FUNDO: A medicina ayurvédica tem sido usada para tratar problemas de saúde mental desde 1000 aC. OBJETIVOS: Revisar os efeitos da medicina ayurvédica ou tratamentos para a esquizofrenia. ESTRATÉGIA DE PESQUISA: Pesquisamos o Cochrane Schizophrenia Group Trials Register (Março 2007) e AMED (Março 2007), inspecionamos as referências de todos os estudos identificados e contatamos o primeiro autor de cada estudo incluído.
CRITÉRIO DE SELEÇÃO: Foram incluídos todos os ensaios clínicos randomizados comparando a medicina ayurvédica ou tratamentos com placebo, drogas antipsicóticas típicas ou atípicas para esquizofrenia e psicoses esquizofrênicas.
COLETA E ANÁLISE DE DADOS: Nós extraímos dados independentemente e calculamos os efeitos aleatórios, o risco relativo (RR), 95% de intervalos de confiança (IC) e, quando apropriado, os números necessários para tratar / causar dano (NNT / H) com intenção de tratar. Para dados contínuos, calculamos as diferenças de média ponderada (WMD).
MAIN RESULTS: From the three small (total n=250) short included studies, we were unable to extract any data on many broad clinically important outcomes such as global state, use of services, and satisfaction with treatment. When Ayurvedic herbs were compared with placebo, about 20% of people left the studies early (n=120, 2 RCTs, RR 0.77 CI 0.37 to 1.62). Mental state ratings were mostly equivocal with the exception of the brahmyadiyoga group using Ayurvedic assessment (n=68, 1 RCT, RR not improved 0.56 CI 0.36 to 0.88, NNT 4 CI 3 to 12). Behavior seemed unchanged (n=43, 1 RCT, WMD Fergus Falls Behavior Rating 1.14 CI -1.63 to 3.91). Nausea and vomiting were common in the brahmyadiyoga group (n=43, RR 13.13 CI 0.80 to 216.30). When the Ayurvedic herbs were compared with antipsychotic drugs (chlorpromazine), again, equal numbers left the study early (n=120, 2 RCTs, RR for brahmyadiyoga 0.91 CI 0.42 to 1.97) but people allocated herbs were at greater risk of no improvement in mental state compared to those allocated chlorpromazine (n=45, RR 1.82 CI 1.11 to 2.98). Again, nausea and vomiting were found with use of brahmyadiyoga (n=45, 1 RCT, RR 20.45 CI 1.09 to 383.97, NNH 2 CI 2 to 38). Finally, when Ayurvedic treatment, in this case a complex mixture of many herbs, is compared with chlorpromazine in acutely ill people with schizophrenia, it is equally ( 10% attrition, n=36, RR 0.67 CI 0.13 to 3.53), but skewed data does seem to favor the chlorpromazine group. AUTHORS’
CONCLUSÕES: A medicação ayurvédica pode ter alguns efeitos no tratamento da esquizofrenia, mas foi avaliada apenas em alguns pequenos estudos pioneiros.