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Study of Natural products Adverse Reactions (SONAR) in children seen in mental health clinics: a cross-sectional study
  1. Emma Sparks1,
  2. Liliane Zorzela2,
  3. Candace Necyk3,
  4. Baljit Khamba4,
  5. Liana Urichuk5,
  6. Joanne Barnes6,
  7. Sunita Vohra7
  1. 1Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  2. 2Pediatrics, University of Alberta, Edmonton, Alberta, Canada
  3. 3Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
  4. 4Natruropathic Medicine, Bastyr University, San Diego, California, United States
  5. 5Physichiatry, University of Alberta, Edmonton, Alberta, Canada
  6. 6School of Pharmacy, University of Auckland School of Education, Auckland, Auckland, New Zealand
  7. 7Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
  1. Correspondence to Dr Sunita Vohra; svohra{at}


Background Paediatric mental health patients frequently use natural health products (NHP) in addition to prescription medications, but very little is known about adverse events and possible NHP–drug interactions.

Objective To determine: (1) the prevalence of paediatric mental health patients taking prescription medications only, NHP only, both NHP and prescription medications concurrently or neither; (2) which prescription medications and NHP are most commonly used in paediatric mental health populations and (3) adverse events experienced in the last 30 days (serious and non-serious).

Design Cross-sectional surveillance study.

Setting Paediatric mental health clinics.

Population/intervention On their first clinic visit, paediatric mental health patients were provided with a form inquiring about prescription drug use, NHP use and any undesirable event experienced in the last month.

Results Of the 536 patients included in this study, 23% (n=120) reported taking only prescription medication(s), 21% (n=109) reported only NHP use, 21% (n=112) reported using both NHP and prescription drugs concurrently, and 36% (n=191) reported using neither. Overall, there were 23 adverse events reported; this represents 6.3%, 2.8%, 10.8% and 0.6% of each population, respectively. The majority of patients who experienced an adverse event reported taking more than one NHP or prescription drug. No serious adverse events were reported.

Conclusion Nearly half of the paediatric mental health patients in this study were taking NHPs alone or in addition to prescription medications. Active surveillance identified multiple adverse events associated with NHP and prescription drug use; none were serious. Healthcare professionals were encouraged to initiate conversations regarding NHP use.

  • alternative medicine

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  • Contributors ES, LZ, BK and CN collected and analyzed the data. JB, LU and SV developed the idea. LZ, BK, CN, JB, LU and SV implemented the project. ES, LZ, BK, CN, JB, LU and SV developed the manuscript and revised the final version submitted.

  • Funding This work was supported by a partnered grant form Canadian Institute of Health Research (CIHR) (#RES0021177) and Alberta Innovates Health Solutions (AIHS) (#RES0025318).

  • Competing interests None to declare.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval Approval by the Human Research and Ethics Board at the University of Alberta was granted for this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. The authors agree in sharing the data on request.

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