Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review

Abstract

BackgroundOver the past several decades, complementary and alternative medications have increasingly become a part of everyday treatment. With the rising cost of prescription medications and their production of unwanted side effects, patients are exploring herbal and other natural remedies for the management and treatment of psychological conditions. Psychological disorders are one of the most frequent conditions seen by clinicians, and often require a long-term regimen of prescription medications. Approximately 6.8 million Americans suffer from generalized anxiety disorder. Many also suffer from the spectrum of behavioural and physical side effects that often accompany its treatment. It is not surprising that there is universal interest in finding effective natural anxiolytic (anti-anxiety) treatments with a lower risk of adverse effects or withdrawal.MethodsAn electronic and manual search was performed through MEDLINE/PubMed and EBSCO. Articles were not discriminated by date of publication. Available clinical studies published in English that used human participants and examined the anxiolytic potential of dietary and herbal supplements were included. Data were extracted and compiled into tables that included the study design, sample population, intervention, control, length of treatment, outcomes, direction of evidence, and reported adverse events.ResultsA total of 24 studies that investigated five different CAM monotherapies and eight different combination treatments and involved 2619 participants met the inclusion criteria and were analyzed. There were 21 randomized controlled trials and three open-label, uncontrolled observational studies. Most studies involved patients who had been diagnosed with either an anxiety disorder or depression (n = 1786). However, eight studies used healthy volunteers (n = 877) who had normal levels of anxiety, were undergoing surgery, tested at the upper limit of the normal range of a trait anxiety scale, had adverse premenstrual symptoms or were peri-menopausal, reported anxiety and insomnia, or had one month or more of elevated generalized anxiety. Heterogeneity and the small number of studies for each supplement or combination therapy prevented a formal meta-analysis. Of the randomized controlled trials reviewed, 71% (15 out of 21) showed a positive direction of evidence. Any reported side effects were mild to moderate.ConclusionsBased on the available evidence, it appears that nutritional and herbal supplementation is an effective method for treating anxiety and anxiety-related conditions without the risk of serious side effects. There is the possibility that any positive effects seen could be due to a placebo effect, which may have a significant psychological impact on participants with mental disorders. However, based on this systematic review, strong evidence exists for the use of herbal supplements containing extracts of passionflower or kava and combinations of L-lysine and L-arginine as treatments for anxiety symptoms and disorders. Magnesium-containing supplements and...

Chemical composition of hydroethanolic extracts from five species of the Passiflora genus

“…edulis . Passifl ora was listed as offi cial plant drug in the 1970s and 1990s by the pharmacopoeias of America, Britain, Germany, France, Switzerland, Egypt and India (Lakhan & Vieira, 2010;Fiebich et al, 2011;Sarris et al, 2012).…”

Comparative randomized open-label trial on efficacy and safety of Persen® and Persen® Night herbal extracts in patients with short-term insomnia

“…Необ-ходимо выделить 3 фитотерапевтических агента, наи-более исследованных и широко применямых в неврологии: валериану лекарственную (Valeriana officinalis L.), мяту перечную (Mentha piperita L.) и ме-лиссу лекарственную (Melissa officinalis L.) [9][10][11][12][13][14][15][16][17][18][19][20][21].…”

Effects of the single supplementation and multiple doses of Passiflora incarnata L. on human anxiety: A Clinical Trial, Double-blind, Placebo-controlled, Randomized

“…Plants that are most studied with anxiolytic potential are Kawa, the St. John's Wort and Passiflora spp. [4][5][6][7]. The Passiflora extract has been used in many researches, presenting in their chemical constitution polyphenols, polyunsaturated fatty acids, fiber and other substances, such as passiflorin, one indole alkaloid, being the last one associated with anxiolytic effects [3].…”

“…The effects of Passiflora incarnata L on anxiety was previously assessed in animals [8,4] and in humans [9][10] with satisfactory results [7]. Epidemiological studies have shown that the fear of public speaking is one of the biggest phobias that affect people, being highly prevalent among students [11].…”

“…[4][5][6][7]. The Passiflora extract has been used in many researches, presenting in their chemical constitution polyphenols, polyunsaturated fatty acids, fiber and other substances, such as passiflorin, one indole alkaloid, being the last one associated with anxiolytic effects [3].The effects of Passiflora incarnata L on anxiety was previously assessed in animals [8,4] and in humans [9-10] with satisfactory results [7]. Epidemiological studies have shown that the fear of public speaking is one of the biggest phobias that affect people, being highly prevalent among students [11].…”