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Nip it in the Bud: Botanicals for Anxiety — a Practical Prescriber’s Guide

  • Complex Medical-Psychiatric Issues (MR Riba, Section Editor)
  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The goal of this paper is to summarize the evidence for the use of botanical medicines for the treatment of anxiety disorders. We sought to make this review practical for psychiatrists and psychiatric prescribers.

Recent Findings

In 2018, the Natural Medicines database produced a Clinical Management of Anxiety guide that summarized the conventional and natural treatments of anxiety disorders. Based on this guide, four herbal supplements (also referred to as botanicals) were selected for deeper study including kava, lavender, lemon balm and passionflower. All four were considered possibly safe and possibly effective according to the Natural Medicines database.

Summary

There is scientific evidence supporting the use of kava, lavender, lemon balm and passionflower in anxiety disorders. Lavender appears to have the best available evidence including comparable efficacy to conventional first line treatments and is available in a patented form that was used in the cited studies (Silexan).

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References

Papers of particular interest, published recently, have been highlighted as: •  Of importance

  1. American Psychological Association. Stress in America 2020: a national mental health crisis. 2020. https://www.apa.org/news/press/releases/stress/2020/sia-mental-health-crisis.pdf. Accessed 7 Jun 2022.

  2. Natural medicines in the clinical management of anxiety. CME Activity. Therapeutic Research Center. 2018.

  3. Malsch U, Kieser M. Efficacy of kava-kava in the treatment of non-psychotic anxiety, following pretreatment with benzodiazepines. Psychopharmacology. 2001;157:277–83.

    Article  CAS  Google Scholar 

  4. Pittler MH, Ernst E. Kava extract for treating anxiety. Cochrane Database Syst Rev. 2003;1:CD003383.

  5. Boerner RJ, Sommer H, Berger W, Kuhn U, Schmidt U, Mannel M. Kava-Kava extract LI 150 is as effective as Opipramol and Buspirone in Generalised Anxiety Disorder–an 8-week randomized, double-blind multi-centre clinical trial in 129 out-patients. Phytomedicine. 2003;10(Suppl 4):38–49. https://doi.org/10.1078/1433-187x-00309.

    Article  PubMed  Google Scholar 

  6. • Bian T, Corral P, Wang Y, Botello J, Kingston R, Daniels T, Salloum R, Johnston E, Huo Z Lu J, Liu A, Xing C. Kava as a clinical nutrient: promises and challenges. Nutrients. 2020;10:3044. https://doi.org/10.3390/nu12103044. Recent review on the historical background, current research, and challenges of using kava clinically.

  7. ComsumerLab.com. https://www.consumerlab.com/recalls/10002/liver-toxicity-with-kava/. Accessed 10 May 2022.

  8. Woelk H, Schlafke S. A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. Phytomedicine. 2010;17:94–9.

    Article  CAS  Google Scholar 

  9. Kasper S, Gastpar M, Muller WE, Volz HP, Moller HJ, Dienel A, Schlafke S. Silexan, an orally administered Lavandula oil preparation, is effective in the treatment of ‘subsyndromal’ anxiety disorder: a randomized, double-blind, placebo controlled trial. Int Clin Psychopharmacol. 2010;25:277–87.

    Article  Google Scholar 

  10. Kasper S, Gastpar M, Müller WE, et al. Lavender oil preparation Silexan is effective in generalized anxiety disorder—a randomized, double-blind comparison to placebo and paroxetine. Int J Neuropsychopharmacol. 2014;17:859–69.

    Article  CAS  Google Scholar 

  11. Diaz A, Luque L, Badar Z, Kornic S, Danon M. Prepubertal gynecomastia and chronic lavender exposure: Report of three cases. J Pediatr Endocrinol Metab. 2016;29:103–7.

    Article  Google Scholar 

  12. Awad R, Muhammad A, Durst T, et al. Bioassay-guided fractionation of lemon balm (Melissa officinalis L.) using an in vitro measure of GABA transaminase activity. Phytother Res. 2009;23:1075–81.

  13. Cases J. Leaf extract in the treatment of volunteers suffering from mild-to-moderate anxiety disorders and sleep disturbances. Mediterr J Nutr Metab. 2010;4:211–8.

    Article  Google Scholar 

  14. • Soltanpour A, Alijaniha F, Naseri M, Kazemnejad A, Heidari MR. Effects of Melissa officinalis on anxiety and sleep quality in patients undergoing coronary artery bypass surgery: a double-blind randomized placebo controlled trial. Eur J Integr Med. 2019;28:27–32. Recent RCT comparing herbal remedy to placebo for anxiety and sleep problems post operatively.

  15. Chehroudi S, Fatemi MJ, Saberi M, Salehi SH, Akbari H, Samimi R. Effects of Melissa officinalis L. on reducing stress, alleviating anxiety disorders, depression, and insomnia, and increasing total antioxidants in burn patients. Trauma Monthly. 2016;22.

  16. Heydari N, Dehghani M, Emamghoreishi M, Akbarzadeh M. Effect of Melissa officinalis capsule on the mental health of female adolescents with premenstrual syndrome: a clinical trial study (in press). Int J Adolesc Med Health. 2018;31:20170015.

    Article  Google Scholar 

  17. Akhondzadeh S, Naghavi HR, Shayeganpour A, et al. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin PharmTher. 2001;26:363–7.

    CAS  Google Scholar 

  18. Mori A, Hasegawa K, Murasaki M, et al. Clinical evaluation of Passiflamin (passiflora extract) onneurosis - multicenter double blind study in comparison with mexazolam. Rinsho Hyoka (Clinical Evaluation). 1993;21:383–440.

    Google Scholar 

  19. Miyasaka LS, Atallah AN, Soares BG. Passiflora for anxiety disorder. Cochrane Database Syst Rev. 2007;1:CD004518.

  20. Nojoumi M, Ghaeli P, Salimi S, Sharifi A, Raisi F. Effects of passion flower extract, as an add-on treatment to sertraline, on reaction time in patients with generalized anxiety disorder: a double-blind placebo-controlled study. Iran J Psychiatry. 2016;11:191–7.

    PubMed  PubMed Central  Google Scholar 

  21. Dantas LP, de Oliveira-Ribeiro A, de Almeida-Souza LM, Groppo FC. Effects of passiflora incarnata and midazolam for control of anxiety in patients undergoing dental extraction. Med Oral Patol Oral Cir Bucal. 2017;22:e95–101.

    PubMed  Google Scholar 

  22. Miroddi M, Calapai G, Navarra M, et al. Passiflora incarnata L: ethnopharmacology, clinical application, safety and evaluation of clinical trials. J Ethnopharmacol. 2013;150:791–804.

    Article  CAS  Google Scholar 

  23. National Institute of Mental Health. Any anxiety disorder. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder. Accessed 10 May 2022.

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Acknowledgements

The editors would like to thank Dr. Harrison Levine for taking the time to review this manuscript.

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Authors and Affiliations

  1. University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI, 48109, USA

    Theresa B. Gattari & Alexander Scott

  2. Centura Health, Denver, CO, USA

    Karina Drake

Authors
  1. Theresa B. Gattari
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Correspondence to Theresa B. Gattari.

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Gattari, T.B., Drake, K. & Scott, A. Nip it in the Bud: Botanicals for Anxiety — a Practical Prescriber’s Guide. Curr Psychiatry Rep 24, 503–508 (2022). https://doi.org/10.1007/s11920-022-01365-w

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