Alternative Medicine and Multiple Sclerosis An Objective Review From an American Perspective

The use of complementary and alternative medicine (CAM), or unconventional medicine, may be challenging for health care providers in the United States. There are several definitions of CAM, and therapies that are considered alternative in one country may be conventional in other countries. Unconventional medical practices may be used instead of, or in addition to, conventional medical therapy. It may be difficult for people with multiple sclerosis (MS) to obtain reliable MS-relevant CAM information, and there may be conflicts between the values of patients and those of health care providers. These issues may create problems in the clinical decision-making process. The relevance to MS of some commonly used CAM therapies is discussed: herbal medicine, vitamins and minerals, marijuana, and a histamine and caffeine transdermal gel patch. Current information about the efficacy and safety of CAM therapies is extremely variable. Some therapies appear promising, others are unsafe or ineffective, and nearly all need to be studied further. Suggested citation: Bowling AC, Ibrahim R, Stewart TM. Alternative medicine and multiple sclerosis: an objective review from an American perspective. Int J MS Care [Serial online]. Oct 2000;2(3). In the United States, complementary and alternative medicine (CAM) are increasing in popularity1 and appears to be widely used by multiple sclerosis (MS) patients.2,3 However, there are limitations to the MS-relevant CAM information that is currently available. In addition, addressing issues raised by patients interested in CAM may be particularly challenging for mainstream health care professionals. This review article discusses CAM issues that are important to health professionals who are specialized in MS care. CAM therapy is defined, and the demographics of CAM users are discussed. The clinical decision-making process is considered as it applies specifically to MS patients. Differing and potentially clashing value systems of MS patients and health care providers are highlighted. Information provided in this article is limited to CAM therapies and selected MS-relevant information. More detailed information may be found in the literature about CAM,4-7 CAM and MS,8 and dietary supplements.9-16