1. Eisenberg DM, et al. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up study. JAMA 1998; 280: 1569-1575.
  2. Eisenberg DM, et al. Unconventional medicine in the United States: prevalence, costs, and patterns of use. N Engl J Med 1993; 328: 246-252.
  3. Tsen LC, et al. Alternative medicine use in presurgical patients. Anesthesiology 2000; 93: 148-151.
  4. Kaye AD, et al. Herbal medications: current trends in anesthesiology practice-a hospital survey. J Clin Anesth 2000; 12: 468-471.
  5. Blendon RJ, et al. American's views on the use and regulation of dietary supplements. Arch Intern Med 2001; 161: 805-810.
  6. Eisenberg DM. Advising patients who seek alternative medical therapies. Ann Intern Med 1997; 127: 61-69.
  7. Elder NC, et al. Use of alternative health care by family practice patients. Arch Fam Med 1997; 6: 181-184.
  8. Ang-Lee MK, et al. Herbal medicines and perioperative care. JAMA 2001; 286: 208-216.
  9. Stevinson C, et al. Garlic for treating hypercholesterolemia: a meta-analysis of randomized clinical trials. Ann Intern Med 2000; 133: 420-429.
  10. Srivastava KC. Evidence for the mechanism by which garlic inhibits platelet aggregation. Prostaglandins Leukot Med 1986; 22: 313-321.
  11. Apitz-Castro R, et al. Ajoene, the antiplatelet principle of garlic, synergistically potentiates the antiaggregatory action of prostacyclin, forskolin, indomethacin and dypiridamole on human platelets. Thromb Res 1986; 42: 303-311.
  12. Rose KD, et al. Spontaneous spinal epidural hematoma with associated platelet dysfunction from excessive garlic ingestion: a case report. Neurosurgery 1990: 26: 880-882.
  13. Kaye AD, et al. Analysis of responses of garlic derivatives in the pulmonary valscular bed of the rat. J Appl Physiol 2000; 89: 353-358.
  14. Ali M, et al. Effect of allicin from garlic powder on serum lipids and blood pressure in rats fed with a high cholesterol diet. Prostaglandins Leukot Essent Fatty Acids 2000; 62: 253-259.
  15. Silagy CA, Neil HA. A meta-analysis of the effect of garlic on blood pressure. J Hypertens 1994; 12: 463-468.
  16. Melchart D, et al. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2000; (2): CD000530.
  17. Pepping J. Echinacea. Am J Health Syst Pharm 1999; 56: 121-122.
  18. See DM, et al. In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients. Immunopharmacology 1997; 35: 229-235.
  19. Rehman J, et al. Increased production of antigen-specific immunoglobulins G and M following in vivo treatment with the medicinal plants Echinacea angustifolia and Hydrastis canadensis. Immunol Lett 1999; 68: 391-395.
  20. Echinacea. In: Gruenwald J, Brendler T, Jaenicke C, eds. PDR for Herbal Medicines. 2nd ed. Montvale, NJ: Medical Economics Co; 2000: 261-266.
  21. Boullata JI, Nace AM. Safety issues with herbal medicine. Pharmacotherapy 2000; 20: 257-269.
  22. Mullins RJ. Echinacea-associated anaphylaxis. Med J Aust 1998; 168: 170-171.
  23. Miller LG. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med 1998; 158: 2200-2211.
  24. Gurley BJ, et al. Content versus label claims in ephedra-containing dietary supplements. Am J Health Syst Pharm 2000; 57: 963-969.
  25. Nightingale SL. From the Food and Drug Administration. JAMA 1997; 278: 15.
  26. Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000; 343: 1833-1838.
  27. Roizen MF. Anesthetic implications of concurrent diseases. In: Miller RD, ed. Anesthesia. 4th ed. New York, NY: Churchill Livingstone Inc; 1994: 903-1014.
  28. Zaacks SM, et al. Hypersensitivity myocarditis associated with ephedra use. J Toxicol Clin Toxicol 1999; 37: 485-489.
  29. Blau JJ. Ephedrine nephrolithiasis associated with chronic ephedrine abuse. J Urol 1998; 160: 825.
  30. Powell T, et al. Ma-huang strikes again: ephedrine nephrolithiasis. Am J Kidney Dis 1998; 32: 153-159.
  31. White LM, et al. Pharmacokinetics and cardiovascular effects of ma-huang (Ephedra sinica) in normotensive adults. J Clin Pharmacol 1997; 37: 116-122.
  32. Gurley BJ, et al. Ephedrine pharmacokinetics after the ingestion of nutritional supplements containing Ephedra sinica (ma huang). Ther Drug Monit 1998; 20: 439-445.
  33. Le Bars PL, et al. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia: North American EGb Study Group. JAMA 1997; 278: 1327-1332.
  34. Oken BS, et al. The efficacy of Ginkgo biloba on cognitive function in Alzheimer disease. Arch Neurol 1998; 55: 1409-1415.
  35. Chung KF, et al. Effect of a ginkgolide mixture (BN 52063) in antagonizing skin and platelet responses to platelet activating factor in man. Lancet 1987; 1: 248-251.
  36. Rowin J, Lewis SL. Spontaneous bilateral subdural hematomas associated with chronic Ginkgo biloba ingestion. Neurology 1996; 46: 1775-1776.
  37. Vale S. Subarachnoid haemorrhage associated with Ginkgo biloba. Lancet 1998; 352: 36.
  38. Gilbert GJ. Ginkgo biloba. Neurology 1997; 48: 1137.
  39. Matthews MK Jr. Association of Ginkgo biloba with intracerebral hemorrhage. Neurology 1998; 50: 1933-1934.
  40. Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med 1997; 336: 1108.
  41. Fessenden JM, et al. Gingko biloba: a case report of herbal medicine and bleeding postoperatively from a laparoscopic cholecystectomy. Am Surg 2001; 67: 33-35.
  42. Ginkgo. In: Mills S, Bone K, eds. Principles and Practice of Phytotherapy. New York, NY: Churchill Livingstone Inc; 2000: 404-417.
  43. Brekham II, Dardymov IV. New substances of plant origin which increase nonspecific resistance. Annu Rev Pharmacol 1969; 9: 419-430.
  44. Attele AS, et al. Ginseng pharmacology: multiple constituents and multiple actions. Biochem Pharmacol 1999; 58: 1685-1693.
  45. Vuksan V, et al. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med 2000; 160: 1009-1013.
  46. Kimura Y, et al. Effects of various ginseng saponins on 5-hydroxytryptamine release and aggregation in human platelets. J Pharm Pharmacol 1988; 40: 838-843.
  47. Kuo SC, et al. Antiplatelet components in Panax ginseng. Planta Med 1990; 56: 164-167.
  48. Park HJ, et al. Effects of dietary supplementation of lipophilic fraction from Panax ginseng on cGMP and cAMP in rat platelets and on blood coagulation. Biol Pharm Bull 1996; 19: 1434-1439.
  49. Teng CM, et al. Antiplatelet actions of panaxynol and ginsenosides isolated from ginseng. Biochim Biophys Acta 1989; 990: 315-320.
  50. Janetzky K, Morreale AP. Probable interaction between warfarin and ginseng. Am J Health Syst Pharm 1997; 54: 692-693.
  51. Chen SE, et al. American ginseng: III, pharmacokinetics of ginsenosides in the rabbit. Eur J Drug Metab Pharmacokinet 1980; 5: 161-168.
  52. Muller WE, et al. Hyperforin represents the neurotransmitter reuptake inhibiting constituent of hypericum extract. Pharmacopsychiatry 1998; 31 (suppl 1): 16-21.
  53. Gaster B, Holroyd J. St John's wort for depression: a systematic review. Arch Intern Med 2000; 160: 152-156.
  54. Shelton RC, et al. Effectiveness of St John's wort in major depression. JAMA 2001; 285: 1978-1986.
  55. Neary JT, Bu Y. Hypericum LI 160 inhibits uptake of serotonin and norepinephrine in astrocytes. Brain Res 1999; 816: 358-363.
  56. Franklin M, et al. Neuroendocrine evidence for dopaminergic actions of hypericum extract (LI 160) in healthy volunteers. Biol Psychiatry 1999; 46: 581-584.
  57. Lantz MS,et al. St. John's wort and antidepressant drug interactions in the elderly. J Geriatr Psychiatry Neurol 1999; 12: 7-10.
  58. Brown TM. Acute St. John's wort toxicity. Am J Emerg Med 2000; 18: 231-232.
  59. Yu PH. Effect of the Hypericum perforatum extract on serotonin turnover in the mouse brain. Pharmacopsychiatry 2000; 33: 60-65.
  60. Muller WE, et al. Effects of hypericum extract (LI 160) in biochemical models of antidepressant activity. Pharmacopsychiatry 1997; 30 (suppl 2): 102-107.
  61. Obach RS. Inhibition of human cytochrome P450 enzymes by constituents of St. John's wort, an herbal preparation used in the treatment of depression. J Pharmacol Exp Ther 2000; 294: 88-95.
  62. Ernst E. Second thoughts about safety of St. John's wort. Lancet 1999; 354: 2014-2016.
  63. Piscitelli SC, et al. Indinavir concentrations and St. John's wort. Lancet 2000; 355: 547-548.
  64. Yue QY, et al. Safety of St. John's wort. Lancet 2000; 355: 576-577.
  65. Breidenbach T, et al. Drug interaction of St. John's wort with cyclosporin. Lancet 2000; 355: 1912.
  66. Ruschitzka F, et al. Acute heart transplant rejection due to Saint John's wort. Lancet 2000; 355: 548-549.
  67. Johne A, et al. Pharmacokinetic interaction of digoxin with an herbal extract from St. John's wort (Hypericum perforatum). Clin Pharmacol Ther 1999; 66: 338-345.
  68. Kerb R, et al. Single-dose and steady-state pharmacokinetics of hypericin and pseudohypericin. Antimicrob Agents Chemother 1996; 40: 2087-2093.
  69. Biber A, et al. Oral bioavailability of hyperforin from hypericum extracts in rats and human volunteers. Pharmacopsychiatry 1998; 31 (suppl 1): 36-43.
  70. Pepping J. Kava: Piper methysticum. Am J Health Syst Pharm 1999; 56: 957-958, 960.
  71. Pittler MH, Ernst E. Efficacy of kava extract for treating anxiety: systematic review and meta-analysis. J Clin Psychopharmacol 2000; 20: 84-89.
  72. Meyer HJ. Pharmacology of kava.1. Psychopharmacol Bull 1967; 4: 10-11.
  73. Backhauss C, Krieglstein J. Extract of kava (Piper methysticum) and its methysticin constituents protect brain tissue against ischemic damage in rodents. Eur J Pharmacol 1992; 215: 265-269.
  74. Jamieson DD, et al. Comparison of the central nervous system activity of the aqueous and lipid extract of kava (Piper methysticum). Arch Int Pharmacodyn Ther 1989; 301: 66-80.
  75. Almeida JC, Grimsley EW. Coma from the health food store: interaction between kava and alprazolam. Ann Intern Med 1996; 125: 940-941.
  76. Norton SA, Ruze P. Kava dermopathy. J Am Acad Dermatol 1994; 31: 89-97.
  77. Rasmussen AK, et al. Metabolism of some kava pyrones in the rat. Xenobiotica 1979; 9: 1-16.
  78. Houghton PJ. The scientific basis for the reputed activity of valerian. J Pharm Pharmacol 1999; 51: 505-512.
  79. Hendriks H, et al. Pharmacological screening of valerenal and some other components of essential oil of Valeriana officinalis. Planta Med 1981; 42: 62-68.
  80. Ortiz JG, et al. Effects of Valeriana officinalis extracts on [3H] flunitrazepam binding, synaptosomal [3H]GABA uptake, and hippocampal [3H]GABA release. Neurochem Res 1999; 24: 1373-1378.
  81. Santos MS, et al. Synaptosomal GABA release as influenced by valerian root extractinvolvement of the GABA carrier. Arch Int Pharmacodyn Ther 1994; 327: 220-231.
  82. Leuschner J, et al. Characterization of the central nervous depressant activity of a commercially available valerian root extract. Arzneimittelforschung 1993; 43: 638-641.
  83. Garges HP, et al. Cardiac complications and delirium associated with valerian root withdrawal. JAMA 1998; 280: 1566-1567.
  84. Hensrud DD, et al. Underreporting the use of dietary supplements and nonprescription medications among patients undergoing a periodic health examination. Mayo Clin Proc 1999; 74: 443-447.
  85. Kassler WJ, et al. The use of medicinal herbs by human immunodeficiency virus-infected patients. Arch Intern Med 1991; 151: 2281-2288.
  86. Coppes MJ, et al. Alternative therapies for the treatment of childhood cancer. N Engl J Med 1998; 339: 846-847.
  87. Anesthesiologists warn: if you're taking herbal products, tell your doctor before surgery. Available at: http://www.asahq.org/PublicEduction/herbal.html. Accessed May 10, 2001.
    88.