PDR for Herbal Medicines, Third Edition

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Interest in and usage of herbal preparations as alternatives to pharmaceuticals has exploded in recent years. Having a complete herbal reference on hand is now absolutely necessary for doctors and other healers when a patient wants to add herbs--let's say St. John's wort--to his drug regimen. Should the patient stop taking the Paxil he's been on for depression, and if so, how long must he wait before he can start taking the St. Johns wort, and what's the recommended dosage?

The PDR for Herbal Medicines will go a long way towards answering such questions. The physician in this case would learn, after consulting the PDR, that "St. John's wort taken concomitantly with an SSRI ... may lead to an increased effect and possible toxicity 'serotonin syndrome', e.g., sweating, tremor, flushing, confusion and agitation." The same physician will also learn that the German Federal Health Authority's Commission E, which has studied the effects of hundreds of herbs, approved St. John's wort for depressive moods, among other conditions.

For more information, the physician can read about the trade names, descriptions of all the medicinal parts of the plant, actions and pharmacology (including the compounds and their effects, with citations), the results of clinical trials, contraindications, precautions and adverse reactions (photosensitization is a biggie for St. John's wort), dosage information, and a complete list of literature citations.

The second edition of this mammoth guide includes over 100 entries more than the first, bringing the total to more than 700. Additions include a selection of Asian herbs, such as Buplerum Chinese (also known as Chinese thoroughwax), which is used in Chinese medicine as an anti-inflammatory, and homeopathic preparations; a directory of manufacturers (with Internet addresses when available), a safety guide (don't use kava kava while nursing), and more. There's even a section that lists unproven uses for each herb. But make no mistake: this is a mainstream reference that relies on scientific proof above all. Therefore, this is not a guide for everyone, but for scientific and medical reference, it's a helpful and comprehensive resource, and even those who push the herbal envelope will find much valuable information here. --Stefanie DurbinBrandon/Hill Medical List first-purchase selection (#22). Provides more than 700 monographs for herbal medicines, completely updated with additional interactions and their clinical management. Each listing includes a detailed description, unique characteristics, and additional common names and synonyms. Previous edition: c2001.

Reader Reviews:

Being a licensed practitioner of Chinese medicine here in the US, I purchased the PDR for Herbal Medicines, 3rd ed. because I wanted to have access to western scientific resource material about the many (about 700) herbal medicinals covered in the volume. If you're looking for a good clinical or diagnostic manual for learning how to prescribe herbal medicinals, this book, by no means, articulates how to actually effectively prescribe herbal medicines properly. In order to prescribe herbal medicines safely and effectively, they must be applied according to a diagnostic pattern discrimination methodology that is suitable for each patient's constitution, clinical presentation and pathological disease situation. All that said, however, the book is an excellent resource for information about known scientific research, references to other source materials as well as pharmacological, chemical, toxicological cautions and contraindications for each herb covered in the volume. In fact, for this kind of information, the text is hard to beat. No one should use or prescribe a medicinal that they do not know the possible side effects and toxicity potential for that particular plant material. Although some naive individuals believe that all medicinal plants are safe to use, in fact, some herbal substances are toxic, contraindicated during pregnancy, should only be used for a short period of time, etc. This book has explicit information that is consistent with many of the best herbal medicine text books that I own. The book even has ratings by the well known German 'Commission E' board that approves herbal medicines in Europe for professional use. And if that isn't enough, many Chinese and Ayurvedic medicinals are also covered. There is also a section that covers many nutritional supplements on the market as well. All in all, I highly recommend the book to those who want detailed identification, dosage, usage, pharmacological and toxicological reference material for a large number of useful plant medicinal substances. This is a great book to fill in the blanks that many other reference texts simply do not cover.The PDR for Herbal Medicines is an excellent, thorough and scientific resource that will prove invaluable to physicians, nurse practitioners, naturopaths and others who use botanicals in the clinical setting. Also important for physicians who want to make sure that patients self-medicating with herbs are doing so safely. The various indexes make it easy to access vital facts rapidly.

Most likely, this text will not be as useful for lay herbalists, medical conspiracy theorists or New Age flakes who want information on the the "spiritual properties" of herbs. This was published by Medical Economics and no author is listed. If you're a true herbalist, expect this book to be slanted to the drug cartel's viewpoint.

Andrew Bentley (Alfalfa and Buckwheat) aptly pointed out that info is left out and it says some data is not available, but it is.

Jerry Cott in his review points out their report on St. John's Wort. Do you really think this was not done on purpose? Imagine the dollars lost if people stopped taking the drugs that this herb will sometimes help.

Be sure to read what the pharmacist said. I applaud you as your lively hood depends on this type of manipulation of the truth.

Buyers beware on this one if you want the truth.This is the most complete reference for herbal medicines that I have seen.It contains many common names as well as Latin names. Being a Certified Pharmacy Technician for 15 years this is a must have. There are probably 100 questions a month on what the side effects and interactions are of various herbal medicines. It is an invaluable reference guide for all pharmacies!This new edition of the PDR for Herbal Medicines goes beyond the first edition, published in December of 1998. While the first edition was somewhat limited by dated, unreferenced information, this one is much more up-to-date and includes recent references to the literature, such as the St. John's wort interactions with indinavir and cyclosporin that were just published this year. Each entry gives a botanical overview, describes actions and pharmacology, and discusses indications and usage in various medical traditions. There is information on clinical trials, and more material on herb/drug interaction, precautions, contraindications, adverse reactions, and dosage. Having a complete herbal reference is a necessity for physicians and other health-care providers in today's world - whether they want to include some herbals in their armamentarium or merely wish to head off possible herb-drug interactions among the patients who are treating themselves.

A careful reading of the hypericum section, however, revealed that several newer clinical trials were not included, while an old (1994) study remained.

In this reference, the physician would learn St. John's wort taken concomitantly with sertraline may lead to "serotonin syndrome," e.g., sweating, tremor, flushing, confusion and agitation. The likelihood of seeing this effect would be difficult to judge, however, since these anecdotal reports from the literature are taken a face value with little critical appraisal. If we don't know how many patients have taken this particular combination, we have no denominator. The inclusion of all material related to toxicologic effects is good for the sake of a comprehensive overview, but the drawback is to lose the feel for what may really be important. An example is the inclusion of a reference regarding hypericum toxicity when directly incubated with sperm or oocytes. Without pointing out that this very unusual study is not the way reproductive or teratogenic is determined during drug development, the reader may be left with the belief that hypericum showed reproductive toxicity. The reference to an interaction with theophylline might have mentioned that the patient was on a plethora of other drugs and relied on her recollection of events. It might also have mentioned that direct human studies of the 1A2 and 2D6 enzymes found no effect from hypericum. Rather, it stated that hypericum "...may significantly affect plasma concentrations of any drug that is metabolized by the cytochrome P-450 system." This is not supported by data. Also unsupported is the incorrect statement taken from Schultz et al's Rational Phytotherapy that phototoxicity may occur at hypericin plasma concentrations of 50 mcg/mL. This should have read 50 mcg/L (or 50 ng/mL) as the original paper reported. Also not useful is the daily dosage recommendation of 200 - 1000 mcg hypericin for depression; one might conclude that there is evidence for this.

While this book is sold as a mainstream reference it may be somewhat daunting for the layman. It's well-organized style and the provision of recent scientific and medical references will make it a useful starting place for more in depth research for health-care professionals. Perhaps the publication of an erratum could be recommended.
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