Table 1.

Publications reporting on use of CAM in countries with western style medical system.

Publication	Studied population	% using CAM	Associations	Doctor’s knowledge	Most used CAM (in descending order, where known)	Reason for use	Outcome measures	Most used non-vitamin, non-mineral natural products (in descending order, where known)
Gidal et al. ,1999 [21]	465 adults with epilepsy from 9 regions in the US	31%, within previous year	Associated with high-school education or less. No influence of age, gender, seizure type.	33%	Ginkgo biloba, vitamins (55%), relaxation (45%), ginseng, St. John’s wort	13% epilepsy (relaxation, vitamins, herbals, homeopathy); 28% general health/cold prevention; 11% mood difficulties; 5% cognition; 4% fatigue.	NA	Gingko biloba (81% of users; 63% used it for cognition), ginseng (44% of users), St. John’s wort (used by 7% of pts.; 53% for mood and 24% for fatigue)
Peebles et al., 2000 [22]	92 adults with epilepsy in Ohio (US)	24%	No significant association with education level, sex, ethnicity, age	31%	Massage (50%), herbs/supplements (41%), music therapy, meditation, art therapy, aromatherapy, acupuncture	2% epilepsy (massage, acupuncture and meditation); pain; muscle tension; stress; low energy; cold; depression.	NA	4 Ginseng, 3 St. John’s wort, 3 melatonin, 3 Ginkgo biloba,1 garlic, 1 black cohosh
Waaler et al.,　 2000 [29]	198 children with active epilepsy in Norway	11.60%	Additional neurological deficits	NA	Homeopathy	NA	NA	NA
Gross-Tsur et al., 2003 [30]	115 children with epilepsy in Israel (compared with children with ADHD and control)	32%	In general - higher education, prior use for current use; for epilepsy and ADHD - longer disease duration, less satisfaction with conventional therapy	NA	Dietary interventions most and also homeopathy, biofeedback, acupuncture, Reike, reflexology, Shiatsu, chiropractice (in all groups)	NA	NA	NA
Sirven et al., 2003 [23]	425 adults with epilepsy in Arizona (US)	44% for epilepsy, 42% for other conditions	No association with education level	93% would tell	Prayer, stress management, botanicals, chiropractic (specifically for epilepsy)	44% epilepsy, 42% other conditions	Stress management, yoga and botanicals subjectively most beneficial. 43% using botanicals for epilepsy had increased seizure frequency; 3 had major side effects (intracranial hemorrhage with ephedra).	General/epilepsy use: 76/13 Garlic, 157/12 gingko, 64/10 soy, 40/11 melatonin, 22/10 kava, 159/8 ginseng, 147/9 St. John’s wort, 89/9 Echinacea, 68/3 cranberry, 40/5 goldenseal, 24/7 grapeseed, 21/4 black cohosh, 33/4 valerian, 14/3 saw palmetto, 7/7 evening primrose, 12/2 licorice, 7/4 hops,3/2 black haw
Plunkett et al., 2004 [24]	187 adults with epilepsy　 in San Francisco area (US)	56%	No association with seizure frequency or with having adverse events from AED.	68%	Vitamins or minerals supplements	3% epilepsy or AED adverse events; general health; supplementing diet; physician’s recommendation.	NA (19% used products wit cyp450 activity and 14% - potentially epileptogenic agents.)	Garlic, echinacea, St. John’s wort, ephedra, ginseng, gingko, evening primrose
Yuncker et al., 2004 [31]	350 children with neurological conditions (60% had epilepsy) in Pennsylvania (US)	28% of children with epilepsy (37% of all conditions)	Diagnosed for less than one year	69%	NA	NA	87% overall felt CAM was effective and similar to conventional therapy. 40% knew possible side effects.	NA
Easterford et al., 2005 [25]	377 adults with epilepsy in Manchester, UK	34.60%	Higher education	37%	NA	11.1% epilepsy	No significant effect on seizure frequency. CAM was cheap.	NA
Liow et al. , 2007 [26]	228 adults with epilepsy in mid west US	39%	No association with education level	49%	Prayer/spirituality, megavitamins, chiropractic, stress management	57 (25%) epilepsy: 33 prayer/spirituality; 14 megavitamins; 11 chiropractic; 11 stress management	Subjective benefit of 74% of 57. Only few side effects. Increased szs in diet pills, chiropractic, ketogenic diet, atkin’s megavitamins.	10 Cranberry, 8 black cohosh, 7 Echinacea, 6 melatonin, 4 garlic, 4 grape seeds, 4 soy, 4 St. John’s wort, 4 valerian, 3 evening primrose, 2 Ginkgo biloba, 2 ginseng, 1 black haw
Murphy et al., 2008 [27]	671 adults with neurological conditions in Ireland (189 with epilepsy)	47.6% of patients with epilepsy (63.3% of all conditions)	NA	25% for all conditions	massage, acupuncture, vitamins, reflexology, yoga, evening primrose/starflower oil, chiropractic, homeopathy (for all conditions)	NA	Most had subjective benefit. Annual cost was 1170.32 euro.	97 evening primrose/starflower oil, 24 marijuana, 16 St. John’s wort, 16 Gingko biloba, Udo’s oil, fish oil, black cohosh, echinacea, bonemeal, coenzyme Q-10
Kaiboriboon et al., 2009 (only use of herbs and dietary supplements was studied) [28]	187 adults with epilepsy at UCSF medical center (US)	56% (current use)	Partial epilepsy and Caucasian race. No association with gender, age, level of education, income, duration of epilepsy or seizure frequency.	71%	Multivitamins and minerals, folic acid, ginseng, Ginkgo biloba, glucosamine and chondroitin, St. John’s wort, black cohosh, Echinacea, evening primrose, ephedra, caffeine, melatonin, milk thistle, omega 3, kava, skullcap, valerian, grapefruit juice, glutamine, clover/nettles, parsley leaf, DHEA, Coenzyme Q10, ginger, fish oil, garlic, grape seed, L-lysine	6 epilepsy (kava, skullcap, valerian, folic acid, vit. B6, vit. E, multivitamins, minerals); 35 general health; 13 physician’s recommendation; 13 improve bone density; 10 increase energy; 10 boost immune system; 7 improve memory.	9 patients reported adverse events that they attributed to these products. None reported aggravation of seizures. 88% of patients spent less than $50 a month and only 5% spent more than $100.	4 Ginseng, 4 Ginkgo biloba, 4 glucosamine and chondroitin, 3 St. John’s wort, 2 black cohosh, 2 Echinacea, 2 evening primrose, 2 ephedra, 2 caffeine, 2 melatonin, 2 milk thistle, 2 omega 3, 1 kava, 1 skullcap, 1 valerian, 1 grapefruit juice, 1 glutamine, 1 clover/nettles, 1 parsley leaf, 1 DHEA, 1 Coenzyme Q10, 1 ginger, 1 fish oil, 1 garlic, 1 grape seed, 1 L-lysine

CAM—complementary and alternative medicine; NA—not available; AED—anti-epileptic drug.