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Author Topic: Homeopathic treatment of sleep bruxism  (Read 277 times)

YanTing

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Homeopathic treatment of sleep bruxism
« on: October 15, 2019, 11:02:43 AM »

Phytomedicine
Volume 58, May 2019, 152869

Homeopathic medicine of Melissa officinalis combined or not with Phytolacca decandra in the treatment of possible sleep bruxism in children: A crossover randomized triple-blinded controlled clinical trial

Cláudia Tavares-Silva et al.
Universidade Federal do Rio de Janeiro, Brazil

Abstract

Purpose:
The present randomized controlled clinical trial evaluated the efficacy of homeopathic medicines of Melissa officinalis (MO), Phytolacca decandra (PD), and the combination of both in the treatment of possible sleep bruxism (SB) in children.
Study design: Patients (n=52) (6.62 ± 1.79 years old) were selected based on the parents report of SB. The study comprised a crossover design that included 4 phases of 30-day treatment (Placebo; MO 12c; PD 12c; and MO 12c + PD 12c), with a wash-out period of 15 days between treatments.

Methods:
At baseline and after each phase, the Visual Analogic Scale (VAS) was used as the primary outcome measure to evaluate the influence of treatments on the reduction of SB. The following additional outcome measures were used: a children's sleep diary with parent's/guardian's perceptions of their children's sleep quality, the trait of anxiety scale (TAS) to identify changes in children's anxiety profile, and side effects reports. Data were analyzed by ANOVA with repeated measures followed by Post Hoc LSD test.

Results:
Significant reduction of SB was observed in VAS after the use of Placebo (-1.72 ± 0.29), MO (-2.36 ± 0.36), PD (-1.44 ± 0.28) and MO + PD (-2.21 ± 0.30) compared to baseline (4.91 ± 1.87). MO showed better results compared to PD (p=0.018) and Placebo (p=0.050), and similar result compared to MO+PD (p=0.724). The sleep diary results and TAS results were not influenced by any of the treatments. No side effects were observed after treatments.

Conclusion:
MO showed promising results in the treatment of possible sleep bruxism in children, while the association of PD did not improve MO results.

https://www.sciencedirect.com/science/article/abs/pii/S0944711319300406


Excerpts:

(from the Introduction)

"Although SB has been extensively studied in terms of prevalence, etiology, and diagnosis, scientific evidence on the effectiveness of pharmacotherapy with synthetic drugs for the treatment of SB is insufficient (Macedo et al., 2014). Therefore, the performance of clinical trials to observe the effect of alternative therapies such as phytotherapy and homeopathy seems to be a promising field of study.

"Among the homeopathic medicines used in the treatment of SB, Melissa officinalis L. may be employed as a natural therapeutic agent due to the sedative, anxiolytic, anti-inflammatory, and anti-spasmodic properties inherent to the essential oil obtained from its leaves (Bortoletto et al., 2016). The use of Phytolacca decandra L. for tooth grinding and clenching has been reported in the Homeopathic Materia Medica (Vijnovsky, 1974). In this sense, the present study aimed to evaluate the efficacy of oral administration of M. officinalis and P. decandra, as homeopathic medicines, administered individually or combined, on the treatment of possible SB in children."

(from the Discussion)

"Homeopathic medications are recommended by the World Health Organization (Poitvein, 1999), because of their low-cost, high availability, low side effects, and the fact that they may be taken indefinitely. Although health professionals do not usually consider homeopathy as the first choice of treatment, independently of the condition, its prescription has been increasing due to its low toxicity."

"In the present study, the authors observed that M. officinalis alone was more efficient on the reduction of SB compared to other treatments. It probably occurred because M. officinalis can modulate a number of behavioral measures, with indications including administration as a mild sedative in disturbed sleep, and in the attenuation of the symptoms of nervous disorders, including the reduction of excitability, anxiety, and stress (Kennedy et al., 2003). M. officinalis have effective anxiolytic activity in reducing stress and physiological disturbances due to its direct interaction with CNS, and cholinergic and GABAergic systems (Sarris et al., 2011; Jayadeepa, and Niveditha, 2012; Fermino et al., 2015).

"Despite the classically known anxiolytic effects of M. officinalis, in the study by Bortoletto et al. (2016) 15 drops of M. officinalis tincture at 20%, prescribed for 30 days in children presenting SB were not able to reduce their muscle events, evaluated through electromyography. An important difference between Bortoletto et al. (2016) and the present study is that our methodology involved dynamization (a step in the process of producing all pharmaceutical homeopathic medicines) of the M. officinalis tincture, which could have contributed to the satisfactory result.

"While M. officinalis alone presented the highest reduction of reported SB, P. decandra alone exerted no effect compared to Placebo. Although P. decandra is prescribed for prevention of tooth grinding and clenching (Vijnovsky,1974) according to Homeophatic materia medica (Hering, 1931), P. decandra can also promote sleep restless, which could have contributed the lack of effectiveness when administered alone or with M. officinalis. Thus, further studies are recommended to clarify this issue."

"Considering that 12c dose is the maximum dilution possible to contain one molecule of the original substance usually used in chronic disease treatment and that it is able to change some mental and emotional behaviors (Vijnovsky, 1974), we intended to observe if these homeopathic medications in the 12c dilution would be able to modify the trait-anxiety of children after each treatment's phase. Since no alterations were observed, independently of the treatment, the authors believe that the 30-day period for each drug was insufficient to modify an individual's emotional pattern. The lack of a sample of children not presenting SB could be considered as a limitation of the present study; however, the authors understood that it would be impossible and unethical to prescribe medicines to children who did not present sleeping problems. Additionally, the selected cross-over design uses the subjects as their own control and reduces the variability among the patients included in the trial.

"One could question about the children follow-up after the treatments. However, since this is a crossover study, the follow-up was characterized by the washout periods.

"In conclusion, M. officinalis homeopathic medicine ameliorated the symptoms of possible children SB, being a promising medication for this sleep disturbance."

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Comments:

As usual, the authors do not refer to the fact that scientific medicine finds homeopathy to be absurd, or even note that it is at all controversial.  They seem to recognize that their highly diluted remedies contain no active molecules, by saying that "12c dose is the maximum dilution possible to contain one molecule of the original substance." 12c means a 10 to the 24th power dilution, which is approximately Avogadro's number.  However, a dilution of that amount would yield about one molecule per liter if you started with a 1 molar solution. In fact the starting concentration is much less than 1 molar and the dose is much less than one liter.

This paper is unusual in that it gives the actual concentrations of 10 different compounds in the mother tincture. The highest of these is vanillic acid, at about 100 micrograms per milliliter, or 100 milligrams per liter. Vanillic acid has a molar mass of 168 g, so 100 milligrams per liter is 0.0006 molar. After the homeopathic dilution this gives a concentration of 6 x 10^-28 M. The dose given to the children was 1 drop times the age of the child in years, which I will approximate by 1 ml. Using Avogadro's number, I calculate that 1 ml will contain on average 0.0000004 molecules of vanillic acid.
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