Oxygen Therapy—Is the Promise Too Good to Be True?

By Adam Voiland
Posted 7/24/07
http://health.usnews.com/usnews/heal...4/24oxygen.htm

According to The Oxygen Revolution by Paul G. Harch, in bookstores this summer, a treatment known as hyperbaric oxygen therapy can work wonders for neurological problems ranging from autism and Alzheimer's to multiple sclerosis and Parkinson's to Lyme disease and alcohol abuse. The therapy, which involves entering a pressurized chamber and breathing purified oxygen, is currently approved to treat 13 conditions, including decompression sickness, carbon monoxide poisoning, thermal burns, and gas gangrene. Now, some practitioners intrigued by claims of its power are administering it for other conditions, too.

But the practice is controversial, and leading medical organizations are waving warning flags. The Undersea and Hyperbaric Medicine Society (UHMS), concerned that there isn't enough scientific evidence to justify off-label use, has published position statements on two of the more controversial treatments: those for multiple sclerosis and chronic brain injury. The paper on multiple sclerosis reviews the results of 18 studies on the topic and concludes that: "At this time, we cannot recommend the routine treatment of MS with HB02T," noting methodological flaws in the research. Likewise, the society doesn't endorse hyperbaric therapy for chronic brain injury, on the grounds that only one reliable clinical trial exists, and found no benefit to the therapy. The society also cites a review of the literature recently completed by the Oregon Health and Science University Evidence Based Practice Center that reached similar conclusions.

All this is not to say that hyperbaric therapy is definitely ineffective against other conditions. Lindell Weaver is a hyperbaric oxygen expert at the University of Utah and the incoming chairman of the UHMS committee that determines which uses have enough scientific credibility to endorse. Weaver says equipment manufacturers lack the financial resources to sponsor rigorous trials, leaving people who are considering treatment an array of conflicting information from competing professional organizations and physicians. And though FDA-approved indications are generally covered by insurance, off-label ones usually are not. At rates of $200 to $300 per hour, taking part in an unproven treatment regime can add up quickly. Plus, there are known side effects such as ear pain, seizures, or even the risk of fires in the chambers, to consider.

The best strategy for wading through the claims is to make sure that the UHMS has given the nod to the therapy for a condition you'd like treated or that the indication is part of an experimental research protocol, according to an article published on www.quackwatch.org by Duncan Kirkby, scientific director at the Antilles Institute for Hyperbaric and Undersea Medicine. Treatment in both of those situations should be covered by insurance. Otherwise, proceed with caution.

Despite criticism, Harch remains undaunted: "The specialty of neurology has taught us that there is nothing we can do for brain damage. There are a lot of people who are going to be embarrassed by this. It counteracts years of dogma," he says.