The article ‘Surely you take complementary and alternative medicines?’ (Psychiatric Bulletin, February 2004, 28, ) has been read with much interest. The content of the article is highly relevant to developing countries as many patients seek complementary and alternative medicines for a variety of illnesses, particularly for long-standing problems including psychiatric disorders. Many patients and their relatives seem to go for alternative therapies in addition to Western medicine. For instance, a study done with regard to puerperal mental disorders in Sri Lanka demonstrated that up to 80% of patients were seeking alternative or complementary medicines in addition to conventional ones (further details available from the author upon request).

It is noteworthy that many herbal preparations seem to contain cannabis, and sometimes alcohol, in addition to the other chemicals. Certainly these substances can precipitate psychiatric disorders or exacerbate existing symptoms. The other important issue, as correctly mentioned in the article, is their potential dangerous drug interactions with prescribed medicines.

Many patients appear to have a good rapport with traditional healers and people who practise complementary and alternative medicine in our countries. Hence, those of us who practise Western medicine must be aware of this important issue and deal with it tactfully and effectively. Undergraduate and post-graduate medical curricula must be strengthened with regard to this in order to improve the awareness among doctors.