Anxiety Disorders: Supplements With Likely Efficacy

Like depression, anxiety is an area of psychopharmacology where many naturopathic compounds have been studied. While kava has established efficacy with adults and consistently has been shown to be effective in decreasing symptoms of anxiety, no studies thus far have been performed with children and adolescents, and some risk of hepatotoxicity may be present, and consequently the supplement is included in this section. In addition, some other compounds have also revealed at least some efficacy, but research has primarily been done with adult patients, and clinicians must use caution when applying results of these studies to pediatric patients. Anxiolytic medications work by increasing the amount of activity in the serotonergic pathways, as well as altering the glutamate-GABA balance in favor of inhibitory effects. Supplements that accomplish similar changes in the brain have been shown to be effective in managing symptoms of anxiety. Kava Kava (Piper methysticum), alsto referred to as kava kava, is a tall bush indigenous to the South Pacific, especially Hawaii, Fiji, Samoa, Tonga, Tahiti, New Guinea, and New Zealand. Its root is typically ground, and indigenous cultures have also chewed it, prepared it as an infusion, Read more […]

Common Herbal Remedies for Anxiety

Ayurveda, the Indian traditional system of medicine uses herbs and their preparations to treat various neuropsychiatric disorders. Numerous herbs have been used for centuries in folk and other traditional medicine to calm the mind and positively enhance mood. Herbal medicine which plays an important role in developing countries, are once again becoming popular throughout developing and developed countries. Study by Sparreboom et al. revealed that use of herbal medicine is increasing enormously in the Western world. In spite of the large number of animal studies evaluating the potential anxiolytic effects of plant extracts, very few controlled studies have been conducted in a clinical setup. The efficacy and safety of utilizing these natural drugs to treat anxiety, has only just begun to be exactly tested in clinical trials within the last 10 to 15 years. For instance, both Kava-kava (Piper methysticum) and St. John’s wort (Hypericum perforatum) showed beneficial effectiveness in double blind, randomized placebo controlled trials to treat anxiety and depression. Also, extracts of valerian, hops, lemon balm and passion flower preparations have been employed for the prevention and treatment of psychiatric disorders such Read more […]

Herbs For Behavioral Conditions

Most behavioral conditions in small animals arise from stress and anxiety. These include aggression, inappropriate urination, lick granuloma, separation anxiety, and storm and other phobias. Herbal medicines provide a number of interesting alternatives to conventional veterinary mood-modifying drugs. The approach depends upon the nature of the behavioral disturbance and the severity and duration of the condition. Other perpetuating factors and health issues such as pain or endocrine disturbances, which can contribute to aggression and anxiety, must be considered. Nervines are the traditional class of herbs employed for emotional conditions in humans, and they have applications in veterinary medicine, too. Nervines can be further classified. Nervine relaxants have anxiolytic, sedating, or hypnotic activity. They include herbs such as Valerian, Hops, Lavender, Lemon balm, and Passion flower, and may be prescribed for anxiety, hyperactivity, restlessness, and irritability. Nervine stimulants are perhaps the least used group in veterinary medicine, but they may be beneficial for a depressed or hypoactive nervous system. They may be used extensively by veterinary staff in the form of tea and coffee. Others, such as Kola Read more […]

Herb-Drug Interactions: Tea

Camellia sinensis (L.) Kuntze (Theaceae) Synonym(s) and related species Camellia thea Link, Thea sinensis L. Note that Green tea (predominantly produced in China and Japan) is produced from steam-treated tea leaves. Black tea or Red tea (predominantly produced in India, Sri Lanka and Kenya) is processed by fermentation and heating, whereas Oolong tea is partially fermented. Pharmacopoeias Powdered Decaffeinated Green Tea Extract (The United States Ph 32). Constituents Tea contains caffeine (around 1 to 5%), with minor amounts of other xanthines such as theophylline and theobromine. Tea also contains flavonoids, the content of which varies between green (unfermented) and black (fermented) tea. Green tea appears to contain greater quantities of the flavonol-type flavonoids than black tea. Black tea also contains theaflavins, which are produced during the fermentation process. Other flavonols present include quercetin and kaempferol. Oolong tea contains some unique flavones known as oolonghomobisflavins. Tea also contains up to 24% tannins. Use and indications The leaf buds and very young leaves of tea are used as a stimulant and diuretic, actions that can be attributed to the caffeine content. They are Read more […]

Herb-Drug Interactions: St John’s wort

Hypericum perforatum L. (Clusiaceae) Synonym(s) and related species Hypericum, Millepertuis. Hypericum noeanum Boiss., Hypericum veronense Schrank. Pharmacopoeias St John’s Wort (British Ph 2009, European Ph 2008, US Ph 32); St John’s Wort Dry Extract, Quantified (British Ph 2009, European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4). Constituents The main groups of active constituents of St John’s wort are thought to be the anthraquinones, including hypericin, isohypericin, pseudohypericin, protohypericin, protopseudohypericin and cyclopseudohypericin, and the prenylated phloroglucinols, including hyperforin and adhyperforin. Flavonoids, which include kaempferol, quercetin, luteolin, hyperoside, isoquercitrin, quercitrin and rutin; biflavonoids, which include biapigenin and amentoflavone, and catechins are also present. Other polyphenolic constituents include caffeic and chlorogenic acids, and a volatile oil containing methyl-2-octane. Most St John’s wort products are standardised at least for their hypericin content (British Pharmacopoeia 2009), even though hyperforin is known to be a more relevant therapeutic constituent, and some preparations are now standardised for both (The United Read more […]

Herb-Drug Interactions: Melatonin

N-(2-(5-Methoxyindol-3-yl)ethyl)acetamide Types, sources and related compounds N- Acetyl-5-methoxytryptamine. Use and indications Melatonin is a hormone that is produced in the pineal gland of the brain and influences the circadian rhythm. Supplements are therefore principally used for treating sleep disturbances and disorders such as jet lag, insomnia, sleep walking, and shift-work sleep disorder. It is also believed to have anticancer and antihypertensive properties, and has been used to treat cluster headaches. Melatonin has also been detected in a large number of plant species, including those used as foods. Concentrations detected have been very variable, the reasons for which are currently uncertain. In addition, the importance of dietary melatonin is unclear. Pharmacokinetics When an oral melatonin supplement 3mg was given to 17 healthy subjects the AUC and maximum serum levels of melatonin were about 18-fold and 100-fold greater, respectively, than overnight endogenous melatonin secretion, although there was a wide variation between individuals.The oral bioavailability was approximately 15% after oral doses of 2 or 4mg, possibly due to significant first-pass metabolism. The half-life has been found Read more […]

Herb-Drug Interactions: Grapefruit

Citrus paradisi Macfad. (Rutaceae) Synonym(s) and related species Citrus paradisi Macfad. Grapefruit is a hybrid of the Pummelo or Pomelo (Citrus maxima (Burm.) Merr) with the sweet orange (Citrus sinensis (L.) Osbeck). Constituents Grapefruit contains furanocoumarins including bergamottin, 6′,7′-dihydroxybergamottin, bergapten, bergaptol, geranyl-coumarin and paradisin A, flavonoid glycosides such as naringin and flavonoid aglycones galangin, kaempferol, morin, naringenin, quercetin and others. The peel contains a volatile oil, mostly composed of limonene. Note that some grapefruit seed extracts have been found to contain preservatives such as benzethonium chloride, triclosan and methyl-p-hydroxybenzoate, which might be present because of the methods of production. Use and indications Grapefruit is used as a source of flavonoids (citrus bioflavonoids), which are widely used for their supposed antioxidant effects, and are covered under flavonoids. Grapefruit seed extracts are used for their antimicrobial properties, but there is some controversy that this might be due to preservative content rather than natural constituents. Grapefruit and grapefruit juice are commonly ingested as part of the diet, Read more […]

Herb-Drug Interactions: Ginkgo

Ginkgo biloba L. (Ginkgoaceae) Synonym(s) and related species Fossil tree, Kew tree, Maidenhair tree. Salisburia adiantifolia Sm., Salisburia biloba Hoffmanns. Pharmacopoeias Ginkgo (US Ph 32); Ginkgo capsules (US Ph 32); Ginkgo dry extract, refined and quantified (British Ph 2009, European Ph 2008); Ginkgo leaf (British Ph 2009, European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4); Ginkgo tablets (US Ph 32); Powdered ginkgo extract (The United States Ph 32). Constituents Ginkgo leaves contain numerous flavonoids including the biflavone glycosides such as ginkgetin, isoginkgetin, bilobetin, sciadopitysin, and also some quercetin and kaempferol derivatives. Terpene lactones are the other major component, and these include ginkgolides A, B and C, and bilobalide, Ginkgo extracts may be standardised to contain between 22 and 27% flavonoids (flavone glycosides) and between 5 and 12% terpene lactones, both on the dried basis. The leaves contain only minor amounts of ginkgolic acids, and some pharmacopoeias specify a limit for these. The seeds contain ginkgotoxin (4-O-methylpyridoxine) and ginkgolic acids. Use and indications The leaves of ginkgo are the part usually used. Ginkgo is often used Read more […]

Kava Kava: Clinical Use. Dosage

Kava extracts are popular in Europe and have been investigated in numerous clinical trials, primarily in European countries. As a result, many research papers have been published in languages other than English. In order to provide a more complete description of the evidence available, secondary sources have been used where necessary. NERVOUS ANXIETY A 2000 Cochrane review of the scientific literature assessed the results from seven, double-blind, randomised placebo-controlled trials and concluded that kava extract has significant anxiolytic activity and is superior to placebo for the symptomatic treatment of anxiety. An update of this review was published in 2003 and analysed results from 12 clinical studies involving 700 subjects. The results of 7 studies that used the Hamilton Anxiety Scale (HAM-A) score were pooled and a significant reduction in anxiety was observed for kava treatment compared with placebo. The results of the five studies that were not submitted to meta-analysis largely support these findings. The extract most commonly tested was WS 1490 at a dose of up to 300 mg daily. Preliminary evidence suggests it may be equivalent to benzodiazepines for non-psychotic anxiety. Safety According to the authors Read more […]