epilepsy Center, Ramos Mejía and El Cruce Hospitals, IBCN-CONICET, Buenos Aires, Argentina.
- 13Department of Nervous Diseases with a Course of Neurosurgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
- 14Iraqi Council for Medical Specializations, Faculty of Epileptology, Medical City, Baghdad, Iraq.
- 15Department of Neurology and Neurosurgery, National Institute of Health, Yerevan, Armenia.
- 16Ahmadi Hospital, Kuwait, Kuwait.
- 17Department of Clinical Nueroscience, Karolinska institutet, Stockholm, Sweden.
- 18Department of Neurology, Bashkir State Medical University, Ufa, Russia.
- 19Moscow Research and Clinical Center for Neurospychiatry; Department of Neurology, Nerosurgery and Medical Genetics, Pirogov Russian National Research Medical University, Moscow, Russia.
- 20Deptartment of Neurology, American Center for Psychiatry and Neurology, Dubai, United Arab Emirates.
- 21Neurology Section, University of Antioquia, Fundación Clínica del Norte-Neuroclínica, Medellín, Colombia.
- 22Neurosciences Department, Hamad Medical Corporation and Weill Cornell Medical College, Doha, Qatar.
- 23Clinica Integral de Epilepsia Infanto-Juvenil, Santiago, Chile.
- 24Neurology Unit, Department of Medicine, College of Medicine and Health Sceinces, Sultan Qaboos University, Oman.
- 25Refractory Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
- 26Department of NeuroPsychiatry, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria.
- 27Laboratory of Clinical and Experimental Neuroscience, Faculty of Medicine, Cadi Ayyad University, Marrakech, Morocco; Department of Neurology, Teaching Hospital Mohammed VI, Marrakesh, Morocco.
- 28Kyrgyz State Medical Academy, Neurology and Clinical Genetics Department, Bishkek, Kyrgyzstan.
Abstract
Purpose: To investigate the opinions of physicians on the use of complementary and alternative medicine (CAM) in patients with epilepsy (PWE) worldwide.
Methods: Online survey addressed to neurologists and psychiatrists from different countries.
Results: Totally, 1112 physicians from 25 countries (different world region: Europe, North America, South America, Middle-East, Africa, Former Soviet Union Republics) participated; 804 (72.3%) believed that CAM might be helpful in PWE. The most commonly endorsed CAM included meditation (41%) and yoga (39%). Female sex, psychiatry specialization, and working in North and South America were associated with the belief that CAM is helpful in PWE. Two-hundred and forty five out of 1098 participants (22.3%) used/prescribed CAM to PWE; among them, 174 (71%) people perceived CAM to be less effective and 114 (46.5%) people found CAM to be safer than conventional antiseizure medications (ASMs). The most common reasons to prescribe CAM for PWE were: to satisfy the patient (49.9%), dissatisfaction with the efficacy (35.6%), and dissatisfaction with the adverse effects (31.2%) of conventional therapies.
Conclusion: Although the evidence supporting the use of CAM for the treatment of epilepsy is extremely sparse, most physicians worldwide believe that it could be integrated with the use of conventional ASMs, at least in some patients. High-quality controlled trials are warranted to provide robust evidence on the usefulness of CAM options in PWE.
Keywords: Alternative; Complementary; Epilepsy; Integrative; Seizure.
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