30 Complementary Medicines

Anthony W. Fox

Complementary medicines are very widely used.
Their relevance to pharmaceutical medicine is the
following:

Many patients in clinical trials will be using
complementary therapies (and we often omit to
ask on the case report form)

Many are pharmacologically active

Some risk well-described drug interactions or
other adverse events

People uncritically pay for worthless therapies
(e.g. the laetrile scandal)

Pharmaceutical physicians are rarely trained in
this area

Geographical and cultural factors are as important
as in any aspect of medicine; for example, there
are especially strong complementary therapy tradi-
tions in places as different as Germany and Utah.
Furthermore, the popularity of drugs varies
between places: for example, the United Kingdom
apparently has the greatest faith in garlic. The

market for complementary therapies is huge: the

Nutrition Business Journalreported as long ago

as 1999 that in the United States alone, about

$14.7 billion (i.e. $14.7 thousands of millions) of

complementary therapies are sold each year, and

that it is a growing market.

Historically, complementary therapies were the

only therapies available. Some orthodox drugs

have their origin in complementary medicine:

Withering’s discovery of digoxin was long after

the gypsy had been using it for dropsy, and the

Revd Edmund Brown’s willow bark extracts were

the result of his belief in the doctrine of similarities.

Much of the Third World has little allopathic med-

icine available to it, and complementary therapies

continue to be offered for a wide variety of diseases.

Even in the developed world, most good hospices

will have complementary therapists on staff.

The ethical aspects of this area of medicine are

as varied as the therapies themselves, and could be

debated almostad infinitum. Thus, the purpose of

this short chapter is to alert pharmaceutical physi-

cians about this topic, discuss the most commonly

encountered therapies (recognizing that this

changes with time) and describe their regulatory

status (which is generally quite simple).

Principles and Practice of Pharmaceutical Medicine, 2nd Edition Edited by L. D. Edwards, A. J. Fletcher, A. W. Fox and P. D. Stonier
#2007 John Wiley & Sons, Ltd ISBN: 978-0-470-09313-9