Research Article Traditional Knowledge and Formulations of

Research ArticleTraditional Knowledge and Formulations of Medicinal PlantsUsed by the Traditional Medical Practitioners of Bangladesh toTreat Schizophrenia Like Psychosis

Md Nasir Ahmed and Md Nur Kabidul Azam

Ethnobotany amp Ethnomedicine Division TechB Herbal Solution Bheramara Kushtia 7040 Bangladesh

Correspondence should be addressed to Md Nasir Ahmed nasirahmedbdhotmailcom

Received 19 March 2014 Revised 28 May 2014 Accepted 30 May 2014 Published 30 June 2014

Academic Editor Jouko Miettunen

Copyright copy 2014 Md N Ahmed and Md N Kabidul Azam This is an open access article distributed under the CreativeCommons Attribution License which permits unrestricted use distribution and reproduction in any medium provided theoriginal work is properly cited

Schizophrenia is a subtle disorder of brain development and plasticity it affects the most basic human processes of perceptionemotion and judgment In Bangladesh the traditional medical practitioners of rural and remote areas characterized theschizophrenia as an insanity or a mental problem due to possession by ghosts or evil spirits and they have used various plantspeciesrsquo to treat such symptoms The aim of the present study was to conduct an ethnomedicinal plant survey and documentationof the formulations of different plant parts used by the traditional medical practitioners of Rangamati district of Bangladesh for thetreatment of schizophrenia like psychosis It was observed that the traditional medical practitioners used a total of 15 plant speciestomake 14 formulationsThe plants were divided into 13 families used for treatment of schizophrenia and accompanying symptomslike hallucination depression oversleeping or insomnia deterioration of personal hygiene forgetfulness and fear due to evil spiritslike genies or ghost A search of the relevant scientific literatures showed that a number of plants used by themedicinal practitionershave been scientifically validated in their uses and traditional medicinal knowledge has been a means towards the discovery ofmany modern medicines Moreover the antipsychotic drug reserpine isolated from the dried root of Rauvolfia serpentina speciesrevolutionized the treatment of schizophrenia So it is very much possible that formulations of the practitioner when examinedscientifically in their entireties can form discovery of lead compounds which can be used as safe and effective antipsychotic drugto treat schizophrenia

1 Introduction

Schizophrenia is a psychological disorder characterized bypsychotic symptoms hallucinations anddelusions that signif-icantly affect emotions behavior and most notably mentalprocesses and mental contents Psychosis is a condition ofmental illness that causes a person to lose his or her senseof reality Schizophrenia is a type of psychosis meaning spiltmind which often describes as a mental disorder character-ized by impairments in the perception or expression of realityand by significant social or occupational dysfunction Peoplewith this disease have delusions hallucinations disorganizedspeech grossly disorganized behavior or catatonic behavior[1 2] The world over from China or Finland to the UnitedStates or New Guinea approximately 1 of the population

will develop schizophrenia at some point in their lives [3 4]Schizophrenia is one of the top five causes of disability amongadults in developed nations ranking with heart diseasearthritis drug use and HIV [5] In the United States about5 of people with schizophrenia (about 100000 individuals)are homeless 5 are in hospitals and 6 are in jail or prison[6] Together these three groups of people represent about16 of Americans with schizophrenia in contrast 34 ofpeople with this disorder live independently According toWorldHealthOrganization (WHO) at least 40million peoplein the world suffer frommental disorders such as schizophre-nia and dementia [7] Over 10 of schizophrenia patientsultimately commit suicide [8 9] this makes the disease aserious psychiatric illness among the various nationalities ofthe world

Hindawi Publishing CorporationSchizophrenia Research and TreatmentVolume 2014 Article ID 679810 10 pageshttpdxdoiorg1011552014679810

2 Schizophrenia Research and Treatment

Bangladesh is a densely populated area where prevalenceof psychiatric illness is not less than that of any other countryin the world A study showed that 29 of patients attendinggeneral practice were suffering from functional disorder and6 from both functional and organic disorders The samestudy demonstrated that 47 of patients were suffering fromneurotic disorder 37 from psychosomatic disorder 10from affective disorder 144 from schizophrenia 288from substance use disorder and 2 fromorganic psychiatricsyndrome [10] Another study conducted in OutpatientDepartment of National Institute of Mental Health (NIMH)Dhaka Bangladesh revealed that 374 of patients were suf-fering from schizophrenia and schizophrenia like psychoticdisorders 1614 from anxiety disorders 1119 from majordepressive disorder and 895 from bipolar mood disorder[11] In theDhaka city most of the patients (704) were fromurban background and from rural area 296 patients [12]According to other studies it was seen that across variouscountries schizophrenia is more common among people inurban areas and lower socioeconomic classes than amongpeople in rural areas and higher socioeconomic classes [1314]

Antipsychotic agents are the cornerstone of acute andmaintenance treatment of schizophrenia and are effectivein the treatment of hallucinations delusions and thoughtdisorders regardless of etiology In recent decades themodern psychiatry has introduced herbal medicine in thetreatment of psychiatric disorders including schizophreniaAfter the rise of a pharmaceutical industry in the last centuryand significant progress in the treatment a period of disap-pointment comes in accepting the fact that synthetic drugsare not almighty Due to this fact there has been a growinginterest in the last decades for the treatment of psychiatricdisorders including schizophrenia by using alternative andcomplementary methods [15] and a study revealed that 44of psychiatric patients with schizophrenia (9) had usedherbal medicine (mainly for psychiatric purposes) during theprevious 12 months [16]

Plants contain various phytochemicals and these phyto-chemicals can play an important role in reducing occurrencesof many diseases by boosting up various organ functions ofthe human body Many traditional healing herbs and theirparts have been shown to have medicinal value and can beused to prevent alleviate or cure several human diseases[17] It has also been observed that number of moderndrugs has been derived from plants used by the indigenouspeople [18] Modern drugs like aspirin atropine ephedrinedigoxin morphine quinine reserpine and tubocurarine areexamples which were originally discovered through obser-vations of traditional cure methods of indigenous peoples[19] Presently there is a resurgence of herbal medicine aspeople want more control in their personal healthcare TheUS herbal market is growing tremendously with consumerdemand way ahead of regulatory agencies It is interestingto note that four (Ginkgo St Johnrsquos Wort Valerian andKava) of the top ten herbs purchased in the US (accordingto 1999 Whole Foods Survey) have psychotropic activityRecent trends in research into African plant uses show thattraditional medicine is commonly used to treat neurological

disorders in the West African region and some recentpublications are available [20]

In Bangladesh traditional medical practice is still ongo-ingThe traditionalmedical practitioners (generally known asKabirajes by the mainstream community) perform a centralrole in providing primary healthcare to the rural inhabitantsof Bangladesh There are 86000 villages in the country andalmost every village has one or two traditionalKabirajesTheyare the providers of primary healthcare to village populationsof Bangladesh and moreover they are the important sourcesof ethnomedicinal knowledge The practices of the Kabirajesextend throughout both urban and rural areas of the countryalthough rural practice ismore extensive than urban practice

The advantage of the Kabirajes is that they rely chiefly onmedicinal plants for treatment The formulations are rarelycomplex and usually consist of simple extraction of juice ofwhole plant or plant part through squeezing plant part Thejuice is then administered orally or typically applied depend-ing on the nature of diseases The previous ethnomedico-botanical studies conducted among folk and tribal medic-inal practitioners of the country have noticed considerablevariation between the medicinal plants selected by differentKabirajes for treatment of a given ailment [21ndash25]The aim ofthe present study was to document the traditional medicineknowledge as well formulations of medicinal plants used bythe traditional medical practitioners of Rangamati district inthe Chittagong Hill Tracts (CHT) region of Bangladesh forthe treatment of schizophrenia like psychosis

2 Materials and Methods

21 Study Area For the present study survey was donebetween March to Mid-Aprilrsquo 2013 in the largest district ofthe country called Rangamati which is located in the CHTregion It is consists of 10 upazilas and bordered by theTripura state of India to the north and Bandarban districtto the south The area of the district is 6116 km2 of which1292 km2 is riverine and 4825 km2 is under forest vegetationThe main survey was conducted in the Rangamati SadarUpazila (located at 226500∘N 921833∘E) which consistsof 6 unions on the information about medicinal plantscommonly used for treatment of psychotic disorders withparticular attention to schizophrenia The study area for thisspecific ethnomedicinal survey was selected by the authorsthemselves regarding information on the noted traditionalmedical practices Moreover the study area as well as thetotal CHT region is very rich in species diversity We areconducting systematic ethnomedicinal survey of Bangladeshsince 2011 as to explore how do the Kabirajes of Bangladeshselect medicinal plants for treatment of any ailment In orderto address such question we conducted this specific surveyamong Kabirajes of Rangamati Sadar Upazila of Bangladesh(Figure 1) The above question is more important from theviewpoint that how and why medicinal plants are selected bythe TMPs can lead the way towards a better linking betweentraditional knowledge with biomedical science [26 27]

22 Mode of Interview and Plant Data Collection The col-lection of data through interviews of 3 traditional medical

Schizophrenia Research and Treatment 3

23∘20

998400

23∘00

998400

22∘40

998400

22∘20

998400

22∘00

998400

92∘00

99840092

∘20

99840092

∘40

998400

23∘20

998400

23∘40

998400

23∘00

998400

22∘40

998400

22∘20

998400

22∘00

998400

N

E92

∘00

99840092

∘

20998400

10 0 10 20

(km)

(a)

(km)2 0 2 4

22∘50

998400

22∘46

998400

22∘42

998400

22∘38

998400

22∘34

998400

22∘44

998400

22∘40

998400

22∘36

998400

22∘32

998400

92∘22

99840092

∘18

99840092

∘14

99840092

∘10

99840092

∘06

99840092

∘02

998400

E92∘20

99840092

∘16

99840092

∘12

99840092

∘08

99840092

∘04

998400

22∘48

998400N

(b)

Figure 1 Map of Bangladesh showing the Rangamati district Study site is marked on the map with black round shade


practitioners (TMP aged between 61ndash67) was conducted bythe researchers themselves with the help of a semistructuredquestionnaire The number of 3 TMPs was chosen on thebasis of recommendation of the local inhabitants as tobeing more proficient and reputed to their practices Inthe preliminary survey the TMPs were specifically askedas to whether they know and treat schizophrenia the basisfor their diagnosis and their mode of treatment when thedisease has been diagnosed as schizophrenia According tofolkmedical practitioners the symptomswere hallucinationsover sleeping in the day insomnia staying alone in the darkroom anxiety being silent or not so much interested to keepattached with family members and most commonly gettingfear due to invisible person (as per patientrsquos thoughts) Thetraditional medical practitioners defined this fear to be dueto evil spirits genies or ghosts The basic method followedwas one of guided fieldwork [28ndash30] Information collectedfrom the Kabirajes consisted of medicinal plants or plantparts used formulations and dosage The information wasnoted down during the daytime interviews At the end of eachinterview plant specimens shown by the traditional medicalpractitioners were collected dried and later brought backto the Dhaka for identification at the Bangladesh NationalHerbarium and all the voucher specimens were depositedthere Nomenclature of plants was compiled from the plantlist database [31] For this specific ethnomedicinal surveythe number of visits was made to the traditional medicalpractitioners to gain their confidence

3 Results

It was observed that the 3 traditional medical practitioners(TMP) of the Rangamati district used a total of 14 formula-tions from the 15 plant species distributed into 13 familiesfor treatment of schizophrenia like psychotic episodes TheRubiaceae and Lamiaceae families were contributing 2 plantsthe rest of the plant families contributed one plant eachThe various plant parts were used including leaf roots barkstem flower seed and fruit This study recorded that severalparts or individual plant species are used as medicine Leavesconstituted themajor plant part used forming 4762 of totaluses Barks and seeds each constituted 1428 of total usesThe other plant parts mentioned constituted respectively952 476 476 and 476 of total uses (Figure 2)

The medicinal knowledge of TMPs was derived fromthe earlier generation practitioners with whom every TMPhad to serve a period of apprenticeship and training beforethey could practice independentlyThismedicinal knowledgehas come out of practice through the centuries and everypractitioner had their own lists of plants for treatment ofany particular disease or disorder As mentioned earlier all 3TMPs were interviewed separately so the plants advised bythe TMPs did not reflect any individual opinion It can beconcluded by the interviewers that schizophrenia and otherrelated psychotic problems have existed for centuries amongthe people surveyed and various TMPs have developedtheir own medicinal plant formulations for treatment ofschizophrenia like psychosis possibly through trial and errormethods over centuries long practices

Leaf 4762

Bark 1428

Seed 1428

Root 952

Stem 476

Flower 476 5 Fruit 476

Figure 2 Parts of medicinal plants used by the traditional medicalpractitioners of Rangamati Sadar Upazila to treat schizophrenia likepsychosis

Any sort of complex formulations was avoided by theTMPs for the treatment of schizophrenia like psychosisGenerally fruits and seeds were consumed directly or withwater In most cases juice obtained from squeezed plantpart was advised to be taken or pills made from paste ofplant part taken orally It was noted that mashed leaves ofPiper retrofractum are taken with rice A combination ofbark and seed of Thevetia peruviana paste is taken orallyAnother formulation suggested by a TMP was that juicefrom macerated Euphorbia neriifolia leaves is taken orallythe formulation was also used to keep head cool and toincrease memory of a patient as per the TMPThere were alsomentioned some more easy formulations smell of flower ofAbroma augusta is taken with the nose and leaves of Vitexnegundo were carried alongside the body If a patient is insevere condition then the leaves of Cannabis sativawere usedto make vapor and the vapor is taken by the nose as advisedby a TMP Leaf juice of Ocimum americanum is mixed withseeds of Brassica juncea and taken orally till cure Most ofthe formulations were usually administrated orally with threeexceptionsThe rest of the formulations were given in Table 1

In our present study TMPs recommended different formsof medication including juice (3 species) pill vegetableand paste (2 each) tablet vapor oil message decoction (1species each) and others (3) Most often standard medicinesare prescribed in mixed ingredient form by mixing severalvaluable medicinal plants or several plant parts of one plantspecies TMPs believe that using plant or plant part mixturesin the preparation of medicine is important as a single plantalone may not be sufficient to cure any disease completelyand the combination of several medicinal plants increases thequality and efficacy of medicine Similar observations havealso been found in Nepal and India [32 33]

4 Discussions

Investigation into the mechanism of action of the drugs usedto treat schizophrenia has not provided clear understandingof the pathogenesis of the disease While schizophrenia


Table 1 Medicinal plants used by the traditional medical practitioners of Rangamati district for treatment of schizophrenia like psychoticepisodes

Serialnumber Formulations and dosage Parts used Botanical

namevernacular name

1Leaves of Piper retrofractum (Piperaceae) aretaken orally in mashed form as vegetable withrice till cure

Leaf Piper retrofractumVahlChoi

2Juice obtained from macerated leaves or rootsof Ficus hirta (Moraceae) is taken orally tillcure

Leaf root Ficus hirta VahlPakur

3A combination of bark and seed ofThevetiaperuviana (Apocynaceae) paste is taken orallytill cure

Bark seedThevetia peruviana

(Pers) K SchumHoldeKorobi

4A combination of leaf and seed paste fromDatura metel L (Solanaceae) is taken orally ormacerated leaves are pressed to the nose

Leaf seed Datura metel LDhutura

5 Juice from macerated Euphorbia neriifolia(Euphorbiaceae) leaves is taken orally Leaf Euphorbia neriifolia

LMonshaseez

6

Juice is collected from macerated bark ofRandia dumetorum (Rubiaceae) It is thendried and turned into powder which is mixedwith sugar Tablets weighing 5 g each are madefrom the mixture and taken till cure

Bark Randia dumetorum(Retz) LamMonkata

7

Aegle marmelos (Rutaceae) leaves and rootscrushed and made into 12 tola amount pillsPills are taken twice daily for three days (1 tola= 1166 g)

Leaf root Aegle marmelos (L)CorrBel

8Litsea polyantha (Lauraceae) bark is maceratedwith 1 g sugar to obtain juice which is thentaken orally

Bark Litsea polyanthaJussUruijja Menda

9 Leaves of Coccinia grandis (Cucurbitaceae) areboiled and the decoction is taken orally Leaf Coccinia grandis (L) J

VoigtTelakuchi

10Leaf juice of Ocimum americanum (Lamiaceae)are mixed with mashed seeds of Brassica juncea(Cruciferae) and taken orally till cure

Leaf seed

Ocimum americanumLRadha tulshi

Brassica juncea (L)CzernShorisha

11

Smell of flower of Abroma augusta (Malvaceae)is taken with the nose or crushed stems aretaken with Aloe vera and sugar twice daily forseven days till cure

Flower steam Abroma augustaLfUlot Kombol

12

Leaves of Vitex negundo (Lamiaceae) are keptor carried alongside the body Anotherformulation is to take pills in the morningmade from the leaves

Leaf Vitex negundoLNishinda

13

Leaves from Cannabis Sativa (Cannabaceae)are used to make oil then message on the scalptill cure If a patient is in severe condition thenthe leaves were used to make vapor and thevapor is taken by the nose

Leaf Cannabis SativaLBhang Siddhi

14Ripe fruit ofMorinda citrifolia (Rubiaceae) iseaten as raw and mashed leaves were eaten asvegetable

Fruit leaf Morinda citrifoliaLinnHoldi Kachu Noni

is highly heritable the genetics are complex and theinterpretation of genetic data has proven difficult Nowadvances in phenotypic analysis neuroimaging genetics andmolecular pathology provide the basis for optimism [34]Schizophrenia can be understood as a subtle disorder of braindevelopment [35ndash37]

41 Neural Communication in Schizophrenia Recent findingshave shown changes in markers in a number of neurotrans-mitter systems in the brains of subjects with schizophreniawhich include the dopaminergic serotonergic glutamatergicand GABAergic systems of the CNS Many of these changesalso appear to be regionally specific and abnormalities in


nonneurotransmitter specific pathways have been found inschizophrenia [38] A major component of the studies usedpostmortem CNS tissue because these sites are amenableto manipulation by therapeutic agents in many cases theyare the sites of action of drugs which provide antipsychoticactivity [39] Ultimately neurobiology of schizophrenia mayhelp illuminate the nature of normal thought perception andemotion

The findings that antipsychotic drugs are dopamine D2receptor antagonists and the dopamine hypothesis proposethat an overproduction of dopamine or an increase in thenumber or sensitivity of dopamine receptors is responsiblefor schizophrenia According to this hypothesis the excessdopamine or extra sensitivity to this neurotransmitter trig-gers a flood of unrelated thoughts feelings and perceptionsDelusions are then attempt to organize these disconnectedevents into a coherent understandable experience [40 41]

There has been an increasing acceptance that antipsy-chotic drugs that bind to both the dopamine D

2-like recep-

tor family and the serotonin (5HT)2A receptor have beenimproved clinical outcomes [42]UsingDNA fromperipheraltissue a number of studies have suggested that mutationsin the gene for the 5HT2A receptor are associated withschizophrenia [43]

The hypothesis that changed glutamatergic function isinvolved in the pathology of schizophrenia and a gluta-mate receptor ion channel blocker reduce or exacerbate aschizophrenia like psychosis [44]TheN-methyl-D-aspartate(NMDA) glutamate receptor has been shown to play a crucialrole in learning and memory and hence abnormalities in itsfunctioning may explain some of the deficits associated withschizophrenia such as deficits in working memory Studieshave found unusually high levels of glutamate in people withschizophrenia particularly in the frontal lobe [45 46] suchan excess of glutamate may disrupt the timing of neuralactivation in the frontal lobe which in turn may impaircognitive activities that depend on the smooth coordinationof different operations such as working memory whereinformation must be actively retained in short-termmemoryas it is operated upon [47]

Research findings suggest that stress can contributeto schizophrenia because stress affects cortisol productionwhich in turn affects the brain The relationship with cortisolappears even in childhood Children who are at risk forschizophrenia reactmore strongly to stress and their baselinelevels of cortisol are higher than those of other children[48]The relationship between stress cortisol and symptomsof schizophrenia has also been noted during adolescence[49] Even after adolescence people with schizophrenia havehigher levels of stress-related hormones including cortisol[50]

Several lines of evidence implicated the GABAergic sys-tem in the pathology of schizophrenia The study of mRNAencoding the different subunits has now extended originalfindings on radioligand binding to show an increase in levelsof mRNA encoding the 120572-1 subunit of the GABAA receptor inBrodmannrsquos areas 9 and 10 from subjects with schizophrenia[51] There are changes in expression of GABAA receptorsubunit in schizophrenia which are the finding that there

is a marked decrease in levels of mRNA encoding for theshort form of the 1205742 subunit of the GABAA receptor in theprefrontal cortex from schizophrenia [52]

42 HerbalMedications in the Enhancement of Brain FunctionHumans consume a wide range of foods drugs and dietarysupplements that are derived from plants and which modifythe functioning of the central nervous system (CNS) Thepsychoactive properties of these substances are attributableto the presence of plant secondarymetabolites inmany casesthe effects of these phytochemicals on the human CNSmightbe linked either to their ecological roles in the life of the plantor to molecular and biochemical similarities in the biology ofplants and higher animals [53] Schizophrenia as well as otherpsychotic disorders is likely to involve a complex interplayof many brain systems and neurotransmitters includingdopamine serotonin and glutamate and there is extensiveevidence that schizophrenia is a biological disease of thebrainThe primarymechanismof action involvesmodulationof neuronal communication via specific plant metabolitesbinding to neurotransmitterneuromodulator receptors [54]and via alteration of neurotransmitter synthesis and generalfunction [55] Other mechanisms involve stimulating orsedating CNS activity and regulating or supporting thehealthy function of endocrine system [56 57] Traditionalantipsychotics have been the first step in treating schizophre-nia that is thorazine (chlorpromazine) is dopamine antag-onist which effectively blocks the action of dopamine anddiminishes positive symptoms in approximately 75ndash80of people with schizophrenia who take such antipsychoticmedication [58] Traditional antipsychotics have sedativeproperties which affect patients quickly such sedation andimprovement in psychotic symptoms can take anywherefrom 5 days to 6 weeks [59]

A huge scientific literature focusing on psychoactiveherbal extracts and their phytochemicals encompassinghundreds of thousands of scientific papers has emerged overrecent decades The vast majority of these papers describein vitro investigations of the potential mechanisms of actionof putatively psychoactive phytochemicals whereas a muchsmaller proportion explores their effects in vivo on animalsand only a tinyminority investigates their efficacy in humansZhang [60] identified extracts and constituents from 85individual medicinal plants that have demonstrated potentialefficacy for treating psychiatric disorders on the basis ofanimal behavioral models alone

A study indicated antipsychotic activity along withantianxiety and anticonvulsant from the hydroalcoholicextract ofEuphorbia neriifolia leaves inmice and rats [61]Theobservation of another study indicated that the anticatalepticactivity exhibited by ethanolic extract of Randia dumetorumLam fruits does not possess antidopaminergic and antisero-tonergic activity Catalepsy usually associated with catatonicschizophrenia [62]

Methanolic extract of Aegle marmelos leaves possessedpotential anxiolytic and antidepressant activities in albinomice and also may be served as a potential resource for nat-ural psychotherapeutic agent [63] In India Aegle marmelos


highly reputed ayurvedic medicinal tree and has been usedin nervous disorder and as tonic for brain [64 65] A surveystudy conducted by Rahmatullah et al [66 67] reported thatTMP of Santals tribe in Bangladesh used Coccinia grandis forthe treatment of mental disorder

Ocimum americanum possessed relaxant effects [68] andcan be considered as beneficial to patients with mentaldisorders The seed of Brassica juncea and leaves juice of Oci-mum americanum were mixed with leaves of Acorus calamusL (Acoraceae) for treating mental disorders as well beingpossessed with evil spirits such combined formulation wasused by the TMP of the Tonchongya tribe of Bangladesh andwhether such beings exist or not is scientifically debatableany possession by ldquoevil spiritsrdquo can be considered as a sortof mental disorder with the status of the patient being ina state of delirium [69] A calamus is also used to makebrahmyadiyoga (an Ayurvedic medicine system) and hasbeen used for the treatment of schizophrenia An importantgeneral issue is the cost of treatment as Ayurvedic treatmentsare cheaper and therefore more accessible to poor peoplethan chlorpromazine let alone the more recent atypicalantipsychotics [70 71]

The effect of acetone soluble fraction of methanolicextract of roots of the Vitex negundo (50 and 100mgkgip) was studied on haloperidol-induced catalepsy in miceamphetamine induced stereotyped behaviour in rats anddopamine-induced contraction isolated vas deferens prepa-ration of rat The acetone soluble fraction of methanolicextract of isolated of V negundo significantly potentiatedhaloperidol induced catalepsy antagonized dose depen-dent amphetamine-induced stereotyped behaviour and alsoantagonized dopamine induced contractions of rat vas defer-ence The result suggests that the methanolic extract of Vitexnegundo possessed antidopaminergic principle [72] Anotherstudy results in mice indicated that roots of Vitex negundohave an effective anxiolytic agent [73]

Since the discovery of the endocannabinoid system agrowing body of psychiatric research has emerged focusingon the role of this system in major psychiatric disorders likeschizophrenia bipolar disorder major depression and anxi-ety disorder A compound found in Cannabis sativa can treatschizophrenia as effectively as antipsychotic medicationswith far fewer side effects according to a preliminary clinicaltrial Researchers led by Markus Leweke of the University ofCologne in Germany studied 39 people with schizophreniawho were hospitalized for a psychotic episode Nineteenpatients were treated with amisulpride an antipsychoticmedication that is not approved in the US but is comparableto other medications that are antipsychotic The rest of thepatients were given cannabidiol (CBD) a substance foundin C sativa that is thought to be responsible for some ofits mellowing or anxiety-reducing effects [74] Unlike themain ingredient in marijuana THC which can producepsychotic reactions and may worsen schizophrenia CBD hasantipsychotic effects according to previous research in bothanimals and humans The use of CBD for schizophrenia isbecoming more and more common Studies from around

the world are showing great promise [75] Moreover fMRIresults strongly suggest that the antipsychotic effects of CBDinvolve the striatum and temporal cortex that have beentraditionally associated with psychosis [76]

Antipsychotic-like activity of Morinda citrifolia in micedemonstrated the antidopaminergic effect suggesting thatthis plant has antipsychotic-like activity which can be utilizedin the treatment of psychiatric disorders [77]

No available scientific literature is found regardingantipsychotic effects of six plants which were used by the tra-ditional medical practitionersrsquo of Rangamati Sadar UpazilaBangladesh and these six species areA augustaLf L polyan-tha Juss P retrofractum Vahl F hirta Vahl T peruviana(Pers) K Schum and Datura metel L However it is verymuch important to conduct proper scientific study for theevaluation of antipsychotic effects of these plants Bangladeshhas a very rich diversity of medicinal plant species which hasbeen used by the traditional healers of several districts for thetreatment of different diseases like mental health problemsbrain disorders malaria cardiovascular disorders diabetestumor snake bite and rheumatoid arthritis [78ndash85]Thus thebody of the existing ethnomedical knowledge has led to greatdevelopments in schizophrenia as well as can be the sourcefor the discovery of new antipsychotic drugs

5 Conclusions

The use of psychoactive plants is practically a universalhuman phenomenon Except for a few cultures lacking accessto psychoactive plants humans tend to use them routinelyThe psychological and behavioral effects of such plants havebeen long recognized and information about their uses hasbeen passed down through generations However with theadvent of modern science we are able to better understandthe composition of these plants and how they interact withthe nervous system

The available scientific literature strongly suggests thatat least some of the plants used by the traditional medicalpractitioners of Bangladesh may have strong scientific basisfor their use in the treatment of schizophrenia like psychoticepisodes This ethnobotanical data provides an interestingbasis for further phytotherapeutical research towards discov-ery of novel and efficacious antipsychotic drugs especiallyconcerning uncommonly used species (ie A augusta LfL polyantha Juss P retrofractum Vahl F hirta Vahl Tperuviana (Pers) K Schum and Datura metel L) Althoughsome formulations have drawn attention in depth clinicaltrials of each one of the plants presented in the table should beconducted which will be a major tool to prove the benefits fora schizophrenia patient as well as to evaluate more scientificresearches for discovering the new antipsychotic drugs withgiving less side effects

Conflict of Interests

The authors declare that there is no conflict of interestsregarding the publication of this paper


Acknowledgments

The authors are grateful to Robin S Rosenberg and StephenM Kosslyn authors of the book of ldquoAbnormal Psychologyrdquofor Chapter 12 The book was very helpful in developing theconcept in the field of schizophrenia Thanks are also due tothe traditional medical practitioners of Rangamati for theircooperation and help during the ethnomedicinal survey Allauthors edited the paper and read and approved the finalpaper

References

[1] S Hodgins ldquoMental disorder intellectual deficiency and crimeevidence from a birth cohortrdquo Archives of General Psychiatryvol 49 no 6 pp 476ndash483 1992

[2] S Hodgins S AMednick P A Brennan F Schulsinger andMEngberg ldquoMental disorder and crime evidence from a Danishbirth cohortrdquo Archives of General Psychiatry vol 53 no 6 pp489ndash496 1996

[3] I I Gottesman Schizophrenia Genesis The Origin of MadnessFreeman New York NY USA 1991

[4] J Perala J Suvisaari S I Saarni et al ldquoLifetime prevalenceof psychotic and bipolar I disorders in a general populationrdquoArchives of General Psychiatry vol 64 no 1 pp 19ndash28 2007

[5] C J L Murray and A D Lopez Eds The Global Burden ofDisease AComprehensiveAssessment ofMortality andDisabilityfrom Diseases Injuries and Risk Factors in 1990 and Projected to2020 Harvard School of Public Health CambridgeMass USA1996

[6] E F Torrey Surviving Schizophrenia A Manual for FamiliesConsumers and Providers Quill New York NY USA 4thedition 2001

[7] A H M Firoz M E Karim M F Alam A H M Rahman MN Zaman and V Chandra ldquoCommunity based MulticentricService Oriented Research on mental illness with focus onprevalence medical care awareness and attitude towards men-tal illness in Bangladesh WHO published data 2003ndash2005rdquoBangladesh Journal of Psychiatry vol 20 no 1 pp 9ndash32 2006

[8] J Addington and P Bumett ldquoWorking with families in theearly stages of Psychosisrdquo in Psychological Interventions in EarlyPsychosis A Treatment Handbook J F M Gleeson and P DMcGorry Eds pp 99ndash116 JohnWiley amp Sons Chichester UK2004

[9] Department of Health The Policy Implementation Guide forMental Health Her Majestyrsquos Stationery Office (HMSO) Lon-don UK 2001

[10] M A Mohit ldquoDiagnosis of patients attending Out PatientDepartment (OPD) of NIMHrdquo Bangladesh Journal Psychiatryvol 15 no 1 pp 5ndash12 2001

[11] M Gelder D Gath R Mayou and P Cowen Oxford Text Bookof Psychiatry Oxford University Press Oxford UK 5th edition2005

[12] A Fahmida M A Wahab and M M Rahman ldquoPattern ofpsychiatric morbidity among the patients admitted in a privatepsychiatric clinicrdquo Bangladesh Journal of Medical Science vol 8no 1 pp 1ndash2 2009

[13] H Freeman ldquoSchizophrenia and city residencerdquo British Journalof Psychiatry vol 164 no 23 pp 39ndash50 1994

[14] P B Mortensen C B Pedersen T Westergaard et al ldquoEffectsof family history and place and season of birth on the risk of

schizophreniardquoThe New England Journal of Medicine vol 340no 8 pp 603ndash608 1999

[15] D Babic and R Babic ldquoComplementary and alternativemedicine in the treatment of schizophreniardquo Psychiatria Danu-bina vol 21 no 3 pp 376ndash381 2009

[16] G Elkins M H Rajab and J Marcus ldquoComplementary andalternative medicine use by psychiatric inpatientsrdquo Psycholog-ical Reports vol 96 no 1 pp 163ndash166 2005

[17] U Dhar R S Rawal S S Samant S Airi and J UpretildquoPeoplersquos participation in Himalayan biodiversity conservationa practical approachrdquo Current Science vol 76 no 1 pp 36ndash401999

[18] JM Balick and P A Cox Plants People and Culture the Scienceof Ethnobotany Scientific American Library New York NYUSA 1996

[19] A H Gilani and A U Rahman ldquoTrends in ethnopharmacol-ogyrdquo Journal of Ethnopharmacology vol 100 no 1-2 pp 43ndash492005

[20] M M Romeiras M C Duarte B Indjai and L CatarinoldquoMedicinal plants used to treat neurological disorders in WestAfrica a case study with Guinea-Bissau Florardquo AmericanJournal of Plant Sciences vol 3 no 7 pp 1028ndash1036 2012

[21] M A H Mollik M S H Hossan A K Paul M Taufiq-Ur-Rahman R Jahan and M Rahmatullah ldquoA comparativeanalysis of medicinal plants used by folk medicinal healers inthree districts of Bangladesh and inquiry as tomode of selectionof medicinal plantsrdquo Ethnobotany Research and Applicationsvol 8 pp 195ndash218 2010

[22] M RahmatullahM AHMollikMN Ahmed et al ldquoA surveyof medicinal plants used by folk medicinal practitioners intwo villages of Tangail district BangladeshrdquoAmerican-EurasianJournal of Sustainable Agriculture vol 4 no 3 pp 357ndash3622010

[23] M S Hossan A Hanif B Agarwala et al ldquoTraditional use ofmedicinal plants in Bangladesh to treat urinary tract infectionsand sexually transmitted diseasesrdquo Ethnobotany Research andApplications vol 8 pp 61ndash74 2010

[24] M Rahmatullah D Ferdausi M A H Mollik R Jahan M HChowdhury and W M Haque ldquoA survey of medicinal plantsused by Kavirajes of Chalna area Khulna district BangladeshrdquoAfrican Journal of Traditional Complementary and AlternativeMedicines vol 7 no 2 pp 91ndash97 2010

[25] F I Jahan M R U Hasan R Jahan et al ldquoA comparisonof medicinal plant usage by folk medicinal practitioners oftwo adjoining villages in Lalmonirhat district BangladeshrdquoAmerican-Eurasian Journal of Sustainable Agriculture vol 5 no1 pp 46ndash66 2011

[26] B Berlin and E A Berlin ldquoAnthropological issues in medicalanthropologyrdquo in Ethnobotany and the Search for New Drugs GPrance Ed Ciba Foundation SymposiumNo 185 pp 240ndash258John Wiley and Sons New York NY USA 1994

[27] C H Browner B R Ortiz de Montellano and A J RubelldquoA methodology for cross-cultural ethnomedical researchrdquoCurrent Anthropology vol 29 pp 681ndash702 1988

[28] G J Martin Ethnobotany A ldquoPeople and Plantsrdquo ConservationManual Chapman and Hall London UK 1995

[29] M N Alexiades Ed Selected Guidelines for Ethno BotanicalResearch A FieldManualTheNewYorkBotanicalGardenNewYork NY USA 1996

[30] P Maundu ldquoMethodology for collecting and sharing indige-nous knowledge a case studyrdquo Indigenous Knowledge andDevelopment Monitor vol 3 pp 3ndash5 1995


[31] ldquoThe plant list databaserdquo httpwwwtheplantlistorg[32] M Ayyanar and S Ignacimuthu ldquoTraditional knowledge of

Kani tribals inKouthalai of Tirunelveli hills TamilNadu IndiardquoJournal of Ethnopharmacology vol 102 no 2 pp 246ndash255 2005

[33] S Bhattarai R P Chaudhary C L Quave and R S LTaylor ldquoThe use of medicinal plants in the trans-himalayan aridzone of Mustang district Nepalrdquo Journal of Ethnobiology andEthnomedicine vol 6 article 14 2010

[34] C A Ross R L Margolis S A J Reading M Pletnikov and JT Coyle ldquoNeurobiology of Schizophreniardquo Neuron vol 52 no1 pp 139ndash153 2006

[35] S E Arnold K Talbot and C Hahn ldquoNeurodevelopmentneuroplasticity and new genes for schizophreniardquo Progress inBrain Research vol 147 pp 319ndash345 2005

[36] P J Harrison and D R Weinberger ldquoSchizophrenia genesgene expression and neuropathology on the matter of theirconvergencerdquo Molecular Psychiatry vol 10 no 1 pp 40ndash682005

[37] J L Rapoport A M Addington S Frangou and M RC Psych ldquoThe neurodevelopmental model of schizophreniaupdate 2005rdquo Molecular Psychiatry vol 10 no 5 pp 434ndash4492005

[38] BDean ldquoUnderstanding the pathology of schizophrenia recentadvances from the study of the molecular architecture ofpostmortem CNS tissuerdquo Postgraduate Medical Journal vol 78no 917 pp 142ndash148 2002

[39] A B Goodman and A B Pardee ldquoMeeting report rsquoMolecularneurobiological mechanisms in schizophrenia seeking a syn-thesisrdquo Biological Psychiatry vol 48 no 3 pp 173ndash183 2000

[40] H Y Meltzer ldquoBiochemical studies in schizophreniardquoSchizophrenia Bulletin vol 2 no 1 pp 10ndash18 1976

[41] S Kapur ldquoPsychosis as a state of aberrant salience a frame-work linking biology phenomenology and pharmacology inschizophreniardquoTheAmerican Journal of Psychiatry vol 160 no1 pp 13ndash23 2003

[42] M Huttunen ldquoThe evolution of the serotonin-dopamine antag-onist conceptrdquo Journal of Clinical Psychopharmacology vol 15supplement 1 no 1 pp 4Sndash10S 1995

[43] B P Riley and P McGuffin ldquoLinkage and associated studies ofschizophreniardquo The American Journal of Medical Genetics vol97 pp 23ndash44 2000

[44] S I Deutsch J Mastropaolo B L Schwartz R B Rosse andJ M Morihisa ldquoA ldquoglutamatergic hypothesisrdquo of schizophreniaRationale for pharmacotherapy with glycinerdquo Clinical Neu-ropharmacology vol 12 no 1 pp 1ndash13 1989

[45] C Abbott and J Bustillo ldquoWhat have we learned from protonmagnetic resonance spectroscopy about schizophrenia A criti-cal updaterdquoCurrent Opinion in Psychiatry vol 19 no 2 pp 135ndash139 2006

[46] L Tebartz van Elst G Valerius M Buchert et al ldquoIncreasedprefrontal and hippocampal glutamate concentration inschizophrenia evidence from a magnetic resonance spectro-scopy studyrdquo Biological Psychiatry vol 58 no 9 pp 724ndash7302005

[47] D A Lewis and B Moghaddam ldquoCognitive dysfunction inschizophrenia convergence of 120574-aminobutyric acid and gluta-mate alterationsrdquoArchives of Neurology vol 63 no 10 pp 1372ndash1376 2006

[48] E F Walker C B Logan and D Walder ldquoIndicators ofneurodevelopmental abnormality in schizotypal personalitydisorderrdquo Psychiatric Annals vol 29 no 3 pp 132ndash136 1999

[49] E F Walker D J Walder and F Reynolds ldquoDevelopmentalchanges in cortisol secretion in normal and at-risk youthrdquoDevelopmentampPsychopathology vol 13 no 3 pp 721ndash732 2001

[50] X Y Zhang D F Zhou L Y Cao G Y Wu and Y C ShenldquoCortisol and cytokines in chronic and treatment-resistantpatients with schizophrenia association with psychopathologyand response to antipsychoticsrdquoNeuropsychopharmacology vol30 no 8 pp 1532ndash1538 2005

[51] T Ohnuma S J Augood H Arai P J McKenna and PC Emson ldquoMeasurement of GABAergic parameters in theprefrontal cortex in schizophrenia focus on GABA contentGABA(A) receptor 120572-1 subunit messenger RNA and humanGABA transporter-1 (hGAT-1) messenger RNA expressionrdquoNeuroscience vol 93 no 2 pp 441ndash448 1999

[52] MM Huntsman B V Tran S G PotkinW E Bunney Jr andEG Jones ldquoAltered ratios of alternatively spliced long and short1205742 subunit mRNAs of the 120574-amino butyrate type A receptor inprefrontal cortex of schizophrenicsrdquo Proceedings of the NationalAcademy of Sciences of the United States of America vol 95 no25 pp 15066ndash15071 1998

[53] D O Kennedy and E L Wightman ldquoHerbal extracts and phy-tochemicals plant secondarymetabolites and the enhancementof human brain functionrdquoAdvances inNutrition vol 2 no 1 pp32ndash50 2011

[54] M SpinellaThe Psychopharmacology of Herbal Medicine PlantDrugs that Alter the Mind Brain and Behavior MIT PressCambridge UK 2011

[55] J Sarris ldquoHerbal medicines in the treatment of psychiatricdisorders a systematic reviewrdquo Phytotherapy Research vol 21no 8 pp 703ndash716 2007

[56] V Kumar ldquoPotential medicinal plants for CNS disorders anoverviewrdquo Phytotherapy Research vol 20 no 12 pp 1023ndash10352006

[57] D S Avinash ldquoHerbal medicine and anxiety disorders anoverviewrdquo Journal of Medicinal Plants Studies vol 1 no 6 pp18ndash23 2013

[58] M F Green Schizophrenia Revealed From Neurons to SocialInteractions WW Norton New York NY USA 2001

[59] B RosenbaumK Valbak S Harder et al ldquoTheDanishNationalSchizophrenia Project prospective comparative longitudinaltreatment study of first-episode psychosisrdquo British Journal ofPsychiatry vol 186 pp 394ndash399 2005

[60] Z Zhang ldquoTherapeutic effects of herbal extracts and con-stituents in animal models of psychiatric disordersrdquo Life Sci-ences vol 75 no 14 pp 1659ndash1699 2004

[61] P Bigoniya and A C Rana ldquoPsychopharmacological profile ofhydro-alcoholic extract of Euphorbia neriifolia leaves in miceand ratsrdquo Indian Journal of Experimental Biology vol 43 no 10pp 859ndash862 2005

[62] M M Ghaisas P B Ninave G P Ganu V S Zope M BTanwar and A D Deshpande ldquoEffect of Randia dumetorumLam on clonidine and haloperidol-induced catalepsy in micerdquoPharmacologyonline vol 2 pp 42ndash50 2008

[63] S Kothari M Minda and S D Tonpay ldquoAnxiolytic andantidepressant activities of methanol extract of Aegle marmelosleaves in micerdquo Indian Journal of Physiology and Pharmacologyvol 54 no 4 pp 318ndash328 2010

[64] K P S Raj and M R Patel ldquoSome medicinal plants of Cambayand its immediate vicinity and their uses in Indian indigenoussystem of medicinerdquo Indian Drugs vol 15 pp 145ndash152 1978


[65] J K Maheshwari and J P Singh ldquoPlants used in ethnomedicineby the Kols of Allahabad district Uttar Pradeshrdquo Bulletin ofMedico-Ethno-Botanical Reserch vol 5 pp 105ndash121 1984

[66] M Rahmatullah A Hasan and W Parvin ldquoMedicinal plantsan formulations used by the sore clan of the Santal tribein Rajshahi District Bangladesh for treatment of variousailemntsrdquo African Journal of Traditional Complementary andAlternative Medicines vol 9 no 3 pp 350ndash359 2012

[67] M Rahmatullah Md A H Mollik A T M A Azam etal ldquoEthnobotanical survey of the Santal tribe residing inThakurgaon District Bangladeshrdquo American-Eurasian Journalof Sustainable Agriculture vol 3 no 4 pp 889ndash898 2009

[68] M H Boskabady S Kiani and B Haghiri ldquoRelaxant effects ofOcimumbasilicum on guinea pig tracheal chains and its possiblemechanism(s)rdquo DARU vol 13 no 1 pp 28ndash33 2005

[69] M Md Rashid F B Rafique N Debnath et al ldquoMedicinalplants and formulations of a community of the Tonchongyatribe in Bandarban district of Bangladeshrdquo The American-Eurasian Journal of Sustainable Agriculture vol 6 no 4 pp292ndash298 2012

[70] N L Soh and G Walter ldquoTraditional and alternative medicinetreatments in child and adolescent mental healthrdquo in IACAPAPe-Textbook of Child andAdolescentMental Health J M Rey EdInternational Association for Child and Adolescent Psychiatryand Allied Professions Geneva Switzerland 2012

[71] V Agarwal A Abhijnhan and P Raviraj ldquoAyurvedic medicinefor schizophreniardquo Cochrane Database of Systematic Reviewsvol 3 Article ID CD006867 2010

[72] L B Borse A K Muthu A Thangatripathi and S L BorseldquoAntidopaminergic activity of vitex negundo (linn) rootsrdquoAsianJournal of Chemistry vol 24 no 7 pp 3171ndash3173 2012

[73] R S Adnaik P T Pai V D Sapakal N S Naikwade andC S Magdum ldquoAnxiolytic activity of Vitex negundo linn inexperimental models of anxiety in micerdquo International Journalof Green Pharmacy vol 3 no 3 pp 243ndash247 2009

[74] F M Leweke D Piomelli F Pahlisch et al ldquoCannabidiolenhances anandamide signaling and alleviates psychotic symp-toms of schizophreniardquo Translational Psychiatry vol 2 articlee94 2012

[75] S Deiana ldquoMedical use of cannabis Cannabidiol a new lightfor schizophreniardquo Drug Testing and Analysis vol 5 no 1 pp46ndash51 2013

[76] A W Zuardi J A Crippa J E Hallak et al ldquoA criticalreview of the antipsychotic effects of cannabidiol 30 years of atranslational investigationrdquoCurrent Pharmaceutical Design vol18 no 32 pp 5131ndash5140 2012

[77] P Vijayapandi N Megala and M Zahurin ldquoAntipsychotic-like activity of noni (Morinda citrifolia Linn) in micerdquo BMCComplementary and Alternative Medicine vol 12 article 1862012

[78] M N K Azam M A Mannan and M N Ahmed ldquoMedicinalplants used by traditional medical practitioners of Barendraand Shamatat (Rajshahi Khulna division) region in Bangladeshfor treatment of cardiovascular disordersrdquo Journal of MedicinalPlants Studies vol 2 no 2 pp 9ndash14 2014

[79] M Rahmatullah S Hossain A Khatun S Seraj and R JahanldquoMedicinal plants used by various tribes of Bangladesh fortreatment of Malariardquo Malaria Research and Treatment vol2012 Article ID 371798 5 pages 2012

[80] M A H Mollik ldquoA preliminary study on the efficacy ofmedicinal plants from the Lawacherra Rain Forest used for

all forms of brain disordersrdquo Alzheimers amp Dementia vol 6supplement 4 p S44 2010

[81] M N Ahmed M N K Azam U S Zohora and M N HasanldquoUse of medicinal plants against snake venom to treat snakebite by folk medicinal practitioners in Barandra and Shamatatregion of Bangladeshrdquo in Proceedings of the International Con-ference Updates on Natural Products in Medicine and HealthcareSystems Khulna Bangladesh July 2013

[82] M N Hasan M N Ahmed M Z A Bhuiyan M MRahman M N K Azam and M Rahmatullah ldquoMedicinalplants used in treatment of tumors results from a survey offolk medicinal practitionersrdquo in Proceedings of the InternationalConference on Green Chemistry for Sustainable DevelopmentJessore Bangladesh July 2012

[83] M Rahmatullah R Jahan A K Azad et al ldquoA randomizedsurvey of medicinal plants used by folk medicinal practitionersin six districts of Bangladesh to treat rheumatoid arthritisrdquoAdvances in Natural and Applied Sciences vol 4 no 2 pp 124ndash127 2010

[84] M Rahmatullah M N K Azam Z Khatun et al ldquoMedicinalplants used for treatment of diabetes by the Marakh sect ofthe Garo tribe living in Mymensingh district BangladeshrdquoTheAfrican Journal of Traditional Complementary and AlternativeMedicines vol 9 no 3 pp 380ndash385 2012

[85] M A H Mollik ldquoBeideyes in Kurigram district of Bangladeshtheir knowledge of common mental health problems andpossible role in primary health carerdquo Alzheimers Dementia vol6 no 4 article S337 2006

Submit your manuscripts athttpwwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014


MEDIATORSINFLAMMATION

of


Behavioural Neurology

EndocrinologyInternational Journal of



Disease Markers


BioMed Research International

OncologyJournal of



Oxidative Medicine and Cellular Longevity


PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of



Computational and Mathematical Methods in Medicine

OphthalmologyJournal of


Diabetes ResearchJournal of



Research and TreatmentAIDS


Gastroenterology Research and Practice


Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom


Bangladesh is a densely populated area where prevalenceof psychiatric illness is not less than that of any other countryin the world A study showed that 29 of patients attendinggeneral practice were suffering from functional disorder and6 from both functional and organic disorders The samestudy demonstrated that 47 of patients were suffering fromneurotic disorder 37 from psychosomatic disorder 10from affective disorder 144 from schizophrenia 288from substance use disorder and 2 fromorganic psychiatricsyndrome [10] Another study conducted in OutpatientDepartment of National Institute of Mental Health (NIMH)Dhaka Bangladesh revealed that 374 of patients were suf-fering from schizophrenia and schizophrenia like psychoticdisorders 1614 from anxiety disorders 1119 from majordepressive disorder and 895 from bipolar mood disorder[11] In theDhaka city most of the patients (704) were fromurban background and from rural area 296 patients [12]According to other studies it was seen that across variouscountries schizophrenia is more common among people inurban areas and lower socioeconomic classes than amongpeople in rural areas and higher socioeconomic classes [1314]

Antipsychotic agents are the cornerstone of acute andmaintenance treatment of schizophrenia and are effectivein the treatment of hallucinations delusions and thoughtdisorders regardless of etiology In recent decades themodern psychiatry has introduced herbal medicine in thetreatment of psychiatric disorders including schizophreniaAfter the rise of a pharmaceutical industry in the last centuryand significant progress in the treatment a period of disap-pointment comes in accepting the fact that synthetic drugsare not almighty Due to this fact there has been a growinginterest in the last decades for the treatment of psychiatricdisorders including schizophrenia by using alternative andcomplementary methods [15] and a study revealed that 44of psychiatric patients with schizophrenia (9) had usedherbal medicine (mainly for psychiatric purposes) during theprevious 12 months [16]

Plants contain various phytochemicals and these phyto-chemicals can play an important role in reducing occurrencesof many diseases by boosting up various organ functions ofthe human body Many traditional healing herbs and theirparts have been shown to have medicinal value and can beused to prevent alleviate or cure several human diseases[17] It has also been observed that number of moderndrugs has been derived from plants used by the indigenouspeople [18] Modern drugs like aspirin atropine ephedrinedigoxin morphine quinine reserpine and tubocurarine areexamples which were originally discovered through obser-vations of traditional cure methods of indigenous peoples[19] Presently there is a resurgence of herbal medicine aspeople want more control in their personal healthcare TheUS herbal market is growing tremendously with consumerdemand way ahead of regulatory agencies It is interestingto note that four (Ginkgo St Johnrsquos Wort Valerian andKava) of the top ten herbs purchased in the US (accordingto 1999 Whole Foods Survey) have psychotropic activityRecent trends in research into African plant uses show thattraditional medicine is commonly used to treat neurological

disorders in the West African region and some recentpublications are available [20]

In Bangladesh traditional medical practice is still ongo-ingThe traditionalmedical practitioners (generally known asKabirajes by the mainstream community) perform a centralrole in providing primary healthcare to the rural inhabitantsof Bangladesh There are 86000 villages in the country andalmost every village has one or two traditionalKabirajesTheyare the providers of primary healthcare to village populationsof Bangladesh and moreover they are the important sourcesof ethnomedicinal knowledge The practices of the Kabirajesextend throughout both urban and rural areas of the countryalthough rural practice ismore extensive than urban practice

The advantage of the Kabirajes is that they rely chiefly onmedicinal plants for treatment The formulations are rarelycomplex and usually consist of simple extraction of juice ofwhole plant or plant part through squeezing plant part Thejuice is then administered orally or typically applied depend-ing on the nature of diseases The previous ethnomedico-botanical studies conducted among folk and tribal medic-inal practitioners of the country have noticed considerablevariation between the medicinal plants selected by differentKabirajes for treatment of a given ailment [21ndash25]The aim ofthe present study was to document the traditional medicineknowledge as well formulations of medicinal plants used bythe traditional medical practitioners of Rangamati district inthe Chittagong Hill Tracts (CHT) region of Bangladesh forthe treatment of schizophrenia like psychosis

2 Materials and Methods

21 Study Area For the present study survey was donebetween March to Mid-Aprilrsquo 2013 in the largest district ofthe country called Rangamati which is located in the CHTregion It is consists of 10 upazilas and bordered by theTripura state of India to the north and Bandarban districtto the south The area of the district is 6116 km2 of which1292 km2 is riverine and 4825 km2 is under forest vegetationThe main survey was conducted in the Rangamati SadarUpazila (located at 226500∘N 921833∘E) which consistsof 6 unions on the information about medicinal plantscommonly used for treatment of psychotic disorders withparticular attention to schizophrenia The study area for thisspecific ethnomedicinal survey was selected by the authorsthemselves regarding information on the noted traditionalmedical practices Moreover the study area as well as thetotal CHT region is very rich in species diversity We areconducting systematic ethnomedicinal survey of Bangladeshsince 2011 as to explore how do the Kabirajes of Bangladeshselect medicinal plants for treatment of any ailment In orderto address such question we conducted this specific surveyamong Kabirajes of Rangamati Sadar Upazila of Bangladesh(Figure 1) The above question is more important from theviewpoint that how and why medicinal plants are selected bythe TMPs can lead the way towards a better linking betweentraditional knowledge with biomedical science [26 27]

22 Mode of Interview and Plant Data Collection The col-lection of data through interviews of 3 traditional medical


23∘20

998400

23∘00

998400

22∘40

998400

22∘20

998400

22∘00

998400

92∘00

99840092

∘20

99840092

∘40

998400

23∘20

998400

23∘40

998400

23∘00

998400

22∘40

998400

22∘20

998400

22∘00

998400

N

E92

∘00

99840092

∘

20998400

10 0 10 20

(km)

(a)

(km)2 0 2 4

22∘50

998400

22∘46

998400

22∘42

998400

22∘38

998400

22∘34

998400

22∘44

998400

22∘40

998400

22∘36

998400

22∘32

998400

92∘22

99840092

∘18

99840092

∘14

99840092

∘10

99840092

∘06

99840092

∘02

998400

E92∘20

99840092

∘16

99840092

∘12

99840092

∘08

99840092

∘04

998400

22∘48

998400N

(b)




3 Results



Leaf 4762

Bark 1428

Seed 1428

Root 952

Stem 476





4 Discussions





namevernacular name











LMonshaseez

6



7






VoigtTelakuchi


Leaf seed



11



12



13











2-like recep-


















5 Conclusions






Acknowledgments


References































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of

















23∘20

998400

23∘00

998400

22∘40

998400

22∘20

998400

22∘00

998400

92∘00

99840092

∘20

99840092

∘40

998400

23∘20

998400

23∘40

998400

23∘00

998400

22∘40

998400

22∘20

998400

22∘00

998400

N

E92

∘00

99840092

∘

20998400

10 0 10 20

(km)

(a)

(km)2 0 2 4

22∘50

998400

22∘46

998400

22∘42

998400

22∘38

998400

22∘34

998400

22∘44

998400

22∘40

998400

22∘36

998400

22∘32

998400

92∘22

99840092

∘18

99840092

∘14

99840092

∘10

99840092

∘06

99840092

∘02

998400

E92∘20

99840092

∘16

99840092

∘12

99840092

∘08

99840092

∘04

998400

22∘48

998400N

(b)




3 Results



Leaf 4762

Bark 1428

Seed 1428

Root 952

Stem 476





4 Discussions





namevernacular name











LMonshaseez

6



7






VoigtTelakuchi


Leaf seed



11



12



13











2-like recep-


















5 Conclusions






Acknowledgments


References































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of


















3 Results



Leaf 4762

Bark 1428

Seed 1428

Root 952

Stem 476





4 Discussions





namevernacular name











LMonshaseez

6



7






VoigtTelakuchi


Leaf seed



11



12



13











2-like recep-


















5 Conclusions






Acknowledgments


References































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of



















namevernacular name











LMonshaseez

6



7






VoigtTelakuchi


Leaf seed



11



12



13











2-like recep-


















5 Conclusions






Acknowledgments


References































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of




















2-like recep-


















5 Conclusions






Acknowledgments


References































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of
























5 Conclusions






Acknowledgments


References































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of

















Acknowledgments


References































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of















































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of












































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of





















of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of
















Documents

Research Article Traditional Knowledge and Formulations of