Warnings on Alternative and So-Called Natural Remedies
Alternative or natural remedies are not regulated and their quality is not publicly controlled. In addition, any substance that can affect the body's chemistry can, like any drug, produce side effects that may be harmful. Even if studies report positive benefits from herbal remedies, the compounds used in such studies are, in most cases, not what are being marketed to the public. There have been a number of reported cases of serious and even lethal side effects from herbal products. In addition, some so-called natural remedies were found to contain standard prescription medication.
The following warnings are of particular importance for people with insomnia:
Chinese Herbal Remedies. Studies suggest that up to 30% of herbal patent remedies imported from China having been laced with potent pharmaceuticals such as phenacetin and steroids. And one study reported a significant percentage of such remedies containing toxic metals. For example, the herbal remedy Sleeping Buddha was recalled in 1998 because it actually contains a benzodiazepine, the major ingredient in many prescription sleeping pills, and also appeared to increase the risk for birth defects in pregnant women. Reports of a few cases of acute hepatitis have occurred from Jin Bu Huan, a Chinese herbal remedy sold as treatment for pain and insomnia.
Kava. Kava has been used to relieve anxiety and improve sleep. It is not generally considered safe, however, after reports of liver failure and death from this medication, with highest risk in those with liver disease. Other side effects include itchy, scaly skin, muscle weakness, and problems with coordination. It also interacts dangerously with certain medications, including alprazolam, an anti-anxiety drug. And it increases the potency of certain other drugs, including other sleep medications, alcohol, and antidepressants.
Tryptophan and 5-L-5-hydroxytryptophan (HTP). Tryptophan is an amino acid used in the formation of the neurotransmitter serotonin, which is known to promote well-being and has been associated with healthy sleep. L-tryptophan was marked for insomnia and other disorders but was withdrawn from the market after contaminated batches caused a rare and even fatal disorder called eosinophilia myalgia syndrome. 5-htp, a byproduct of tryptophan, is still available as a supplement. There have been reports that some brands contain a substance called Peak X, which some evidence suggests may be harmful. To date, no serious adverse effects have been reported and reliable brands are available. Evidence that 5-HTP alleviates insomnia is scant.
The following website is building a database of natural remedy brands that it tests and rates. Not all are yet available and the information requires a paid subscription (www.consumerlab.com).
The Food and Drug Administration has a program called MEDWATCH for people to report adverse reactions to untested substances, such as herbal remedies and vitamins (call 800-332-1088).