Integrative medicine approaches to chronic depression: case studies of the recovery process with a three-step path to recovery and significant cure

Ronko Itamura

doi:10.1515/jcim-2022-0034

Artikel Open Access

Integrative medicine approaches to chronic depression: case studies of the recovery process with a three-step path to recovery and significant cure

Ronko Itamura

Veröffentlicht/Copyright: 25. November 2022

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Aus der Zeitschrift Journal of Complementary and Integrative Medicine Band 20 Heft 1

Abstract

Objectives

The support provided by conventional treatments centered on the administration of medication for chronic or other types of depression is limited. Integrative medicine, which is based on both modern Western medicine and a range of complementary and alternative medicine practices, is patient-centered and promotes natural healing in patients to achieve significant cure. This report focuses on the indications of recovery from depression using integrative medicine, especially homeopathy.

Methods

Thirty-one patients (9 males and 22 females) with depression underwent homeopathic treatment using various strategies over 3 months, in addition to antidepressants. All patients were diagnosed with Major Depressive Disorders, except bipolar disorders. Three steps were used to model indications of their recovery from depression: reducing difficulties in everyday life, reducing and stopping antidepressants, and reducing and stopping the homeopathic remedies. Patients were considered to have recovered when antidepressants had been stopped for 6 months or more and 3 or more months had passed since homeopathic medicines were stopped.

Results

Of the 31 patients with depression, 13 recovered within 2 years of starting homeopathic treatment, and 11 completely recovered from chronic depression.

Conclusions

This study suggests that integrative medicine can be a useful strategy for depression, including the use of a three-step strategy for reducing all dependence on clinical treatment. As most patients, especially chronic patients, significantly recovered from depression through homeopathy over 2 years, this model can help understand recovery from depression through integrative medicine.

Keywords: approach; depression; integrative; recovery; three-step

Introduction

Depression is predicted to be the leading contributor to the global disease burden by 2030 [1]. In Japan, about 20,000 people die by suicide each year, and many are considered to have depression [2]. Whether chronic, long-term, or severe depression, the support provided by conventional treatments centered on drug administration is limited [3].

In previous clinical trials of antidepressants, remission rates were reported to be low (≤50%) for any given drug among the patient groups evaluated [4, 5]. Despite the success of pharmacologic treatment of depression in terms of remission, an unmet need for full symptomatic and functional recovery remains. Among the patients seeking this degree of recovery, some turn to complementary and alternative medicine (CAM) after undergoing prolonged antidepressant treatment because they continue to experience difficulties in daily life [6], [7], [8].

Integrative medicine goes beyond the framework of conventional medicine based on modern Western medicine to include various CAMs. Recently, integrative psychiatry has been selectively incorporating elements of CAM into practice [9]. This practice of psychiatry views patients holistically, considering not only mind–body issues and interactions but also spiritual values. In integrative psychiatry, homeopathic medicine can be used with conventional medicines. Homeopathy is a CAM and a patient-centered medicine considered to stimulate the patient’s own healing process; thus, the homeopathic process treats the “individual patient as a whole” [10, 11].

This study reports the progress of 31 patients with depression who received homeopathy over 3 months in addition to antidepressants, and presents one specific case of recovery from depression through homeopathy using a three-step path to recovery and significant cure.

Subjects and methods

This retrospective case study focused on patients with chronic depression treated with a combination of modern Western medicine and CAM in May 2005–December 2011. When homeopathy is used for depression in patients who initially received conventional treatment, it is important to assess the progress of these patients after receiving homeopathy. The three-step path to recovery from depression through homeopathy is shown in Figure 1 and summarized as follows: (1) Step I is to reduce difficulties in daily life, with the goal to improve the quality of life (QOL) without changing the conventional medicines; (2) Step II is to reduce or stop conventional medicines; and (3) Step III is to reduce or stop homeopathic medicines and ultimately to have no need for homeopathic medicine.

Figure 1:

Step I is to reduce difficulties in daily life, which is defined as improvement of quality of life. Step II is to reduce or stop conventional medicines. Step III is to reduce or stop homeopathic medicines and ultimately to have no need for homeopathic medicine.

According to the patient’s disease pathology and degree of disease fluctuation, the homeopathic strategies used included a holistic approach based on totality, or the method of complexity, especially for patients with chronic or intractable disease who had deep and hidden personal conflicts at subconscious levels. In the pathologic approach, homeopathic repertorization was used. According to the Criteria for Major Depressive Episodes by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) [12], some computer-analyzed homeopathic medicine rubrics are available, such as MacRepertory (Synergy Homeopathic; https://www.synergyhomeopathic.com). Disease severity was determined using the Zung Self-Rating Depression Scale (SDS) [13] at the patient’s first consultation for integrative medicine. The SDS score was from 37 to 75 points, and the mean score was 52.5 (>50 is classified as severe). Cases considered recovered were those for which antidepressants had been stopped ≥6 months and homeopathic medicines had been stopped ≥3 months.

Ethical approval: The research related to human use is in accordance with the tenets of the Helsinki Declaration. Ethical approval was not necessary due to the retrospective nature of the study.

Informed consent was obtained from all individuals included in this study.

Results

This retrospective study analyzed 31 patients with depression (22 women, 9 men; age 20–59 years, mean age 41.5 years). The average duration of depression was 4 years and 2 months, ranging from 3 months to 15 years. All patients had a DSM-IV-TR diagnosis of a major depressive disorder, except bipolar disorders. All patients had already received antidepressant medication for 6 months to 15 years.

Patients had their first consultation for integrative medicine between May 2005 and December 2009. Chronic depression met the full criteria for a major depressive episode, and patients with chronic depression had continuously met these criteria for at least the past 2 years. Of the 31 patients assessed, 87% (27) had chronic depression.

All 31 patients were given homeopathy using various strategies over 3 months, in addition to antidepressants. Treatment duration was from 3 months to 6 years and 4 months (May 2005–December 2011), as shown in Figure 2.

Figure 2:

Results of 31 patients treated with homeopathy using various strategies over 3 months, in addition to antidepressants.

Of the 31 patients, 13 patients recovered from depression, defined as proceeding from Step III to a complete cure;7 patients reduced the dose or the number or frequency of antidepressants and experienced symptom control with homeopathic medicines, thus reaching Step II; 4 patients reduced their conventional drug doses and finished homeopathic treatment, defined as the incompletion of Step I; and 7 patients did not continue homeopathic treatment. Details for the specific patients cased are shown in the following tables: Table 1 presents 31 cases with their first consultation between July 2005 and December 2009. These data indicate whether a patient had a strong tendency toward suicide or had attempted suicide, include a list of the patient’s conventional medicines, and the results of a psychological test, the Cornell Medical Index [14].

Table 1:

Data of 31 patients with depression who had integrative medicine consultation in July 2005–December 2009.

Case no.	Age	Sex (F/M)	Suicide idea/attempt	Duration of illness	Conventional medicines	SDS first visit	CMI first visit	Remedies	Progress Step I–III to recovery
1. S.N	36	F	Idea ++	8 years	Fluvoxamine maleate (75 mg), mianserin hydrochloride (30 mg), bromazepam (15 mg), triazolam (0.25 mg), clotiazepam (15 mg)	58	IV	Thuja	2 years later, reduce conventional medicines and finished treatment. Step I
1. S.N	36	F	Idea ++	8 years		58	IV	Calcarea carbonica
2. H.T	44	F	Idea ++	2 years	Milnacipran hydrochloride (75 mg), lorazepam (3 mg)	52	IV	Aurum metallicum	12 months later, did not continue treatment
								Sepia
								Magnesia carbonica
3. A.I	33	F	Idea +	2 years	Paroxetine hydrochloride (40 mg), mianserin hydrochloride (30 mg), ethyl loflazepate (3 mg), zolpidemtartrate (10 mg), rilmazefone hydrochloride (1 mg)	54	III	Silica	Gradually reduce conventional medicines. Continue homeopathic medicines. Step II
								Ignatia amara
								Phosphoricum acidum
								Carcinosinum
4. C.H	47	F	No	5 years	Milnacipran hydrochloride (100 mg), brotizolam (0.25 mg), etizolam (1 mg)	50	IV	Staphisagria	One year later, no conventional medicine, Step III to recovery
								Causticum
								Magnesia muriatica
5. E.H	47	F	No	2 years and 10 months	Maprotilinehydrochloride (75 mg), sulpiride (150 mg), alprazolam (1.2 mg)	37	II	Arsenicum album	10 months later, no conventional medicines. 1 and 4 months later, Step III to recovery
								Natrum muriaticum
								Casusticum
6. H.T	40	F	Idea ++	1 year	Fluvoxamine maleate (75 mg), sulpiride (150 mg)	51	II	Calccarea phosphorica	3 months later, no conventional medicines. Continue homeopathic medicines. Step II
6. H.T	40	F	Idea ++	1 year	Fluvoxamine maleate (75 mg), sulpiride (150 mg)	51	II	Magnesia muriatica
7. T.K	50	F	Idea +	2 years and 6 months	Amixapine (25 mg), etizolam (1 mg)	48	II	Arsenicum album	4 months later, no conventional medicines. 10 months later, Step III to recovery
8. S.I	29	F	Idea+	2 years and 2 months	Amixapine (30 mg)	59	III	Staphisagria	2 months later, no conventional medicines. 8 months later, Step III to recovery
9. S.K	57	F	Attempt	6 years	Milnacipran hydrochloride (25 mg)	46	III	Phosphorus arsenicum album	No conventional medicines after the first visit. 6 months later Step III to recovery
10. M.F	42	F	Attempt	2 years and 1 month	Fluvoxamine maleate (75 mg)	45	II	Argentum nitricum	1 month later, no conventional medicines. 7 months later, Step III to recovery
11. T.I	50	F	Idea +	5 years	Fluvoxamine maleate (50 mg), milnacipran hydrochloride (100 mg), loprazolam (0.4 mg), flunitrasepam (1 mg)	55		Staphisagria	4 months later, no conventional medicines. 10 months later, Step III to recovery
11. T.I	50	F	Idea +	5 years		55		Calcarea sulphurica
12. Y.S	29	F	Idea +	2 years	Amixapine (75 mg), etizolam (1.5 mg), milnacipran hydrochloride (75 mg), flunitrazepam (3 mg), triazolam (0.25 mg)	49	III	Calcarea silicata	Amoxapine (50 mg) lorazepam (1 mg) 10 months later, finished. Step I
								Staphisagria
								Silica
13.N.O	34	M	Attempt	3 months	No	59	IV	Kali phosphoricum	1 year and 2 months later, Step III to recovery
13.N.O	34	M	Attempt	3 months	No	59	IV	Rhus toxicodendron	1 year and 2 months later, Step III to recovery
14. K.F	38	F	Idea +	5 years	Fluvoxamine maleate (150 mg), aloprazolam (1.2 mg), etizolam (2 mg), zopiclone (15 mg), brotizolam (0.5 mg) zolpidem tartrate (20 mg)	68	IV	Lycopodium	One year later, no conventional medicine. Continue homeopathic medicines. Step II
14. K.F	38	F	Idea +	5 years		68	IV	Staphisagria medorrhinum
15. Y.I	59	F	Idea++	15 years	Maprotiline hydrochloride (75 mg), sulpiride (100 mg), cloxazolam (2 mg)	50	IV	Natrum muriaticum	2 years and 2 months later, no conventional medicine. Did not continue treatment
								Arsenicum album
								Thuja
								Staphisagria
16. S.M	43	M	No	2 years and 8 months	Amoxapine (30 mg), aloprazolam (1.2 mg)	44		Lycopodium	3 years and 3 months later, no conventional medicines. Continued homeopathic medicines. Step II
17. KS	42	F	Idea ++	4 years	Nortriptyline hydrochloride (50 mg), amoxapine (50 mg), diazepam (4 mg) ethyl loflazepate (1 mg), flunitrazepam (4 mg), etizolam (1 mg)	75	III	Natrum muriaticum	Nortriptyline hydrochloride (20 mg), amoxapine (100 mg), sulpiride (100 mg), diazepam (4 mg). 1 year and 6 months later, did not continue treatment.
								Gelsemium
								Lycopodium
								Cuprum
18. A.S	41	M	Idea+	6 months	Paroxetine hydrochloride (10 mg)	57		Lycopodium	4 months later, Step III to recovery
18. A.S	41	M	Idea+	6 months	Paroxetine hydrochloride (10 mg)	57		Aurum m-natronatum	4 months later, Step III to recovery
19. S.K	20	M	No	3 years	Paroxetine hydrochloride (40 mg), perospironehydrochloride hydrate (4 mg), lorazepam (0.5 mg), trazodone hydrochloride (25 mg)	49	IV	Lycopodium	1 year and 11 months, paroxetine hydrochloride (10 mg). Did not continue treatment.
19. S.K	20	M	No	3 years		49	IV	Arsenicum album
20. Y.N	52	M	No	2 years and 3 months	Fluvoxamine maleate (75 mg), amitriptyline hydrochloride (75 mg), amoxapine (75 mg), brotizolam (50 mg) flunitrazepam (2 mg)	41	III	Lycopodium	6 months later, did not continue treatment.
21. H.T	58	M	No	3 years	Fluvoxamine maleate (150 mg), brotizolam (0.25 mg), trazodone hydrochloride (1 mg)	45	III	Phosphrus	One year and 9 months later, no conventional medicine. One year and 11 months later, Step III to recovery
22. T.O	59	F	Idea +	5 years	Sulpiride (150 mg), fluvoxamine maleate (150 mg), lorazepam (0.5 mg), quazepam (15 mg), brotizolam (0.25,mg)	58	IV	Natrum muriaticum	8 months later, did not continue treatment.
								Lycopodium
								Bryonia
23. J.T	46	F	Idea +	5 years	Sertraline hydrochloride (50 mg), alprazolam (1.2 mg), brotizolam (0.25 mg)	58	IV	Merrcurius solubilis	11 months later, no conventional medicine. One year and 2 months later, Step III to recovery
23. J.T	46	F	Idea +	5 years		58	IV	Sepia
24. K.N	47	M	No	3 years	Paroxetine hydrochloride (20 mg), etizolam (1 mg), zolpidem tartrate (5 mg)	56	IV	Aurum metalicum	3 months later, less conventional medicine: Zolpidem tartrate (5 mg). 5 months later, finished. Step I
24. K.N	47	M	No	3 years		56	IV	Aurum sulphratum
25. Y.S	37	F	Attempt	6 years	Paroxetine hydrochloride (40 mg), cloxazolam (2 mg)	59	IV	Aurum m-natronatum	1 year and 3 months later, Step III to recovery
25. Y.S	37	F	Attempt	6 years	Paroxetine hydrochloride (40 mg), cloxazolam (2 mg)	59	IV	Carcinosinum	1 year and 3 months later, Step III to recovery
26. N.T	47	M	Idea+	5 years	Paroxetine hydrochloride (40 mg), ethyl loflazepate (3 mg), bromazepam (15 mg), zopiclone (10 mg), flunitrasepam (2 mg)	48	IV	Aurum arsenicum	Paroxetine hydrochloride (5 mg), bromazepam (6 mg) zopiclone (10 mg) continue homeopathic medicines. Step II
26. N.T	47	M	Idea+	5 years		48	IV	Aurum sulphratum
27. M.S	30	F	No	6 years	Sertraline hydrochloride (50 mg), flunitrazepam (2 mg), etizolam (1 mg)	54	IV	Ignatia amara	4 months later, did not continue treatment.
								Aurum m-natronatum
								Natronatum
28. S.I	37	F	Idea +	8 years	Paroxetine hydrochloride (10 mg), sulpiride (50 mg), brotizolam (0.25 mg)	59	II	Lachesis	1 year and 7 months later, mirtazapine (15 mg), brotizolam (0.125 mg). Continue homeopathic medicines. Step II
28. S.I	37	F	Idea +	8 years		59	II	Chamomilla
29. H.M	32	F	Idea ++	10 years	Paroxetine hydrochloride (10 mg), alprazolam (1.2 mg), brotizolam (0.25 mg), zolpidem tartrate (10 mg)	50	III	Carcinosinum	2 years later, paroxetine hydrochloride (5 mg), bromazepam (6 mg), brotizolam (0.25 mg), zolpidem tartrate (10 mg). Continue homeopathic medicines. Step II
								Caisticum
								Kaliphosphoricum kali arsenicosum
30. T.K	36	M	Idea+	4 years	Sertraline hydrochloride (50 mg), aripiprazole (3 mg), mirtazapine (15 mg), tandospirone citrate (40 mg), lormetazepam (1 mg), lithium carbonate (200 mg)	49	II	Staphisagria	One year and 1 month later, no conventional medicines. One year and 4 months later, no remedies, Step III to recovery
30. T.K	36	M	Idea+	4 years		49	II	Aurum sulphratum
31. A.N	25	F	Attempt	1 year and 6 months	Sertraline hydrochloride (100 mg), amoxapine (50 mg), aripiprazole (3 mg), nortriptyline hydrochloride (150 mg), mianserin hydrochloride (30 mg), setiptiline maleate (1 mg), triazolam (0.25 mg) dosulepin hydrochloride (50 mg), zolpidem tartrate (10 mg)	51	IV	Calcarea carbonica	Less conventional medicines: Lorazepam (1.5 mg), zolpidem tartrate (5 mg). 1 year later, finished. Step I
								Calcarea phosphoria
								Magnesia carbonica

Four of the seven patients who did not continue treatment did not benefit from homeopathy, and the duration of homeopathic treatment ranged from 4 to 12 months (Nos. 2, 20, 22 and 27). The remaining three patients did not visit the clinic because they had completed their treatment or were in the process of reducing their antidepressant medications, and the duration of homeopathic treatment was >18 months (Nos. 15, 17 and 19).

The four Step I cases (Nos. 1, 12, 24, and 31) included those in whom the homeopathic treatment was terminated at the patients’ request when their daily life has improved and the treatment with antidepressants was completed or being reduced.

Seven patients in Step II (Nos. 3, 6, 14, 16, 26, 28, and 29) were receiving homeopathy for >2 years.

Table 2 presents the data of the 13 recovered patients. Except for 2 cases, the duration of depression was 2–6 years. The recovery point for 11 cases was 6–23 months after treatment initiation. One of the 11 cases is achieved complete cure through homeopathy based on the three-step path to recovery.

Table 2:

Data for 10 patients with depression who had integrative medicine consultation in June 2007–December 2008.

Case no.	Age	Sex (F/M)	Suicide idea/attempt	Duration of illness	Conventional medicines	SDS first visit	CMI first visit	Remedies	Progress
1. T.I	50	F	Idea +	5 years	Fluvoxamine maleate (50 mg), milnacipran hydrochloride (100 mg), loprazolam (0.4 mg), flunitrasepam (1 mg)	55		Staphisagria	4 months later, no conventional medicines. 10 months later, recovered.
1. T.I	50	F	Idea +	5 years		55		Calcarea sulphurica
2. Y.S	29	F	Idea +	2 years	Amixapine (75 mg), etizolam (1.5 mg), milnacipran hydrochloride (75 mg), flunitrazepam (3 mg), triazolam (0.25 mg)	49	III	Calcarea silicata	Amoxapine (50 mg) lorazepam (1 mg) 10 months later, finished.
								Staphisagria
								Silica
3.N.O	34	M	Attempt	3 months	No	59	IV	Kali phosphoricum	1 year and 2 months later, recovered.
3.N.O	34	M	Attempt	3 months	No	59	IV	Rhus toxicodendron	1 year and 2 months later, recovered.
4. K.F	38	F	Idea +	5 years	Fluvoxamine maleate (150 mg), aloprazolam (1.2 mg), etizolam (2 mg), zopiclone (15 mg), brotizolam (0.5 mg) zolpidem tartrate (20 mg)	68	IV	Lycopodium	One year later, no conventional medicine. Continue homeopathic medicines.
4. K.F	38	F	Idea +	5 years		68	IV	Staphisagria medorrhinum
5. Y.I	59	F	Idea++	15 years	Maprotiline hydrochloride (75 mg), sulpiride (100 mg), cloxazolam (2 mg)	50	IV	Natrum muriaticum	2 years and 2 months later, no conventional medicine. Did not continue.
								Arsenicum album
								Thuja
								Staphisagria
6. S.M	43	M	No	2 years and 8 months	Amoxapine (30 mg), aloprazolam (1.2 mg)	44		Lycopodium	3 years and 3 months later, no conventional medicines. Continue homeopathic medicines.
7. K.S	42	F	Idea ++	4 years	Nortriptyline hydrochloride (50 mg), amoxapine (50 mg), diazepam (4 mg) ethyl loflazepate (1 mg), flunitrazepam (4 mg), etizolam (1 mg)	75	III	Natrum muriaticum	Nortriptyline hydrochloride (20 mg), amoxapine (100 mg), sulpiride (100 mg), diazepam (4 mg). 1 year and 6 months later, did not continue.
								Gelsemium
								Lycopodium
								Cuprum
8. A.S	41	M	Idea+	6 months	Paroxetine hydrochloride (10 mg)	57		Lycopodium	4 months later, recovered.
8. A.S	41	M	Idea+	6 months	Paroxetine hydrochloride (10 mg)	57		Aurum m-natronatum	4 months later, recovered.
9. S.K	20	M	No	3 years	Paroxetine hydrochloride (40 mg), perospironehydrochloride hydrate (4 mg), lorazepam (0.5 mg), trazodone hydrochloride (25 mg)	49	IV	Lycopodium	1 year and 11 months, paroxetine hydrochloride (10 mg). Did not continue.
9. S.K	20	M	No	3 years		49	IV	Arsenicum album
10. Y.N	52	M	No	2 years and 3 months	Fluvoxamine maleate (75 mg), amitriptyline hydrochloride (75 mg), amoxapine (75 mg), brotizolam (50 mg) flunitrazepam (2 mg)	41	III	Lycopodium	6 months later, did not continue.

SDS, Zung self-rating depression scale.

Clinical case presentation (case 30 in Table 1)

A 36-year-old man first experienced depression 5 years before his integrative medicine consultation. He had been treated with antidepressants for >4 years. He reported intermittent unemployment as he had started and lost 4 jobs because he could not concentrate and exhibited an indifference and aversion to his work. His SDS score was 49. Medications were sertraline hydrochloride, aripiprazole, mirtazapine, tandospirone, citrate, lormetazepam, and lithium carbonate. His clinical and homeopathic history is shown in Figure 3. Based on the holistic approach, he was prescribed Staphisagria 30c, 1 pill daily. His three-step path to recovery is described as follows.

Figure 3:

Homeopathic history of case 30 in Table 1.

Step I: To reduce difficulties in daily life (months 1–4)

At the 1-month follow-up after starting homeopathic treatment, the patient reported feeling less tired and sleeping well. At 2 months, however, his condition had not changed further. He reported feeling very “empty” and was concerned about his high alcohol intake. The treatment strategy was changed because the holistic approach was determined not to be working very well. Consequently, the method of complexity was used for understanding the deeper level of disease fluctuations, and Aurum sulphuratum 30c, one pill daily, was changed to a daily dose. At 4 months, the patient reported feeling better and had decreased emotional experience of emptiness. The depression level before starting homeopathy was 7 compared with 10 (7/10).

Step II: To reduce or stop conventional medicines (months 6–12)

At the 6-month follow-up, the patient was able to successfully reduce his antidepressant dose. He did not take tandospirone citrate and lithium carbonate. His depression level had fallen to 3/10. At 8 months, he was no longer in a depressive state, and he began to prepare to work again. At 10 months, he was preparing to restart work within the month. At the 1-year follow-up, he had stopped all conventional medicines and resumed working.

Step III: To reduce or stop homeopathic medicines (after 1 year)

After 1 year and 4 months of treatment with integrative medicine, the patient’s mental health status was good, and he no longer needed any homeopathic medicines. He reported feeling fulfilled in his life. He reported experiencing no recurrence of depression for >6 months, and he subsequently ended his treatment because he had recovered completely.

Discussion

The effect of antidepressants in preventing relapse and recurrence of depression is limited [15, 16]. Despite long-term treatment with antidepressants, difficulties in daily life persist for some patients. For patients with depression who have been treated with antidepressants, it is important to assess their progress after treatment with integrative psychiatry and homeopathy.

This study has suggested an approach to assess progress using the three-step path to recovery from depression through homeopathy. Step I is to decrease daily difficulties by adding homeopathic treatment, which improves the patient’s QOL. As patients improve, they can naturally reduce or stop their prescribed dose of antidepressants, which is Step II. Homeopathy aids their natural healing, so they can recover by themselves and subsequently not need any remedies, which is Step III, leading to a complete cure.

Recent research addressing the recurrence of depression reported that it is desirable to continue long-term conventional medicine for at least 1 year and preferably for 2 years [17]. However, an increasing number of patients with chronic depression do not improve with antidepressant treatment over 2 years [18].

The industry of psychopharmacology has been reported to be in crisis—the billions of dollars and decades of research spent on psychopharmacology are no longer producing new effective treatments [19]. Clinical evidence supports continuing the treatment of depression with pharmacotherapy, psychotherapy, and other nonpharmacotherapeutic approaches [20, 21]. Recent meta-analyses have found high dropout and low remission rates as well as clinically significant differences between antidepressants and placebos only for patients with severe depression [22], [23], [24]. This lack of effective treatment or cure may lead patients to search for CAM.

Homeopathy is a patient-centered and holistic medical system that utilizes the natural healing power of the sick person; it treats the person, not the disease. In homeopathy, the story told by a sick person is understood in a different context for each individual, and remedies are selected accordingly. In this process, a variety of strategies are used to respond to the “state” of the sick person at the time, including the use of different remedies with great precision [25], [26], [27].

In the present study, homeopathy has been integrated with conventional medicine since 2000, mainly for treating chronic diseases; 94% had already received conventional medicine, especially all psychiatry patients.

Owing to the variety and complexity of the remedies, they can be used in an integrated manner with conventional treatment for patients with depression who have not shown improvement with conventional treatment. For these patients, especially those with chronic depression who have difficulty in their daily lives despite receiving medications, homeopathy, as part of integrative psychiatry, will work according to the patient’s own natural recovery process.

Homeopathy is an individualized treatment; it has been difficult to report its efficacy in RCTs, especially for psychiatric disorders [28]. The reports of homeopathy as treatment for depression to date include a preliminary study by Katz et al. in 2005 and a study by Adler et al. in 2011, both of which included fluoxetine as treatment [29, 30]. They reported that homeopathy was as effective as fluoxetine in patients with acute depression. Subsequently, in 2020, they reported that homeopathy was more effective than fluoxetine in treating perimenopausal women with moderate to severe depression [31]. In 2020, the efficacy of homeopathy in the treatment of mental disorders was evaluated and the results showed that no difference in the outcomes between homeopathy and placebo treatment was found in patients with major depression [32].

It is worth noting that, in the current study, homeopathy resulted in complete healing within 2 years.These patients with chronic depression who have been treated with antidepressants for more than 2 and 6 years recovered in 6 months to 1 year and 11 months. All cases recovered within 2 years. Patients with depression for whom daily life remains difficult despite receiving medication may benefit from starting homeopathy as part of integrative psychiatry. The homeopathic recovery process leads to improvement of QOL, reduction of drug dosage, disappearance of symptoms, and complete recovery.The three-step path to recovery from depression illustrates and serves as a natural healing process for recovery, with homeopathy as an integrative medicine.

Corresponding author: Ronko Itamura, MD, PhD, MFHom, Clinical Director, Physics Clinic for Integrative Medicine, 2F Quatre Saison Koji-machi, 4-8-19 Koji-machi, Chiyoda-ku, Tokyo, 102-0083, Japan, Phone: +81.3.6280.8853, Fax: +81.3.6280.8859, E-mail: ronkoita@yk.rim.or.jp

Research funding: None declared.
Author contributions: The author has accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Author states no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The research related to human use is in accordance with the tenets of the Helsinki Declaration. Ethical approval was not necessary due to the retrospective nature of the study.

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Received: 2022-05-16

Accepted: 2022-11-07

Published Online: 2022-11-25

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approach; depression; integrative; recovery; three-step

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