Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor
In Reply: We agree with Dr Ritter and Mr Dembicki
and thank them for reminding us that experiences with digitalis provide an
important precedent for evaluating the current resurgence of interest in botanical
medicine. Digitalis, one of the most effective drugs ever developed from a
plant, underscores the difficulty of evaluating herbal products.
Indeed, many currently popular "natural products"1,2
have similar problems. These include: (1) little data concerning adverse effects
and drug-herb interaction; (2) little or no evidence of efficacy; (3) inadequate
scientific assessment of active chemical constituents and insufficient information
concerning optimal preparation and dosages; (4) lack of consistency in chemical
compositions between different manufacturers or between different batches
of the same manufacturer; (5) chaotic or commercially determined forms of
standardization; (6) contradictory and difficult to interpret traditional
claims; and (7) poor monitoring for deterioration of potency, contamination,
and adulteration. All these problems need to be addressed by increased research
efforts, improved government regulation, and postmarketing vigilance.
Eisenberg DM, Kaptchuk TJ. The Herbal History of Digitalis: Lessons for Alternative Medicine—Reply. JAMA. 2000;283(7):884–886. doi:10.1001/jama.283.7.882
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