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Wiener Medizinische Wochenschrift

, Volume 165, Issue 11–12, pp 217–228 | Cite as

Phytopharmaceutical treatment of anxiety, depression, and dementia in the elderly: evidence from randomized, controlled clinical trials

  • Siegfried Kasper
main topic

Summary

Based on subgroup analyses of randomized, controlled clinical trials, we review the efficacy of three phytopharmaceutical drugs, respectively of the corresponding active substances silexan® (WS® 1265, lavender oil) in anxiety disorders, WS® 5570 (Hypericum extract) in major depression, and EGb 761® (Ginkgo biloba extract) in Alzheimer, vascular, or mixed type dementia, in elderly patients aged ≥ 60 years.

Four trials were eligible in each indication. Meta-analyses and analyses based on pooled raw data showed that the three drugs were significantly superior to placebo in the elderly subset, and that their treatment effects reflected in the main outcome measures (Hamilton Anxiety scale, Hamilton Depression scale, Neuropsychiatric Inventory) were comparable with those observed in the original trials without age restrictions.

The results confirm the efficacy of the three herbal active substances in elderly patients of ≥ 60 years of age. In anxiety, depression, and dementia, they thus represent efficacious and well-tolerated alternatives to synthetic drugs.

Keywords

Evidence-based phytotherapy Elderly Anxiety/depression/dementia Randomized controlled trials 

Phytopharmaka bei der Behandlung von Angststörungen, Depressionen und Demenz bei älteren Patienten – Evidenz aus randomisierten, klinischenStudien

Zusammenfassung

Auf der Grundlage randomisierter, kontrollierter Studien untersuchten wir die Wirksamkeit dreier Phytopharmaka mit den Wirkstoffen Silexan® (WS® 1265, Lavendelöl) bei Angststörungen, WS® 5570 (Hypericum-Extrakt) bei Depressionen und EGb 761® (Ginkgo-biloba-Extrakt) bei Alzheimer- oder vaskulärer Demenz und bei Mischformen, bei Patienten im Alter ab 60 Jahren.

In jeder der drei Indikationen genügten vier Studien unseren Auswahlkriterien. Metaanalysen und Analysen auf der Grundlage der gepoolten Rohdaten wiesen auch im Kollektiv der Patienten ab 60 Jahren die Überlegenheit der drei Phytopharmaka gegenüber Plazebo nach. Dabei waren die Behandlungseffekte ähnlich jenen, die in den Ausgangsstudien für die nicht nach Alter ausgelesenen Wirksamkeitskollektive beobachtet worden waren. Das galt für die Hauptzielvariablen Hamilton Angstskala, Hamilton Depressionsskala und Neuropsychiatrisches Inventar.

Die Ergebnisse bestätigen die Wirksamkeit der drei pflanzlichen Wirkstoffe auch für ältere Patienten ab 60 Jahre. Die Präparate bieten sich damit als wirksame und gut verträgliche Alternative zu synthetischen Therapeutika bei Angststörungen, Depressionen oder Demenz an.

Schlüsselwörter

Evidenz-basierte Phytotherapie Ältere Menschen Angst/Depression/Demenz Randomisierte kontrollierte klinische Studie 

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© Springer-Verlag Wien 2015

Authors and Affiliations

  1. 1.Department of Psychiatry and PsychotherapyMedical University of ViennaViennaAustria

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