Don’t ask your pharmacist about Nervoheel N or Neurexan

Magic beans

I can across a strange full-page ad in yesterday’s Globe and Mail. The headline was huge:

Reclaim your inner peace. Homeopathic Preparations. Scientifically proven effective.

Proven effective? Large comprehensive reviews have concluded that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible. Consequently, it seems quite a stretch to say any homeopathic remedy is “Scientifically proven effective”.  This particular ad was for two homeopathic products from Heel.  Both Nervoheel N (“calms stressful moments, eases nervousness”) and Neurexan (“restores your natural sleep patterns, improves sleep quality”) are approved by Health Canada as safe and effective. Kim Hebert over at Skeptic North went looking for the published clinical evidence to support these efficacy claims:

  • For Nervoheel N there was one open-label, non-randomized cohort study that stated “The differences between the treatment groups [Nervoheel and lorazepam] were not significant.” The paper concluded that Nervoheel N is non-inferior to lorazepam. No placebo group was included.
  • For Neurexan there were two studies. Both non-random studies compared Neurexan with another unproven treatment, valerian, in the absence of a placebo group. There is no objective way to separate these results from unintentional researcher/patient bias or the placebo effect. Therefore, the results of both are clinically meaningless.

This data was presumably adequate for Health Canada (search their database for products 80007796 and 80004914 here) unless there’s unpublished data that was supplied.  The ad continues:

Both products are suitable for the whole family, for short or long-term use, as they are clinically proven effective, non-addictive, and non-sedative. They have no known side effects, medicinal interactions, or contraindications.

In order to have side effects, first a product has to have effects. So no surprise there.  The strangest statement, however, is at the bottom of the ad:

AVAILABLE IN PHARMACIES AND HEALTH FOOD STORES.

Ask your chiropractor or naturopath for more infomation.

Presumably they don’t want you to ask your pharmacist for more information. What kind of response might a pharmacist give about the scientific evidence supporting this, or any other homeopathic remedy? Hopefully, a science-based one.

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6 thoughts on “Don’t ask your pharmacist about Nervoheel N or Neurexan

    • Nancy. Did you read the study, and the conclusions?

      Bell et al. Effects of homeopathic medicines on polysomnographic sleep of young adults with histories of coffee-related insomnia.

      CONCLUSIONS: The study demonstrated the feasibility of using in-home, all-night sleep recordings to study homeopathic remedy effects. Findings are similar though not identical to those reported in animals with the same remedies. Possible mechanisms include initial disruption of the nonlinear dynamics of sleep patterns by the verum remedies.

      The conclusion says nothing about the efficacy of homeopathy

  1. Lorazepam is one of the stronger benzodiazepines currently in use. In the US, it wouldn’t generally be a first line choice for management of insomnia under most circumstances. The study design, even from the abstract, is simply one of the crummiest I’ve seen.

    Their inclusion criteria: “insomnia, distress, anxieties, restlessness or burnout and similar nervous conditions”. Some of these aren’t even diagnosable – they’re vague symptoms if anything. Hardly a homogenous sampling, and not a good design of a cohort. Add in the open label, non-randomized nature with the subjective inclusion criteria and rather non-rigorous measures and you’ve got a recipe for a trash study. Just the sort homeopathic journals are so fond of publishing.

    Comparing to Valerian as a measure of efficacy is just beneath mention.

  2. To be fair, the main purpose of getting Health Canada approval isn’t to show effectiveness, it’s presumably safety/quality.

    Effectiveness shouldn’t even be mentioned for HM-DIN products, since they can assert action for specified conditions on the basis of historical use or homeopathic pharmacopoeia. It’s a joke.

    • Agree, but Health Canada’s statement is as follows:

      Through the Natural Health Products Directorate, Health Canada assures that all Canadians have ready access to natural health products that are safe, effective and of high quality, while respecting freedom of choice and philosophical and cultural diversity.

      • I know. I’m so glad I work on biologics instead. I think that the safety/quality aspect is important (as we see with adulterated products, products with bacterial contamination, and natural products that contain heavy metals), but it’d be great if NHPD didn’t bother looking at efficacy at all, rather than lending any legitimacy to alt-med that way.

        I’m curious whether anything would be gained by going through the Food and Drug Act Liaison Office with a complaint. Probably not, but at least it represents one way to try to change the system.

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