I´d like to thank Dr. Manish Bhatia for his kind invitation, since it´s a pleasure to contribute for Homeopathy for Everyone and it´s also an opportunity to make some observations on the subject of Research Challenges in Homeopathy.
Quoting the challenges pointed out by the U.S. National Center for Complementary and Alternative Medicine (NCCAM)[1], I´d like to pose some questions and considerations.
“Homeopathy is a controversial area of CAM because a number of its key concepts are not consistent with established laws of science (particularly chemistry and physics). Critics think it is implausible that a remedy containing a miniscule amount of an active ingredient (sometimes not a single molecule of the original compound) can have any biological effect—beneficial or otherwise. For these reasons, critics argue that continuing the scientific study of homeopathy is not worthwhile.”
On the pathway towards plausible mechanisms to explain the biological effects of Homeopathy, the hypothesis of modification of the electromagnetic characteristics of the solvent has recently gained support in the findings of Nobel Prize winner Prof. Montagnier and his Colleagues. Using a device designed by Prof. Benveniste and Collaborators[2] [3] they demonstrated that bacterial DNA sequences at high aqueous dilutions can induce electromagnetic waves, if those sequences are serially diluted and strongly agitated on a Vortex apparatus[4]. Finding a general plausible explanation is different from determining the exact mechanism of action of homeopathic remedies. This knowledge however, is not essential for clinical research. For instance, after six decades of intensive research on the development of antidepressant drugs, the therapeutic action of these agents remains largely unknown[5] [6].
Back to NCCAM:
“Homeopathy is difficult to study using current scientific methods because highly diluted substances (known as ultra-high dilutions or UHDs) cannot be readily measured, making it difficult to design or replicate studies.
Is it? As widely known, gold standard scientific method in clinical research is randomized controlled trials (RCTs). Should RCTs aim at measuring UHDs or their effects on samples of patients suffering from a specific disease? In an analogous manner, Psychotherapy cannot be readily measured either, but it has been extensively investigated by “current scientific methods”[7]. Why should it be so difficult to study homeopathy, if dynamized medicines are even easier to compare to placebo or active controls than Psychotherapy?
“In addition, homeopathic treatments are highly individualized and there is no uniform prescribing standard for homeopaths. There are hundreds of different homeopathic remedies which can be prescribed in a variety of different dilutions, to treat thousands of symptoms.”
In fact, a study design in which the selection of a suitable, individualized homeopathic medicine occurs during the double-blind randomized phase evaluates not only the efficacy of homeopathy, but also the efficiency of the homeopath in selecting and managing that medicine[8]. However, in some cases an open-label phase for remedy selection can precede the randomization[9], rendering it easier to assess the efficacy of individualized homeopathic approaches.
Individualized or not, the homeopathic approaches being investigated must be (as far as possible) standardized, which might be a major challenge in Homeopathy, since it has become a heterogeneous therapeutic system with a multitude of schools and directions[10].
“On the other hand, many aspects of the interaction between the homeopathic practitioner and his or her patients may be quite beneficial, and can be studied more easily.”
Yes, the homeopathic consultation probably “is in itself a therapeutic intervention, working independently or synergistically with the prescribed remedy”[11], but only randomized placebo-controlled trials studying standardized clinical-pharmaceutical methodologies can ascertain if there is a specific effect of the homeopathic medicines. Researchers, Clinicians, Pharmacists and other health care professionals working with Homeopathy should be aware that without RCTs showing that specific effect, the advantages of Homeopathy tend to be reduced to its anamnesis, at least from the point of view of medical science.
Ubiratan Adler
MD, PhD, Homeopath
Nov 2009
[1] Available at http://nccam.nih.gov/health/homeopathy/#status
[2] Benveniste J, Jurgens P, A¨?ssa, J. Digital recording/ transmission of the cholinergic signal. Faseb Journal, 1996; 10, A1479.
[3] Benveniste J, Guillonnet D. Method, system and device for producing signals from a substance biologicaland/or chemical activity. 2003 US Patent Nr. 6 541,978 B1.
[4] Montagnier L, Aissa J, Ferris S, Montagnier J-L, Lavallee C. Electromagnetic Signals Are Produced by Aqueous Nanostructures Derived from Bacterial DNA Sequences. Interdisciplinary Sciences: Computational Life Sciences, 2009; 1: 81-90.
[5] Baghai TC, Baumann P; Leonard BE, Pinder R. Mechanisms of action and future directions in the development of antidepressants. In Antidepressant medications and other treatments of depressive disorders: a CINP task force report based on review of evidence. The International Journal of Neuropsychopharmacology, 2007; 10(1):S38-S45,
[6]Lee H-Y; Kim Y-K. Plasma Brain-Derived Neurotrophic Factor as a Peripheral Marker for the Action Mechanism of Antidepressants. Neuropsychobiology, 2008;57:194-199
[7] Imel ZE, Malterer MB, McKay KM, Wampold BE. A meta-analysis of psychotherapy and medication in unipolar depression and dysthymia. Journal of Affective Disorders, 2008; 110 (3):197-206.
[8] Adler UC, Paiva NM, Cesar AT, Molina A, Adler MS, Padula AE, Calil HM. Homeopathy versus fluoxetine for moderate to severe depression: double-blind, randomized non-inferiority trial. eCAM Advanced Access published August 17, 2009. Available at:
[9] Frei H, Everts R, von Ammon K, Kaufmann F, Walther D, Hsu-Schmitz SF, Collenberg M, Fuhrer K, Hassink R, Steinlin M, Thurneysen A. Homeopathic treatment of children with attention deficit hyperactivity disorder: a randomized, double blind, placebo controlled crossover trial. Eur J Pediatr 2005; 164(12):758-767.
[10] Lüdtke, R. Homoeopathie – Zum Stand der klinischen Forschung: Eine Stellungnahme der Karl und Veronica Carstens-Stiftung, Der Vorstand der Karl und Veronica Carstens-Stiftung,2006.
[11] Thompson TD, Weiss M. Homeopathy-what are the active ingredients? An exploratory study using the UK Medical Research Council’s framework for the evaluation of complex interventions.BMC Complement Altern Med 06;6:37
