In practice, the herb is prescribed in combination with other herbal medicines, such as valerian and passionflower. As is representative of clinical practice, most studies have investigated the effects of hops in combination with other herbs.
RESTLESSNESS AND ANXIETY
Based on the herb’s sedative activity, it is likely to have some effect in the treatment of restlessness and anxiety, but careful dosing would be required to avoid sedation. This indication has been approved by Commission E and ESCOP.
Although there have been no clinical studies to support hops as a stand-alone sedative agent, several studies have demonstrated formulas combining hops with other sedative herbs are effective for insomnia.
Two randomised double-blind studies have investigated the effects of an oral preparation of hops and valerian in sleep disorders. One study observed equivalent efficacy and tolerability of a hops-valerian preparation comparable to benzodiazepine treatment, with withdrawal symptoms only reported for benzodiazepine use. Improvement in subjective perceptions of sleep quality was confirmed in another study, which also reported that a hops-valerian combination was well tolerated compared with flunitrazepam.
A pilot study tested a preparation containing a fixed combination of valerian extract (500 mg) and hops extract (120 mg) known as Ze 91019 in 30 subjects with mild-to-moderate, non-organic insomnia. The treatment was used at bedtime and found to reduce sleep latency and wake time as diagnosed by polysomnographic examination.
Hops has also been used as a bath additive for sleep disturbances. A randomised double-blind study involving 40 patients found that taking three hops baths (4 g hops in a concentrated extract) on successive days significantly improved both objective and subjective sleep quality.
A randomised, double-blind, placebo-controlled trial of a standardised extract of hops (100 µg and 250 µg 8-prenylnaringenin) demonstrated a significant reduction in menopausal discomfort, in particular hot flushes, after 12 weeks of treatment in 67 women. Interestingly, no dose-response relationship could be made, as the lower standardised dose was shown to be more effective.
• Infusion or decoction: 0.5 g in 150 mL water.
• Fluid extract (1:1) (g/mL): 0.5 mL/day; 0.5-1 mL three times daily.
• Tincture (1:5) (g/mL): 1-2.5 mL/day.
• Also used as a bath additive (4 g hops in a concentrated extract) and in pillows.