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Herbal remedies for depression and anxiety

  • Edzard Ernst

Herbal remedies are used by many people suffering from anxiety or depression. It is therefore important to know whether they generate more good than harm. A systematic review of the published literature revealed trial data for Ginkgo biloba, Lavandula angustifolia, Hypericum perforatum, Valeriana officinalis, Crataegus oxyacantha, Eschscholzia californica, Matricaria recutita, Melissa officinalis, Passiflora incarnate and Piper methysticum. Only two of these herbal remedies are supported by sound evidence: Hypericum perforatum (St John's wort) for mild to moderate depression and Piper methysticum (kava) for anxiety. Neither is free of risks. Our knowledge of herbal remedies is incomplete and the subject merits rigorous study.

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Adreatini, R., Sartori, V. A., Seabra, M. L. et al (2002) Effect of valpotriates (valerian extract) in generalised anxiety disorder: a randomised placebo-controlled pilot study. Phytotherapy Research, 16, 650654.
Akhondzadeh, S., Naghavi, H. R., Vazirian, M. et al (2001) Passionflower in the treatment of generalised anxiety: a pilot double-blind randomized controlled trial with oxazepam. Journal of Clinical Pharmacy and Therapeutics, 26, 363367.
Akhondzadeh, S., Kashani, L., Fotouhi, A. et al (2003) Comparison of Lavandula angustifolia Mill. tincture and imipramine in the treatment of mild to moderate depression: a double-blind, randomized trial. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 27, 123127.
Akhondzadeh, S., Fallah-Pour, H., Afkham, K. et al (2004) Comparison of Crocus sativus L. and imipramine in the treatment of mild to moderate depression: a pilot double-blind randomized trial. BMC Complementary and Alternative Medicine, 4, 12.
Eisenberg, D., David, R. B., Ettner, S. L. et al (1998) Trends in alternative medicine use in the United States: 1990–1997. JAMA, 280, 15691575.
Emslie, M. J., Campbell, M. K. & Walker, K. A. (2002) Changes in public awareness of, attitudes to, and use of complementary therapy in North East Scotland: surveys in 1993 and 1999. Complementary Therapies in Medicine, 10, 148153.
Ernst, E. (2000) Risks associated with complementary therapies. In Meyler's Side Effects of Drugs (eds Dukes, M. N. G. & Aronson, I. K.) (14th edn), pp. 16491681. Elsevier.
Ernst, E. (2003) Serious psychiatric and neurological adverse effects of herbal medicines – a systematic review. Acta Psychiatrica Scandinavica, 108, 8391.
Ernst, E. (2004) Second thoughts about kava. American Journal of Medicine, 113, 347348.
Ernst, E. & Schmidt, K. (2004) ‘Alternative’ cures for depression – how safe are web sites? Psychiatry Research, 129, 297301.
Ernst, E. & Weihmayr, T. (2000) UK and German media differ over complementary medicine. BMJ, 321, 707.
Ernst, E. & White, A. R. (2000) The BBC survey of complementary medicine use in the UK. Complementary Therapies in Medicine, 8, 3236.
Ernst, E., Pittler, M.H., Stevinson, C. et al (2001) The Desktop Guide to Complementary and Alternative Medicine. Mosby.
Ernst, E., Boddy, K., Pittler, M. H. et al (2006) The Desktop Guide to Complementary and Alternative Medicine: An Evidence-Based Approach (2nd edn). Mosby.
Freeman, M. P., Hibbeln, J. R., Wisner, K. L. et al (2006) Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry. Journal of Clinical Psychiatry, 67, 19541967.
Garrard, J., Harms, S., Eberly, L. E. et al (2003) Variations in product choices of frequently purchased herbs. Archives of Internal Medicine, 163, 22902295.
Giveon, S. M., Liberman, N., Klang, S. et al (2004) Are people who use natural drugs aware of their potentially harmful side effects and reporting to family physician? Patient Education and Counseling, 53, 511.
Hanus, M., Lafon, J. & Mathieu, M. (2004) Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of fixed combination containing two plant extracts (Crataegus oxyacantha and Eschscholtzia californica) and magnesium in mild-to-moderate anxiety disorders. Current Medical Research and Opinion, 20, 6371.
Honda, K. & Jacobson, J. S. (2005) Use of complementary and alternative medicine among United States adults: the influences of personality, coping strategies, and social support. Preventive Medicine, 40, 56–53.
Izzo, A. A. & Ernst, E. (2001) Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs, 15, 21632175.
Johne, A. & Roots, I. (2005) Clinical drug interactions with medicinal herbs. Evidence-Based Integrative Medicine, 2, 207228.
Kales, H. C., Blow, F. C., Welsh, D. E. et al (2004) Herbal products and other supplements: use by elderly veterans with depression and dementia and their caregivers. Journal of Geriatric Psychiatry and Neurology, 17, 2531.
Kennedy, D. O., Little, W. & Scholey, A. B. (2004) Attenuation of laboratory-induced stress in humans after acute administration of Melissa officinalis (lemon balm). Psychosomatic Medicine, 66, 607613.
Linde, K., Mulrow, C., Berner, M. et al (2005) St John's wort for depression. Cochrane Database of Systematic Reviews, issue 2. Art. no. CD000448. Wiley InterScience.
Lingaerde, O., Foreland, A. R. & Magnusson, A. (1999) Can winter depression be prevented by Ginkgo biloba extract? A placebo-controlled trial. Acta Psychiatrica Scandinavica, 100, 6266.
Mills, E., Montori, V. M., Wu, P. et al (2005) Interaction of St John's wort with conventional drugs: systematic review of clinical trials. BMJ, 329, 2730.
Pittler, M. H. & Ernst, E. (2003) Kava extract for treating anxiety. Cochrane Database of Systematic Reviews, issue 1. Art. no. CD003383. Wiley InterScience.
Richardson, J. (2004) What patients expect from complementary therapy: a qualitative study. American Journal of Public Health, 94, 10491053.
Roder, C., Schaefer, M. & Leucht, S. (2004) Meta-analysis of effectiveness and tolerability of treatment of mild to moderate depression with St. John's Wort [in German]. Fortschritte der Neurologie-Psychiatrie, 72, 330343.
Roy-Byrne, P. P., Bystritsky, A., Russo, J. et al (2005) Use of herbal medicine in primary care patients with mood and anxiety disorders. Psychosomatics, 46, 117122.
Silvers, K. M., Woolley, C. C. & Hedderley, D. (2006) Dietary supplement use in people being treated for depression. Asia Pacific Journal of Clinical Nutrition, 15, 3034.
Wong, A. H. C., Smith, M. & Boon, H. S. (1998) Herbal remedies in psychiatric practice. Archive of General Psychiatry, 55, 10331044.
Wright, T. (2005) Herbs and botanicals update. Nutraceuticals World (July/August), 5062.
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BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
  • URL: /core/journals/bjpsych-advances
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Herbal remedies for depression and anxiety

  • Edzard Ernst
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