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Treatment of moderately severe anxiety states

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Abstract

100 outpatients with symptoms of anxiety requiring therapy were randomly assigned on a double-blind basis to treatment with either a herbal combination of standardized extracts of St. John's wort and European Valerian root (Sedariston® Concentrate) of diazepam. Therapeutic efficacy was assessed by means of standardized Physician's Rating Scale and Patient's Self-Rating Scales. After 2 weeks of treatment, Sedariston® Concentrate showed a more marked efficacy than diazepam. The differences in all median scores and arithmetic means of the scales were highly significant in favour of the herbal combination.

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... Valeric acid (Val) or pentanoic acid, a prime component of Valeriana wallchii DC., Caprifioliaceae has potent biological activities with a molecular weight of 102.15 and chemical formula C 5 H 10 O 2 has potent biological properties. Valeriana has extensive traditional reputation for its protective activity against insomnia, neurosis, pain [35,36] and depression [37,38]. Moreover, Val has an identical structure to neurotransmitter gamma-aminobutyric acid (GABA) but without amine functional group which is responsible for GABA's biological activity. ...
... Valeric acid (Val) or pentanoic acid, a prime component of Valeriana wallchii DC., Caprifioliaceae has potent biological activities with a molecular weight of 102.15 and chemical formula C5H10O2 has potent biological properties. Valeriana has extensive traditional reputation for its protective activity against insomnia, neurosis, pain [35,36] and depression [37,38]. Moreover, Val has an identical structure to neurotransmitter gamma-aminobutyric acid (GABA) but without amine functional group which is responsible for GABA's biological activity. ...
... Valeric acid, an terpenoid ester from Valeriana species have been known to possess various biological activities [35]. Valeriana has got extensive reputation for its ability to treat pain insomnia, epilepsy, neurosis, anxiety and depression [36][37][38]. Though Valeriana and its bioactive component Val possess various biological properties, its antioxidant ability has not been studied previously. ...
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Parkinson's disease, the second common neurodegenerative disease is clinically characterized by degeneration of dopaminergic neurons in the substantia nigra pars compacta (SNpc) with upregulation of neuroinflammatory markers and oxidative stress. Autophagy lysosome pathway (ALP) plays a major role in degradation of damaged organelles and proteins for energy balance and intracellular homeostasis. However, dysfunction of ALP results in impairment of α-synuclein clearance which hastens dopaminergic neurons loss. In this study, we wanted to understand the neuroprotective efficacy of Val in rotenone induced PD rat model. Animals received intraperitoneal injections (2.5 mg/kg) of rotenone daily followed by Val (40 mg/kg, i.p) for four weeks. Valeric acid, a straight chain alkyl carboxylic acid found naturally in Valeriana officianilis have been used in the treatment of neurological disorders. However, their neuroprotective efficacy has not yet been studied. In our study, we found that Val prevented rotenone induced upregulation of pro-inflammatory cytokine oxidative stress, and α-synuclein expression with subsequent increase in vital antioxidant enzymes. Moreover, Val mitigated rotenone induced hyperactivation of microglia and astrocytes. These protective mechanisms prevented rotenone induced dopaminergic neuron loss in SNpc and neuronal fibers in the striatum. Additionally, Val treatment prevented rotenone blocked mTOR-mediated p70S6K pathway as well as apoptosis. Moreover, Val prevented rotenone mediated autophagic vacuole accumulation and increased lysosomal degradation. Hence, Val could be further developed as a potential therapeutic candidate for treatment of PD.
... 10,12 The plant is widely used in the treatment of anxiety and depression either alone or in combination with other herbs. [13][14][15] Yasad bhasma is the natural source of Zinc and it helps strengthens the bone density, which is to reduced due to hormonal imbalance. Thus it prevents osteoporosis after menopause. ...
... The ®ndings of such trials include a combination of valerian root and St John's wort exhibiting bene®ts equivalent to the drug amitriptyline (Tryptanol) but without the high frequency of sideeffects caused by this drug such as dry mouth and lethargy (Hiller & Rahlfs, 1995). Steger (1985) found this herbal combination achieved signi®cant improvement compared with the antidepressant desipramine as assessed by physicians and Panijel (1985) found it to be more effective than diazepam (Valium) for patients with moderate anxiety but was accompanied by fewer side-effects. A comparable reduction in symptoms of fear and depressive mood were observed in comparison with amitriptyline in patients diagnosed with fear and depression (Kniebel & Burchard, 1988). ...
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An overview is given of the current position of medicinal herbs in general in relation to usage, market and production, types of pharmacological activity and how they differ from conventional drugs. The increasing importance of quality and manufactured products is also discussed. A more detailed consideration of these issues is given in relation to echinacea, valerian and St John's wort as these herbs are well studied, are market leaders and have widespread community usage.
... 10, 12 The plant is widely used in the treatment of anxiety and depression either alone or in combination with other herbs. [13][14][15] Yasad bhasma is the natural source of Zinc and it helps strengthens the bone density, which is to reduced due to hormonal imbalance. Thus it prevents osteoporosis after menopause. ...
Article
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Background: To evaluate the clinical efficacy and safety effect of Zanopause tablet a marketed herbal formulation of Emami Ltd., in pre-menopausal and menopausal women Methods: 50 women patients age range between 40 to 70 years old suffering from pre-menopausal and menopausal symptoms like hot flashes, night sweats, irregular periods, loss of libido, vaginal dryness and mood swings. Zanopause tablet was given twice a day for 60 days. Results: A significant improvement was observed in clinical symptoms like hot flashes, night sweats, irregularity of periods, loss of libido, vaginal dryness and mood swings after ZZT medication. Laboratory investigation showed improved Haemotological levels in all the patients. Other parameters were observed in normal range. On '0 th ' day 7.6-14.1 (G %), 8.1-14.7 (G %) on 45 th day and 8.7-15.2 (G %) on 60 th day. ZZT medication showed a significant increase in Haemoglobin level of patients. 5200-9900 (/cu.mm.) on '0 th ' day, 5600-1100 (/ cu.mm.) on 45 th day and 4.01-5800-9700 (/ cu.mm.) on 60 th day, WBC count was observed in normal range, from the data obtained from blood samples of 50 patients. Upper Abdomen USG was normal in all the 50 patients. Conclusion: Menopause symptoms like hot flashes, night sweats, irregularity of periods, loss of libido, vaginal dryness were taken care off. Increase in Haemoglobin levels and status of wellbeing. Reduce pain in knee joints were observed.
... It has got considerable reputation for its traditional use in pain (Vohora and Dandiya, 1992), epilepsy, insomnia, neurosis, sciatica (Nadkarni, 1976;Marder et al., 2003). The plant is widely used in the treatment of anxiety and depression (Panijel, 1985;Ron et al., 2000). It has been used as sedative in the treatment of insomnia and restlessness (Leathwood and Chauffard, 1985). ...
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Valeriana wallichii DC., Caprifoliaceae, is used to have anti-ulcer, anti-spasmodic, anti-epileptic, memory enhancer, anti-anxiety, anti-rheumatic, sedative, anti-asthmatic and diuretic activities. V. wallichii is reported to contain valpotriates, valeric acid, valerenic acid, valechlorine, valerianine, resins and alkaloids. Valeric acid, found in V. wallichii appears similar in structure to the neurotransmitter GABA. Valeric acid also acts as an NMDA-receptor antagonist. The aim of present study was to investigate the neuroprotective effect of V. wallichii containing valeric acid and its possible mechanism of action in amelioration of intracerebroventricular streptozotocin induced neurodegeneration in Wistar rats. The rhizomes of V. wallichii were powdered coarsely and extracted by percolation method using dichloromethane. Wistar rats (220–250 g) of either sex were divided into 5 groups, comprising 6 animals each. Valeric acid was isolated from plant extract and characterized using FT-IR. Picrotoxin (2 mg/kg) was used as GABA-A antagonist. Intracerebroventricular streptozotocin administration caused significant (p < 0.05) increase in escape latency, retention transfer latency on morris water maze on 17th, 18th, 19th and 20th day and elevated plus maze on 19th and 20th day respectively, as compared to normal untreated rats. Treatment with V. wallichii extract 100 and 200 mg/kg and valeric acid 20 and 40 mg/kg significantly decreased the escape latency and retention transfer latency, as compared to intracerebroventricular-streptozotocin group. Plant extract and valeric acid also decreased the level of lipid peroxidation and restored glutathione level in rat brains. Administration of picrotoxin significantly reversed the effects produced by plant extract and valeric acid in intracerebroventricular-streptozotocin treated rats. The findings may conclude that valeric acid present in V. wallichii has significant GABAergic effect in amelioration of experimental dementia.
... Valeriana wallichii has considerable reputation for its traditional use in inflammatory conditions such as scorpion stings and jaundice (Nadkarni, 1976) and in pain conditions (Vohora & Dandiya, 1992) epilepsy, insomnia, neurosis, sciatica (Nadkarni, 1976;Marder, et al., 2003). The plant is widely used in the treatment of anxiety and depression either alone or in combination with other herbs specifically St. John's Wort (Ron et al., 2000;Panijel, 1985;Leathwood & Chauffard, 1982). The plant is also used in habitual constipation (Baquar, 1989), antispasmodic (Gilani et al., 2005) and as cytotoxic (Bos, et al., 1986). ...
Article
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Valeriana wallichii DC (Valerianaceae) is an indigenous medicinal plant used in ethno medicine for the treatment of habitual constipation, insomnia, epilepsy, neurosis, anxiety and as a diuretic, hepatoprotective, analgesic and cytotoxic. The aqueous extract (Aq.Ext) and methanolic extract (Me.Ext) were subjected to anti-inflammatory activity using experimental animal model of carrageenan induced paw oedema in the presence of control for comparison. The results showed that both Aq and Me extracts significantly ameliorate oedema comparable to reference standard, aspirin. The results of this study explicate justification of the use of this plant in the treatment of inflammatory disease conditions.
... [3,5] The plant is widely used in the treatment of anxiety and depression either alone or in combination with other herbs, specifically St. John's Wort. [4,10,11] The plant is also used in habitual constipation, [12] antispasmodic [13] and as cytotoxic. [14] An herbal preparation (Dhanya Panchaka Kashaya), containing Valeriana wallichii has been found to be effective in dyspeptic symptoms. ...
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Preparations of herbal drugs have drawn considerable interest in scientific community in recent years for the treatment of several stress related health problems including radiation-injury. An aqueous extract from Valeriana wallichii containing hesperidin as one of its major constituent was evaluated for its ability to protect against radiation-injury in model systems like plasmid deoxyribonucleic acid (DNA) and cultured human fibroblast cells. The extract was found to significantly counter radiation-induced free radicals at 4 h after 5 Gy irradiation, reduced prolonged oxidative stress led increase in mitochondrial mass, enhanced reproductive viability of cultured cells and protected against radiation-induced DNA damage in solution. Further studies are required to validate the radioprotective ability of the extract and to develop a safer radioprotective agent.
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Anxiety disorders are a very common mental health problem in the community. Most of the medications used to treat anxiety have side effects. Valerian is a phytotherapeutic medication frequently used for insomnia. The aim of this study was to investigate the efficacy and safety of valerian for anxiety disorders. Only one study was identified, involving 36 patients and comparing valerian with placebo and diazepam. This study found no significant differences in effectiveness between valerian and placebo, or between valerian and diazepam, for clinician-rated anxiety symptoms, and that both valerian and diazepam were equally well tolerated by patients. However, additional studies with larger numbers of patients are necessary before drawing conclusions about the effectiveness and safety of valerian as a treatment option for anxiety disorders.
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To review the evidence for the effectiveness of complementary and self-help treatments for anxiety disorders. Systematic literature search using PubMed, PsycLit, and the Cochrane Library. 108 treatments were identified and grouped under the categories of medicines and homoeopathic remedies, physical treatments, lifestyle, and dietary changes. We give a description of the 34 treatments (for which evidence was found in the literature searched), the rationale behind the treatments, a review of studies on effectiveness, and the level of evidence for the effectiveness studies. The treatments with the best evidence of effectiveness are kava (for generalised anxiety), exercise (for generalised anxiety), relaxation training (for generalised anxiety, panic disorder, dental phobia and test anxiety) and bibliotherapy (for specific phobias). There is more limited evidence to support the effectiveness of acupuncture, music, autogenic training and meditation for generalised anxiety; for inositol in the treatment of panic disorder and obsessive-compulsive disorder; and for alcohol avoidance by people with alcohol-use disorders to reduce a range of anxiety disorders.
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St. John's wort is an herb commonly used in Europe for decades and more recently the topic of scientific investigation in this country. St. John's wort has been found more effective than placebo and equally as effective as tricyclic antidepressants in the short-term management of mild-to-moderate depression. Comparisons to selective serotonin reuptake inhibitors have provided equivocal data. While it is generally well tolerated in clinical use, there is accumulating evidence of significant interactions with drugs. This evidence-based presentation of the literature includes a brief description of pharmacodynamics and clinical applications, followed by a systematic review of adverse effects, toxicity, and drug interactions.
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St John's wort (SJW) was introduced into Australia during the 1880s for medicinal purposes, but was subsequently declared a noxious weed. There is now a resurgence of interest in the therapeutic properties of this herb. In particular, use of SJW as an antidepressant has increased in recent months owing to reports of its effectiveness and safety. Nevertheless, the controlled trials available have limitations. Increasing use of SJW in the community poses a variety of questions. For example, should medical practitioners become more knowledgeable about the effects and interactions of alternative remedies? What are the ethical and medical implications of "antidepressant" prescribing by non-medical persons? Who is to fund further research and treatment studies? How can quality of SJW preparations be guaranteed?
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This article aims to summarize the current state of knowledge on St. John's wort (Hypericum perforatum L.) which is one of the oldest and best investigated medicinal herbs. Dried alcoholic extracts are the most important preparations on the market although a variety of other preparations are available. Depressive disorders according to modern diagnostic standards are the best known and most widely investigated indication although the more traditional, broader indication of 'psycho-vegetative disorders, depressive disorders, anxiety and/or nervous agitation', including diagnoses such as somatoform disorders, might more adequately describe what Hypericum extracts are actually used for by many practitioners. The exact mechanisms of action are still unclear, but the available research clearly shows that various bioactive constituents contribute to the clinical effects reported, often in a synergistic manner. Hypericum extracts have consistently shown activity in pharmacological models related to antidepressant effects. Randomized clinical trials show that Hypericum extracts are more effective than placebo and similarly effective as standard antidepressants while having better tolerability in the acute treatment of major depressive episodes. The most important risk associated with Hypericum extracts are interactions with other drugs. Therefore, physicians need to be informed whether their patients take St. John's wort products. If the risk of interactions is adequately taken into account, high quality Hypericum extracts are an effective and safe tool in the hand of qualified health profession-als in primary care.
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The proposed volume will assist practicing mental health professionals in expanding their knowledge about nutritional and herbal interventions that can be attempted as alternatives to prescription medications. Designed to provide guidance for non-medical caregivers treating children and adolescents who present with emotional and/or behavioral difficulties such as such as depression, anxiety, ADHD, sleep difficulties, impulsivity, distractibility, and other psychological and psychiatric disorders, the volume provides a comprehensive discussion of naturopathic solutions based on existing research. In areas where research is not extensive, conclusions will be provided about potentially beneficial effects based on the specific pharmacologic action of the compounds. Dosage for specific age groups, schedules of administration, dietary considerations (i.e., whether or not to take the supplement with food), monitoring for response and adverse effects, signs of dangerous reactions, and the need to control interactions with other compounds (i.e., prescription medications) will be thoroughly reviewed with regard to each supplement discussed in the book. Reviews specific psychological disorders (i.e. ADHD, depression, mania, anxiety, sleep difficulties, tic behaviors and autism) and the available data about their treatment with the use of nutritional and herbal supplements. Provides rationale for the use of every specific compound with detailed recommendations tailored for each age group with regard to the dosage, frequency of administration, possible dangers and monitoring for side effects. Discusses claims of efficacy used to market various products and ground those claims within fully vetted scientific research. Discusses neurobiology, pharmacodynamics and pharmokinetics in detailed but accessible language *Non-medical clinicians with limited knowledge of medicine and pharmacology come away with understanding of key issues involved in Fully covers assessment, diagnosis & treatment of children and adolescents, focusing on evidence-based practices *Consolidates broadly distributed literature into single source and specifically relates evidence-based tools to practical treatment, saving clinicians time in obtaining and translating information and improving the level of care they can provide Detailed how-to explanation of practical evidence-based treatment techniques *Gives reader firm grasp of how to more effectively treat patients Material related to diversity (including race, ethnicity, gender and social class) integrated into each chapter *Prepares readers for treating the wide range of youth they will encounter in practice.
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There is a lack of basic knowledge on the part of both clinicians and patients as to the indications for use and safety of herbal medicines in pregnancy and lactation. This is one article in a series that systematically reviews the evidence for commonly used herbs during pregnancy and lactation. To systematically review the literature for evidence on the use, safety, and pharmacology of St. John's wort focusing on issues pertaining to pregnancy and lactation. We searched 7 electronic databases and compiled data according to the grade of evidence found. There is very weak scientific evidence based on a case report that St Johns wort is of minimal risk when taken during pregnancy. There is in vitro evidence from animal studies that St John's wort during pregnancy does not affect cognitive development nor cause long-term behavioral defects, but may lower offspring birth weight. There is weak scientific evidence that St. John's wort use during lactation does not affect maternal milk production nor affect infant weight, but, in a few cases, may cause colic, drowsiness or lethargy. There is weak scientific evidence that St John's wort induces CYP450 enzymes, which may lower serum medication levels below therapeutic range; this may be of concern when administering medications during pregnancy and lactation. Caution is warranted with the use of St John's wort during pregnancy until further high quality human research is conducted to determine its safety. St John's wort use during lactation appears to be of minimal risk, but may cause side effects. Caution is warranted when using medications along with St John's wort.
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