Evidence-Based Use of Herbal/OTC Products in the Management of Psychiatric Illness

Course Description

This session will identify the herbal/OTC products that are commonly used by individuals to support the treatment of depression and anxiety. The session will review the evidence-based literature on the place in therapy, benefits, side effects, drug interactions, and other therapeutic features of individual products in these areas. The pharmacy practitioner should be able to educate patients on key points to empower them with expectations with these products when used for depression and anxiety.

Learning Objectives

  1. Discuss the level of evidence supporting the use of herbal products in the management of common psychiatric symptoms, including anxiety and depression.
  2. Outline important patient education for individuals initiating treatment with an herbal or over-the-counter product for management of symptoms of a mental health disorder. 
  3. Describe a treatment plan utilizing evidence-based herbal or over-the-counter products for the management of symptoms of anxiety and depression.

Target Audience

If you are a pharmacist, nurse practitioner, or other health care professional involved in the comprehensive medication management of individuals living with mental health and/or substance use disorders, we invite you to participate in this online course.

Faculty

Angela M. Hill, PharmD, CRPh
View biographical information

Angela M. Hill, PharmD, CRPh
Professor & Associate Dean of Clinical Affairs
University of South Florida Taneja College of Pharmacy
Tampa, FL

Dr. Angela Hill is a professor and the Associate Dean of Clinical Affairs at the USF Health Taneja College of Pharmacy. She is a career-academic and licensed Consultant pharmacist in Florida with specialization areas that include mental health, neurological disorders, alternative medicine and geriatrics. Dr. Hill has been involved in teaching pharmacy students didactically and experientially, pharmacy and other health practitioners, and the lay public about the proper use of herbal medications her other areas of specialization.
 
Her career has included clinical work and student training at State Mental Health hospitals, psychiatric stabilization units, community practice, and primary and long-term care in Florida. She has also provided consultant pharmacy services for organizations like Medicaid, the Florida Department of Elder Affairs, long-term care facilities, and Memory Disorder , Parkinson’s, Epilepsy, ADHD, Neuroleptic Review, Clozaril, and Multiple Sclerosis Clinics. One of her duties as the Associate Dean of Clinical Affairs includes her serving as the project manager for WE-CARE, a community-based participatory research entity within the College of Pharmacy where she coordinates activities within the community to recruit, retain, and educate underrepresented groups on research participation and other health issues to close the gap on health disparities that includes a focus on disparities in cancer, mental health, Alzheimer’s disease, population health and COVID-care. She has been involved in two This is My Brave productions with NAMI, serves on the North Florida FACT Team, and is co-coordinating a Faith & Pharmacy Mental Health initiative as a member of the Georgia Health Equity Alliance for Mental Illness. 
 
She received her Pharm.D. from Florida A&M University College of Pharmacy and completed a residency in Neurology at the Neuroscience Foundation Inc. She is currently providing services at Reliance Medical Centers in Lakeland, Florida where she provides comprehensive medication reviews and education for aging patients with co-morbid medical, neurological, and psychiatry disorders.
 
No Relevant Financial Relationships to Disclose

Course Requirements

To receive ACPE credit for this session, you must:

  • Register for this course.
  • Review the full content of the activity and reflect upon its teachings.
  • Complete the evaluation at the end of the activity.
  • Provide the necessary details in your profile to ensure correct reporting by AAPP to CPE Monitor.

Continuing Education Credit and Disclosures

Activity Date: 04/17/2023
ACPE Contact Hours: 1
ACPE Number: 0284-0000-23-030-H01-P (Knowledge)
Nursing Credit Reminder: Note that ACPE credit is accepted for ANCC Certification Renewal and AANPCB advanced practice provider content. For specific questions related to your organization's acceptance of ACPE continuing education units, please contact your organization directly.

ACPEThe American Association of Psychiatric Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

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View planning committee disclosures

2023 Program Committee and Recertification Editorial Board

Elayne D. Ansara, PharmD, BCPP, BCPS
Program Committee Chair
Clinical Pharmacy Specialist
Veteran Health Indiana
Indianapolis, IN
No Relevant Financial Relationships to Disclose
Jolene R. Bostwick, PharmD, BCPP, BCPS
Program Administrative Chair
Assistant Dean for Co-Curriculum and Professional Development & Clinical Professor
University of Michigan College of Pharmacy
Ann Arbor, MI
No Relevant Financial Relationships to Disclose

Bridget Bradley, PharmD, BCPP
Associate Professor
Pacific University School of Pharmacy
Hillsboro, OR
External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: ACCP PSAP May 2021, Neurology and Psychiatry Book
Educational Grants, Research Grants or Contracts: NACDS Community Pharmacy Residency Grant

Austin R. Campbell, PharmD, BCPP
Clinical Assistant Professor
UMKC School of Pharmacy at MU
Columbia, MO
External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Sunovion Pharmaceuticals Inc. Speakers Bureau
Financial Interests: Up To Date Contributor "Pharmacotherapy for schizophrenia: Long-acting injectable antipsychotic drugs"
Non-Financial Interests: Extension for Community Healthcare Outcomes, Show-Me ECHO Project

Chelsea N. Carr, PharmD, BCPP
Advanced Practice Pharmacist - Psychiatry
University of Maryland School of Pharmacy
Catonsville, MD
No Relevant Financial Relationships to Disclose
Dana Chiulli, PharmD, BCPP
Clinical Pharmacist - Mental Health
VISN 06 Mental Health Clinical Resource Hub
Savannah, GA
No Relevant Financial Relationships to Disclose
Jordan Cooler Haygood, PharmD, BCPP
Clinical Assistant Professor
University of South Carolina College of Pharmacy
Columbia, SC
No Relevant Financial Relationships to Disclose
Marissa Cullen, PharmD, BCPP
Clinical Pharmacist
UPMC Western Psychiatric Hospital
Pittsburgh, PA
No Relevant Financial Relationships to Disclose
Beth DeJongh, PharmD, BCPP, BCPS
Recertification Editorial Board Chair
Pharmacist
Concordia University Wisconsin
Mequon, WI
No Relevant Financial Relationships to Disclose

Bennett J. Doughty, PharmD, BCPP, BCPS
Clinical Assistant Professor
Binghamton University School of Pharmacy and Pharmaceutical Sciences
Binghamton, NY
External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Achieve CE - CE provided for compensation, PsychU- Speaker's Bureau
Non-Financial Interests: New York State American College of Clinical Pharmacists Executive Board

Traci M. Dutton, PharmD, BCPP, BCPS
Clinical Pharmacy Specialist - Mental Health; Program Director - PGY2 Psychiatric Pharmacy Residency
VA Tennessee Valley Healthcare System
Murfreesboro, TN
External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Member of VA PBM Educational Advisory Committee
which oversees Board Certification Study Groups

Megan J. Ehret, PharmD, BCPP, MS
BCPP Program Director
Professor
University of Maryland
Baltimore, MD
External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Psych U Section Advisor, Lexi-Comp Consultant/Reviewer,
SMI Adviser; Pharmacist Consultant
Educational Grants, Research Grants or Contracts: FDA/University of Maryland CERSI, Maryland Behavioral Health Department, NIH

Kimberly Ehrhard, PharmD
Clinical Pharmacist, Psychiatry
The University of Kansas Health System
Kansas City , KS
No Relevant Financial Relationships to Disclose
Michelle L. Geier, PharmD, BCPP
Psychiatric Clinical Pharmacist Supervisor
San Francisco Department of Public Health
San Francisco, CA
External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Weitzman Institute Project ECHO Faculty
Abigail Hampton, PharmD, BCPP
Psychiatric Clinical Pharmacist - Ambulatory
University of Kansas Health System
Kansas City, KS
No Relevant Financial Relationships to Disclose
Courtney A. Iuppa, PharmD, BCPP
Clinical Pharmacy Manager & Residency Program Director
Center for Behavioral Medicine
Kansas City, MO
No Relevant Financial Relationships to Disclose
Archana R. Jhawar, PharmD, BCPP
Clinical Pharmacist
Jesse Brown VAMC/ UIC College of Pharmacy
Chicago, IL
No Relevant Financial Relationships to Disclose
Kayla D. Johnson, PharmD, BCPP, BCPS
Vanderbilt University Medical Center
Thompsons Station, TN
No Relevant Financial Relationships to Disclose
Farah E. Khorassani, PharmD, BCPP
Associate Clinical Professor
St. John's University
Queens, NY
External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Consultant- Alkermes (Sept 2021)
Dongmi Kim, PharmD, BCPP, BCPS
Assistant Clinical Professor
Fairleigh Dickinson University School of Pharmacy
Florham Park, NJ
No Relevant Financial Relationships to Disclose
Jamie C. Kneebusch, PharmD, BCPP, BCPS
Assistant Clinical Faculty
UC San Diego, Skaggs School of Pharmacy
La Jolla, CA
No Relevant Financial Relationships to Disclose
Erin D. Knox, PharmD, BCPP
Director of Experiential Education
UCI School of Pharmacy & Pharmaceutical Sciences
Irvine, CA
Non-Financial Interests: Santa Ana Community College, Pharmacy Technology Program, Advisory Committee
Lauren E. Leiby, PharmD, BCPP
Behavioral Health Patient Care Pharmacist
Nationwide Childrens Hospital
Columbus, OH
No Relevant Financial Relationships to Disclose
Amber R. Lemons, PharmD, BCPP
Behavioral Health Pharmacist
Denver Health Medical Center
Denver, CO
No Relevant Financial Relationships to Disclose
Linda D. Logan, PharmD, BCACP, BCPP, BCPS
Public Service Associate
University of Georgia
Athens, GA
Educational Grants, Research Grants or Contracts: HRSA Graduate Psychology Education Grant, CPNP Foundation Student Grant (Advisor),
UGA College Pharmacy Ansel Fund
Monica Mathys, PharmD, BCGP, BCPP
Professor
Texas Tech University School of Pharmacy
Dallas, TX
Non-Financial Interests: CPNP Foundation Board member

Lindsey N. Miller, PharmD, BCPP
Clinical Pharmacist and Associate Professor
Lipscomb University and Vanderbilt Psychiatric Hospital
Nashville, TN
External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Social Security Administration- Board of Adjudication: Presentations on various disease states
Financial Interests: Pharmacy Times Panel Discussant- Payer Forum Sponsored by Alkermes (January 2020),
Pharmacy Times- CE Presentation Sponsored by Otsuka (August 2019)

Melissa Mitchell, PharmD, BCGP, BCPP, BCPS
Assistant Director of Pharmacy;Residency Program Director
RUHS Medical Center
Moreno Valley , CA
External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Neurocrine Speakers Bureau - Ingrezza, Janssen Speakers Bureau - Spravato,
Otsuka - PsychU.org Speaker
Thea R. Moore, PharmD, BCPP
Associate Professor
University of South Florida
Tampa, FL
No Relevant Financial Relationships to Disclose
Jessica L. Mulhollan, PharmD, BCPP
Clinical Pharmacy Specialist, Substance Use Disorders and Mental Health Clinical Pharmacy Supervisor
Louis Stokes Cleveland VA Medical Center
Cleveland, OH
No Relevant Financial Relationships to Disclose
Kristen Neumeister, PharmD, BCPP
Clinical Pharmacist- Mental Health
John Peter Smith Hospital
Fort Worth, TX
No Relevant Financial Relationships to Disclose
Megan O'Connell, PharmD, BCPP
Advanced Practice Pharmacist - Psychiatry
University of Maryland - Clifton T. Perkins Hospital
jessup, MD
No Relevant Financial Relationships to Disclose
Melissa C. Palmer, PharmD, BCPP, BCPS
Clinical Pharmacy Specialist - Mental Health
Alaska VA Healthcare System
Anchorage, AK
No Relevant Financial Relationships to Disclose
Haley Pals, PharmD, BCPP
Substance Use Disorder/Psychiatric Clinical Pharmacist
Tomah VA Medical Center
Tomah, WI
No Relevant Financial Relationships to Disclose
Brittany L. Parmentier, PharmD, BCPS, BCPP
Clinical Assistant Professor
University of Texas at Tyler
Tyler, TX
No Relevant Financial Relationships to Disclose
Jake R. Peters, PharmD, BCPP, BCPS
Assistant Professor of Pharmacy Practice/Clinical Pharmacy Specialist - Psychiatry
Butler University College of Pharmacy/Indiana University Health
Indianapolis, IN
No Relevant Financial Relationships to Disclose
Lindsey Peters, PharmD, BCPS
Associate Professor of Pharmacy Practice
Ohio Northern University
Ada, OH
No Relevant Financial Relationships to Disclose
Sarah J. Popish, PharmD, BCPP
Academic Educator
Department of Veterans Affairs
Vallejo, CA
No Relevant Financial Relationships to Disclose
Nina Vadiei, PharmD, BCPP
Assistant Professor
University of Arizona Colleges of Pharmacy and Medicine
Tucson, AZ
No Relevant Financial Relationships to Disclose
Heidi J. Wehring, PharmD, BCPP
Adjunct Associate Professor of Psychiatry
Maryland Psychiatric Research Center, University of Maryland School of Medicine
Baltimore, MD
No Relevant Financial Relationships to Disclose
Kara R. Wong, PharmD, BCPP
Clinical Pharmacy Specialist, Mental Health; PGY2 Psychiatric Pharmacy Residency Program Director
Minneapolis VA Health Care System
Minneapolis, MN
No Relevant Financial Relationships to Disclose

All relevant relationships have been mitigated.

View disclaimer and disclosure of off-label use

Off-Label Use: This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA (see faculty information). The opinions expressed in the educational activity do not necessarily represent the views of AAPP and any educational partners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Presentation-Specific Disclosure: My presentation will include discussion of off-label, experimental, and /or investigational use of drugs or devices: The herbals/OTC products that are commonly used for depression and anxiety include, but are not limited to: St. John?s wort, SAM-e, Kava Kava, Valerian root, Lavendar oil, Rhodiola, Ashwaganda, Maca Root, Rosemary, Thyme. Because of the way these products are regulated, the FDA does not approve these products for use. I will also be discussing the role of vitamins such as omega-3, B-12, B-1, B-3 & magnesium which have been used to support other pharmacological therapies for depression and anxiety.

View fair balance and integrity statement

It is the policy of AAPP to ensure independence, balance, objectivity, scientific rigor, and integrity in continuing education activities. Those involved in the development of this continuing education activity have made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation of this continuing education activity. Information regarding drugs (e.g., their administration, dosages, contraindications, adverse reactions, interactions, special warnings, and precautions) and drug delivery systems is subject to change, however, and the reader is advised to check the manufacturer’s package insert for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering the drug or using the drug delivery systems.

Fair balance is achieved through ongoing and thorough review of all materials produced by faculty, and all educational and advertising materials produced by supporting organizations, prior to educational offerings. Approval of credit for this continuing education activity does not imply endorsement by AAPP for any product or manufacturer identified.