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Herbal medicines in the treatment of psychiatric disorders: 10-year updated review
Abstract
This paper provides a 10‐year update of the 2007 systematic review of herbal medicines studied in a broad range of psychiatric disorders, including depression, anxiety, obsessive–compulsive, seasonal affective, bipolar, psychotic, phobic, somatoform, and attention‐deficit hyperactivity disorders. Ovid Medline, PubMed, and the Cochrane Library were searched for herbal medicines with both pharmacological and clinical evidence of psychotropic activity. This updated review now covers clinical trial evidence for 24 herbal medicines in 11 psychiatric disorders. High‐quality evidence was found to exist for the use of Piper methysticum (Kava), Passiflora spp. (passionflower) and Galphimia glauca (galphimia) for anxiety disorders; and Hypericum perforatum (St John's wort) and Crocus sativus (saffron) for major depressive disorder. Other encouraging herbal medicines with preliminary evidence include Curcuma longa (turmeric) in depression, Withania somnifera (ashwagandha) in affective disorders, and Ginkgo biloba (ginkgo) as an adjunctive treatment in Schizophrenia. Although depression and anxiety are commonly researched, many other mental disorders still require further prospective investigation. Although the previous review suggested increasing the adjunctive study of select herbal medicines with pharmaceuticals, this was still only found to sparingly occur in research designs. Aside from this, future focus should involve the incorporation of more biomarker analysis, in particular pharmacogenomics, to determine genetic factors moderating response to herbal medicines.
... Oxidative and nitrosative damage also cause neurodegeneration, apoptosis, and reduction of neurogenesis and neuronal plasticity, leading to mitochondrial alterations, mitochondrial DNA damage, and a reduction of ATP production [14,[20][21][22][23][24][25]. In the case of the relationship between depression and oxidative stress, some drugs can reduce the increase in markers of oxidative stress while producing a regulated increase in Nrf2, which is involved in the expression of different genes and antioxidant enzymes [20]. ...
... Oxidative and nitrosative damage also cause neurodegeneration, apoptosis, and reduction of neurogenesis and neuronal plasticity, leading to mitochondrial alterations, mitochondrial DNA damage, and a reduction of ATP production [14,[20][21][22][23][24][25]. In the case of the relationship between depression and oxidative stress, some drugs can reduce the increase in markers of oxidative stress while producing a regulated increase in Nrf2, which is involved in the expression of different genes and antioxidant enzymes [20]. In this context, compounds with antioxidant properties could be of interest in the treatment of depression. ...
... Another example is the phenolic curcumin, which has been shown to regulate NO levels, possibly through the inhibition of iNOS, as well as the activity of nNOS in humans. Since NO is elevated in patients with major depression, a decrease in these levels could induce antidepressant effects, especially through the modulation exerted by NO on the production of neurotransmitters such as NA, 5-HT, and DA [20]. Consistent with these results, studies have found that the administration of cytokines induces behavioral changes through MAOs, modifying their uptake from the synaptic cleft into presynaptic neurons or modifying the transport, such as serotonin transporter (SERT), selective serotonin reuptake inhibitor (SSRI) or selective serotonin reuptake enhancer (SSRE) [27][28][29]. ...
Depression is a syndrome characterized by deep sadness and the inhibition of psychic functions, sometimes accompanied by neurovegetative disorders, with symptoms of anxiety almost always present. The disease produces alterations in a variety of neural networks and neurotransmission systems, along with a dysfunction of the hypothalamic-pituitary-adrenal axis, which leads to concomitant alterations in the immunological response. Generally, there is a parallel increase in proinflammatory mediators as well as oxidative and nitrosative damage caused by a reduction of antioxidant defenses. In a previous review, we compiled and examined studies of medicinal plants that had been evaluated in preclinical assays, including existing data on 155 species studied and reported as antidepressants or as sources of active principles for treating this condition. This review will thus limit its focus to the 95 clinical trials found in PubMed among the 670 articles on antidepressant-like medicinal plants. To this end, we have reviewed the publications cited in the Cochrane Database of Systematic Reviews, PubMed, and the Science Citation Index from 2000 to 2020. Our review emphasizes those species that have demonstrated the greatest pharmacological potential when studied for their antidepressant properties in humans through clinical trials. Saffron, turmeric, St. Johnʼs wort, ginkgo, kava, and golden root are the most relevant plants that have provided important evidence for the treatment of depression in clinical trials.
... Many herbal substances have demonstrated antidepressant effects in preclinical and clinical studies, often with similar mechanisms to that of standard antidepressants (Fajemiroye et al., 2016;Sarris, 2018). Additionally, these preparations may exhibit multi-target mechanisms of action on many different neurobiological processes implicated in MDD (Fajemiroye et al., 2016;Sarris, 2018). ...
... Many herbal substances have demonstrated antidepressant effects in preclinical and clinical studies, often with similar mechanisms to that of standard antidepressants (Fajemiroye et al., 2016;Sarris, 2018). Additionally, these preparations may exhibit multi-target mechanisms of action on many different neurobiological processes implicated in MDD (Fajemiroye et al., 2016;Sarris, 2018). While most of these natural substances show potential as monotherapy, others indicate more favourable results when combined with traditional antidepressants (Akhondzadeh et al., 2003). ...
... monoamines, neurotrophins, immune-inflammatory components etc (Brand et al., 2015), study additional behavioural parameters akin to MDD, e.g. anxiety, anhedonia, cognition, and investigate its possible synergistic actions when combined with traditional treatments (Dodd et al., 2005;Sarris, 2018). Albeit preliminary, this is the first investigation of Zembrin® versus an SSRI in a genetic rodent model of MDD that provides an evidence-based ethnopharmacological basis for the traditional and modern day use of Sceletium tortuosum in the treatment of mood disorders. ...
Ethnopharmacological relevance
Sceletium tortuosum (L.) N.E.Br. (ST) has been used by the Khoisan people of South Africa as a mood elevator. Its various pharmacological mechanisms of action suggest distinct potential as an antidepressant. Clinical studies in healthy individuals suggest beneficial effects on mood, cognition, and anxiety.
Aim of the study
To obtain a chromatographic fingerprint of a standardized extract of S. tortuosum (Zembrin®), and to evaluate the acute antidepressant-like properties of Zembrin® versus the reference antidepressant, escitalopram, in the Flinders Sensitive Line (FSL) rat, a genetic rodent model of depression.
Materials and methods
The chemical profile of Zembrin® was determined by ultra-performance liquid chromatography-mass spectrometry (UPLC-MS) chromatogram method using alkaloid standards. Twelve saline treated FSL and six Flinders Resistant Line (FRL) control rats were used to confirm face validity of the FSL model using the forced swim test (FST). Thereafter, FSL rats (n = 10) received either 5, 10, 25, 50 or 100 mg/kg of Zembrin®, or 5, 10 or 20 mg/kg escitalopram oxalate (ESC), both via oral gavage, and subjected to the open field test (OFT) and FST.
Results
Four main ST alkaloids were identified and quantified in Zembrin® viz. mesembrenone, mesembrenol, mesembrine, and mesembranol (47.9%, 32%, 13.2%, and 6.8% of the total alkaloids, respectively). FSL rats showed significantly decreased swimming and climbing (coping) behaviours, and significantly increased immobility (despair), versus FRL controls. ESC 5 mg/kg and Zembrin® 25 mg/kg and 50 mg/kg showed significant dose-dependent reversal of immobility in FSL rats and variable effects on coping behaviours. Zembrin® 50 mg/kg was the most effective antidepressant dose, showing equivalence to ESC 5.
Conclusions
Zembrin® (25 and 50 mg/kg) and ESC (5 mg/kg) are effective antidepressants after acute treatment in the FST. Moreover, Zembrin® 50 mg/kg proved equivalent to ESC 5. Further long-term bio-behavioural studies on the antidepressant properties of Zembrin® are warranted.
... are beginning to understand and appreciate the merits of using traditional medicines and countries such as China and India have already incorporated their traditional system of medicine into their healthcare system, or are working to do so [15], [83], [86], [109], [173], [197], [384]. ...
... Forskolin ↑ cAMP availability [6], [9], [124], [140], [144], [162], [200], [450], [461], [13], [35], [40], [79], [82], [83], [94], [ Works with the noradrenergic, dopaminergic, and serotonergic systems; Possibly through restoration of brain monoamines [6], [40], [164], [200], [276], [309], [352], [354], [401], [431], [454], [55], [65], [71], [77], [83], [98], [103], [142] [6], [44], [56], [76], [79], [82], [83], [109], [112], [116], [133], [9], [143], [144], [162], [164], [168], [188], [195], [401], [431], [439], [11], [442], [446], [449], [456], [464], [466], [473], [13], [22], [29], [32], [37], [40] Crocus sativus Saffron [5], [6], [24], [29], [30], [32]- [36], [38], [39], [7], [40], [41], [43], [44], [46], [51], [61], [65], [74], [82], [9], [83], [89], [98]- [100], [103], [104], [109], [110], [112], [10], [113], [116], [120]- [124], [128], [132], [140], [11], [144], [147], [148], [156], [158], [159], [162]- [165], [12], [166]- [168], [176], [181], [188], [194], [195], [200], [203], [13], [268], [276], [309], [310], [336], [337], [354], [373], [385], [386], [15], [401], [410], [412], [416], [428], [430], [433], [435]- [437], [23], [443], [444], [449], [454], [455], [459], [463], [473], [476], [477] Dactylicapnos scandens Zi jin long Nepal protopine ↓ SERT and ↓ NET [293], [388], [420] PAST [5], [6], [43], [44], [51], [56], [62], [71], [73], [74], [82], [83], [11], [94], [98], [103], [106], [109], [123], [125], [136], [159], [162], [13], [164], [188], [194], [198], [200], [276], [309], [316], [362], [375], [29], [385], [401], [412], [416], [439], [463], [30], [33], [35], [40], [41] Epimedium brevicornum [39], [164], [167], [200], [354], [412], [446], [452], [453], [472] Eugenia brasiliensis syn. Eugenia uniflora Brazilian cherry or grumichama South America Essential oil Worked with serotonergic (5-HT3, 5-HT2A, and 5-HT1A) receptors, NE (α1 and α2) receptors, and DA (D1 and D2) receptors. ...
... [5], [13], [142], [153], [163], [183], [200], [291], [295], [390], [401], [402], [15], [411], [478], [17], [36], [40], [46], [65], [102], [140] Gastrodia [13], [354], [401], [412], [442], [43], [58], [137], [200], [276], [309], [316], [336] Gentiana kochiana [5], [6], [29], [30], [34], [36], [38]- [41], [43], [44], [7], [51], [56], [76], [82], [83], [85], [88], [94], [98], [103], [9], [109], [110], [112], [121], [123], [124], [128], [136], [143], [144], [10], [148], [154], [162], [164], [166], [181], [188], [200], [276], [277], [11], [278], [301], [309], [390], [401], [410], [412], [416], [426], [444], [12], [446], [450], [461], [473], [477], [13], [22], [ [82], [98], [109], [112], [124], [144], [149], [164], [166], [188], [9], [197], [200], [277], [309], [336], [342], [354], [401], [410], [412], [12], [416], [452], [453], [477], [13], [24], [40], [43], [44], [65] Gossypium herbaceum ...
Mental illness has long been a part of human history; however, not as long as humans have been using plants for medicinal purposes. Medicinal plants are the source of over 50% of our medications today. Several countries integrate traditional systems of medicine (homeopathic medicine) with international systems of medicine. However, the presence of medicinal plants for anxiolytic and anti-depressant medications is sorely lacking. This is despite a 30-year gap between the last new medications for anxiety and depressive disorders and the availability of ketamine in 2019. Several gaps and lack of access to research regarding the potential benefits of using medicinal plants as anxiolytic and antidepressant solutions create even more difficulties for researchers. In addition to this, the cost of development associated with creating new medications within this field of medicine is incredibly resource and time-intensive. Despite this level of stagnation pharmaceutical companies are still hesitant to approach medicinal plants and phytochemicals as potential sources of pharmaceutical interest. A hesitancy that seems to be echoed by several nations despite the vast amounts of money lost due to symptoms caused by anxiety and depressive disorders. This paper takes an in-depth look at all the issues listed above and more, analyzing the merit of researching/using medicinal plants for anxiolytic and antidepressant purposes, in the past, present, and potentially the future.
... Introduction hypericin and hyperforin, which have antidepressant, antiviral, and antimicrobial activity. There are many commercial products for internal (herbal teas, tablets) or external use (oil extractions, tinctures) [3], the highest in demand being those of H. perforatum [4][5]. Although generally considered as safe, there are concerns about the potential side effects when used in combination with other drugs [5]. ...
... There are many commercial products for internal (herbal teas, tablets) or external use (oil extractions, tinctures) [3], the highest in demand being those of H. perforatum [4][5]. Although generally considered as safe, there are concerns about the potential side effects when used in combination with other drugs [5]. Hypericum is one of the largest genera of angiosperms with over 500 species, classified in 36 sections [6]. ...
Plants of the genus Hypericum, commonly known as “St. Johnʼs wort” (“spathohorto” or “valsamo” in Greek), have been used since antiquity for their therapeutic properties. Wild-harvested Hypericum plants are still popular today in herbal medicines, commercially exploited due to their bioactive compounds, hypericin and hyperforin, which have antidepressant, antimicrobial and antiviral activity. Species identification of commercial products is therefore important and DNA barcoding, a molecular method that uses small sequences of organismsʼ genome as barcodes, can be useful in this direction. In this study, we collected plants of the genus Hypericum that grow wild in North-Eastern Greece and explored the efficiency of matK, and trnH-psbA regions as DNA barcodes for their identification. We focused on 5 taxa, namely H. aucheri, H. montbretii, H. olympicum, H. perforatum subsp. perforatum, and H. thasium, the latter a rare Balkan endemic species collected for the first time from mainland Greece. matK (using the genus-specific primers designed herein), trnH-psbA, and their combination were effectively used for the identification of the 5 Hypericum taxa and the discrimination of different H. perforatum subsp. perforatum populations. These barcodes were also able to discriminate Greek populations of H. perforatum, H. aucheri, H. montbretii, and H. olympicum from populations of the same species growing in other countries.
... The ancestral traditional medical systems worldwide have widely used medicinal plants for the treatment of different ailments, including neurological disorders. Recent review reports have described the use of psychoactive medicinal plants and herbal formulations for treatment of different neurological disorders [53][54][55][56][57][58]. Among the medicinal plants with neurological effects, a prominent example is Banisteriopsis caapi, a woody vine plant that generally grows in the Amazonian basin. ...
... B. caapi contains beta-carbolines, which have therapeutic properties for neurological disorders [60][61][62]. Other notable examples are Pegnanum harmala (wild rue), Rhodiola rosea (roseroot), and Crocus sativus (saffron) for depression; Passiflora incarnata (passionflower), Scutellaria lateriflora (scullcap), Gingko biloba (gingko), and Zizyphus jujuba (jujube) for early dementia and anxiety disorders; and Piper methysticum (kava-kava) for phobic, panic, and obsessive-compulsive disorders [53,54]. Moreover, many species of mind-altering (psychodysleptic) plants have been used by humans throughout the planet to reach mind distortion states; among those, a few examples have been utilized for therapeutic aims, including Cannabis sativa (cannabis), Tabernanthe iboga (iboga), psychotria viridis (chacruna), and Papaver somniferum (opium poppy) [63]. ...
Monoamine oxidase inhibitors (MAOIs) are an important class of drugs prescribed for treatment of depression and other neurological disorders. Evidence has suggested that patients with atypical depression preferentially respond to natural product MAOIs. This review presents a comprehensive survey of the natural products, predominantly from plant sources, as potential new MAOI drug leads. The psychoactive properties of several traditionally used plants and herbal formulations were attributed to their MAOI constituents. MAO inhibitory constituents may also be responsible for neuroprotective effects of natural products. Different classes of MAOIs were identified from the natural product sources with non-selective as well as selective inhibition of MAO-A and -B. Selective reversible natural product MAOIs may be safer alternatives to the conventional MAOI drugs. Characterization of MAO inhibitory constituents of natural products traditionally used as psychoactive preparations or for treatment of neurological disorders may help in understanding the mechanism of action, optimization of these preparations for desired bioactive properties, and improvement of the therapeutic potential. Potential therapeutic application of natural product MAOIs for treatment of neuroblastoma is also discussed.
... This poses a serious risk for possible drug interactions and toxicity, e.g. serotonin syndrome when SSRIs are co-administered with for instance Saint John's wort (Sarris, 2018). Given the serotonergic actions of ST (Table 4) (Harvey et al., 2011), and similar supportive evidence from our laboratory (Gericke, 2020), such studies need to be undertaken. ...
... Given the serotonergic actions of ST (Table 4) (Harvey et al., 2011), and similar supportive evidence from our laboratory (Gericke, 2020), such studies need to be undertaken. These real-world issues, plus that plant constituents may have interacting effects with one another, warrant dedicated research into the pharmacokinetic and pharmacological profiles of herbal medicines (Sarris, 2018). Such studies need to be carried out with S. tortuosum. ...
Ethnopharmacological relevance
Sceletium tortuosum (L.) N.E.Br., the most sought after and widely researched species in the genus Sceletium is a succulent forb endemic to South Africa. Traditionally, this medicinal plant is mainly masticated or smoked and used for the relief of toothache, abdominal pain, as a mood-elevator, analgesic, hypnotic, anxiolytic, thirst and hunger suppressant, and for its intoxicating/euphoric effects. Sceletium tortuosum is currently of widespread scientific interest due to its clinical potential in treating anxiety and depression, relieving stress in healthy individuals, and enhancing cognitive functions. These pharmacological actions are attributed to its phytochemical constituents referred to as mesembrine-type alkaloids.
Aim of the review
The aim of this review was to comprehensively summarize and critically evaluate recent research advances on the phytochemistry, pharmacokinetics, biological, pre-clinical and clinical activities of the medicinal plant S. tortuosum. Additionally, current ongoing research and future perspectives are also discussed.
Methods
All relevant scientific articles, books, MSc and Ph.D. dissertations on botany, behavioral pharmacology, traditional uses, and phytochemistry of S. tortuosum were retrieved from different databases (including Science Direct, PubMed, Google Scholar, Scopus and Web of Science). For pharmacokinetics and pharmacological effects of S. tortuosum, the focus fell on relevant publications published between 2009 and 2021.
Results
Twenty-five alkaloids belonging to four structural classes viz: mesembrine, Sceletium A4, joubertiamine, and tortuosamine, have been identified from S. tortuosum, of which the mesembrine class is predominant. The crude extracts and commercially available standardized extracts of S. tortuosum have displayed a wide spectrum of biological activities (e.g. antimalarial, anti-oxidant, neuromodulatory, immunomodulatory, anti-HIV, neuroprotection) in in vitro or in vivo studies. While the plant has been studied in clinical populations, this has only been in healthy subjects, so that further study in pathological states remains to be done. Nevertheless, the aforementioned studies have demonstrated that S. tortuosum has potential for enhancing cognitive function and managing anxiety and depression.
Conclusion
As an important South African medicinal plant, S. tortuosum has garnered many research advances on its phytochemistry and biological activities over the last decade. These scientific studies have shown that S. tortuosum has various bioactivities. The findings have further established the link between the phytochemistry and pharmacological application, and support the traditional use of S. tortuosum in the indigenous medicine of South Africa.
... This poses a serious risk for possible drug interactions and toxicity, e.g. serotonin syndrome when SSRIs are co-administered with for instance Saint John's wort (Sarris, 2018). Given the serotonergic actions of ST (Table 4) (Harvey et al., 2011), and similar supportive evidence from our laboratory (Gericke, 2020), such studies need to be undertaken. ...
... Given the serotonergic actions of ST (Table 4) (Harvey et al., 2011), and similar supportive evidence from our laboratory (Gericke, 2020), such studies need to be undertaken. These real-world issues, plus that plant constituents may have interacting effects with one another, warrant dedicated research into the pharmacokinetic and pharmacological profiles of herbal medicines (Sarris, 2018). Such studies need to be carried out with S. tortuosum. ...
Ethnopharmacological relevance
Sceletium tortuosum (L.) N.E.Br, the most sought after and widely researched species in the genus Sceletium is a succulent forb endemic to South Africa. Traditionally, this medicinal plant is mainly masticated or smoked and used for the relief of toothache, abdominal pain, and as a mood-elevator, analgesic, hypnotic, anxiolytic, thirst and hunger suppressant, and for its intoxicating/euphoric effects. Sceletium tortuosum is currently of widespread scientific interest due to its clinical potential in treating anxiety and depression, relieving stress in healthy individuals, and enhancing cognitive functions. These pharmacological actions are attributed to its phytochemical constituents referred to as mesembrine-type alkaloids.
Aim of the review
The aim of this review was to comprehensively summarize and critically evaluate recent research advances on the phytochemistry, pharmacokinetics, biological and clinical activities of the medicinal plant S. tortuosum. Additionally, current ongoing research and future perspectives are also discussed.
Methods
All relevant scientific articles, books, MSc and Ph.D. dissertations on botany, behavioral pharmacology, traditional uses, and phytochemistry of S. tortuosum were retrieved from different databases (including Science Direct, PubMed, Google Scholar, Scopus and Web of Science). For pharmacokinetics and pharmacological effects of S. tortuosum, the focus fell on relevant publications published between 2009 and 2021.
Results
Twenty-five alkaloids belonging to four structural classes viz: mesembrine, Sceletium A4, joubertiamine, and tortuosamine, have been identified from S. tortuosum, of which the mesembrine class is predominant. The crude extracts and commercially available standardized extracts of S. tortuosum have displayed a wide spectrum of biological activities (e.g. antimalarial, anti-oxidant, immunomodulatory, anti-HIV, neuroprotection, enhancement of cognitive function) in in vitro or in vivo studies. This plant has not yet been studied in a clinical population, but has potential for enhancing cognitive function, and managing anxiety and depression.
Conclusion
As an important South African medicinal plant, S. tortuosum has garnered many research advances on its phytochemistry and biological activities over the last decade. These scientific studies have shown that S. tortuosum has various bioactivities. The findings have further established the link between the phytochemistry and pharmacological application, and support the traditional use of S. tortuosum in the indigenous medicine of South Africa.
... Esta planta é um estimulante neurológico, constituído pelos fenilpropanóides rosavina, rosina e rosarina. A sua atividade antidepressiva ocorre por via da modulação da monoaminaoxidase-A e modulação do cortisol(SARRIS, 2018).Editora e-Publicar -Science e Saúde: Atuação multiprofissional a área da saúde, Volume 1 330 Extratos das folhas desta planta podem aumentar os níveis de serotonina no hipocampo. Estes, promovem também a proliferação e reparação de células estaminais no hipocampo(LIU et al., 2016). ...
... Os extratos de R. rosea medeiam mais de 50 genes envolvidos na regulação do comportamento, humor e transtornos depressivos, tais como, genes que codificam os receptores acoplados à proteína G localizados nas membranas celulares e desempenham uma função importante na transmissão de sinais de muitos hormônios e neurotransmissores.Pesquisadores apontaram que um extrato de 1500 mg/kg das folhas de R. rosea aumentou os níveis de serotonina e promoveu a proliferação e diferenciação de células estaminais no hipocampo de ratos induzidos por stress, processo que pode ter um possível papel na reparação dos neurónios do hipocampo danificados(AMSTERDAM & PANOSSIAN, 2016).Outra espécie também utilizada contra a depressão é a Curcuma longa, conhecida popularmente como açafrão-da-terra(OOKO et al., 2017). A parte mais utilizada desta espécie medicinal é o seu rizoma, que normalmente é consumido em pó(YADAV & TARUN, 2017).O principal constituinte ativo da espécie C. longa é a curcumina, que possui um forte potencial anti-inflamatório, antioxidante, neuroprotetor e com atividade monoaminérgica e modulatória(SARRIS, 2018). Um ensaio randomizado, duplo-cego, controlado por placebo estudou o efeito antidepressivo combinado do extrato dos rizomas de C. longa com C. sativus(açafrão-verdadeiro), em 123 indivíduos com depressão, durante 12 semanas. ...
... This poses a serious risk for possible drug interactions and toxicity, e.g. serotonin syndrome when SSRIs are co-administered with for instance Saint John's wort (Sarris, 2018). Given the serotonergic actions of ST (Table 4) (Harvey et al., 2011), and similar supportive evidence from our laboratory (Gericke, 2020), such studies need to be undertaken. ...
... Given the serotonergic actions of ST (Table 4) (Harvey et al., 2011), and similar supportive evidence from our laboratory (Gericke, 2020), such studies need to be undertaken. These real-world issues, plus that plant constituents may have interacting effects with one another, warrant dedicated research into the pharmacokinetic and pharmacological profiles of herbal medicines (Sarris, 2018). Such studies need to be carried out with S. tortuosum. ...
... To obtain a half kilogram of pure saffron, nearly 200,000 dried stigmas are required [24]. Clinical trials are being conducted to evaluate the effectiveness of saffron against mild depression [25]. Scientists have investigated the antiinflammatory and antinociceptive properties of different parts of stigma flower including petals and stigmas [26]. ...
... This open-field apparatus was placed in a soundattenuated room, and mice were acclimatized in the dim red light for 1 h before the initiation of the experiment. Mice were categorized into negative control group (distilled water; 10 mL/kg), positive control group (diazepam; 0.5 mg/kg), crude saffron stigma extract-treated groups (15,25,50, and 100 mg/kg), and saffron flower stigmabased gold nanoparticles-treated groups (2.5, 5, and 10 mg/kg). After 30 min administration of respective treatment, each mouse was placed in the center of the apparatus for 10 min, and the number of lines crossed by each mouse was counted and noted [31]. ...
Currently, nanotechnology is gaining massive attention compared to conventional methods as the biosynthesis of plant-based nanoparticles is considered safe, effective, and ecofriendly. Therefore, keeping in view the importance of nanotechnology, the present study was designed to synthesize, characterize, and evaluate the biological effectiveness of saffron stigma-based gold nanoparticles (SS-AuNPs) for their in vitro and in vivo biological properties. These gold nanoparticles were characterized by UV–Vis spectroscopy, Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and X-ray diffraction (XRD). The highest antibacterial effect was observed by the saffron extract against Escherichia coli (22 mm). SS-AuNPs significantly inhibited the activity of enzyme urease (54.98%) and CA-II (64.29%). However, the nonsignificant inhibitory effect was observed in the case of α-chymotrypsin. Maximum analgesic (84.98%) and antiinflammatory (88.98%) effects were observed for SS-AuNPs (10 mg/kg). Similarly, SS-AuNPs demonstrated a significant ( P < 0.01) sedative effect at all tested doses.
... [4] Nowadays, natural products are considered promising therapeutic tools for the management of these conditions, and several studies have been conducted to confirm their efficacy and safety. [5] Recently, lot of efforts have been put in the investigation of the involvement of the endocannabinoid system in the pathophysiology of mood disorders. [6,7] In particular, cannabinoid receptor (CB) 1 activation was demonstrated to affect the glutamatergic synaptic transmission, reducing the hyperexcitability state of neuronal cells, [8] and the increased activity of CB1 receptor was related to the induction of anxiolytic effects. ...
... [25] These results suggested that MOE is a selective and safe anxiolytic agent, not inducing locomotor impairment or excessive sedative effects different to the currently available drugs. [5,34] Honokiol has been studied for its affinity at CB1 and CB2 receptors, being a structural analogue of THC. Rempel and colleagues described that honokiol extracted from M. officinalis bark is a CB1 agonist and a CB2 antagonist. ...
Objectives:
The exposure of neurons to an excessive excitatory stimulation induces the alteration of the normal neuronal function. Mood disorders are among the first signs of alterations in the central nervous system function. Magnolia officinalis bark extract has been extensively used in the traditional medicine systems of several countries, showing several pharmacological activities. Honokiol, the main constituent of M. officinalis, is a GABA modulator and a CB1 agonist, which is deeply investigated for its role in modulating mood disorders.
Methods:
Thus, we evaluated the possible neuroprotective effect of a standardized M. officinalis bark extract (MOE), enriched in honokiol, and its effect on animal mood behavioural tests and in an in vitro model of excitotoxicity.
Key findings:
MOE showed neuroprotective effect using SH-SY5Y cells, by normalizing brain-derived neurotrophic factor release. Then, we tested the effect of MOE in different behavioural tests evaluating anxiety and depression and we observed a selective anxiolytic-like effect. Finally, we confirmed the involvement of CB1 in the final effect of MOE by the co-administration of the CB1 antagonist, AM251.
Conclusion:
These results suggest that MOE could be considered an effective and safe anxiolytic candidate with neuroprotective activity.
... [2] Today, the usage of medicinal plants in the cure of different human psychological disorders has become widespread. [3,4] Herbal drugs have an important role in health care. [5] Iranian traditional medicine (ITM) or Persian medicine has been used for many years in the diagnosis and prevention of diseases. ...
... (lavender) and Rhodiola rosea (roseroot), have also become more or less established for the treatment of depression. 16 Meanwhile, Traditional Chinese medicine (TCM) is one of the most empirical systems of medicine, which has systematically used medicinal plants for disease treatment over centuries. A review of TCM plants therefore could enrich the current candidates for antidepressant drugs development, promote the relative phytochemical and pharmacological research, and eventually support their clinical applications. ...
Depression, which can be accompanied by many fatal diseases and a low life quality, has become the leading cause of ill health and disability worldwide. However, Chinese Pharmacopoeia, the most authoritative and evidence-based encyclopedia of Traditional Chinese Medicine (TCM), could contain leads and insights into the development of new antidepressant drugs. In this work, nine herbal medicines with ‘dispel melancholy functions’ specifically documented in Chinese Pharmacopoeia have been comprehensively reviewed with respect to clinical trials, and phytochemical and pharmacological aspects. The nine drugs are Rosae Chinensis Flos, Croci Stigma, Albiziae Cortex and Flos, Roase Rugosae Flos, Curcumae Radix, Hyperici Perforati Herba, Cyperi Rhizoma and Bupleuri Radix. The mechanisms of action of their functional antidepressant compounds, including gallic acid, hypericin, kaempferol, crocetin, crocin, quercetin, luteolin, isorhamnetin, curcumin, hyperforin, adhyperforin, catechin, rutin, puerarin, and saikosaponins A and D, have been collected and discussed. These traditional Chinese herbs and their active compounds provide a promising resource to develop effective new antidepressant drugs in future. Moreover, mechanistic investigations, safety verification and large-scale clinical trials are still expected to finally transform such TCM-based antidepressant resources to new drugs for patients suffering from depression.
... 100 Several natural products, including constituents of traditional Eastern medicines, have anti-inflammatory properties and have been empirically used for the treatment of depressive symptoms. [101][102][103] These include various natural herbs and/or their ingredients, such as Centella asiatica, Poria cocos, Magnoliae cortex, and Anemarrhenae rhizome that showed anti-inflammatory effects and alleviated stress-induced behaviors. [104][105][106][107][108][109] Centella asiatica revealed anxiolytic, antidepressant, and cognitive improvement effects in mice subjected to chronic stress, potentially via down-regulation of proinflammatory cytokines such as IL-1β, IL-6, and TNF-α in the hippocampus, and inhibition of NF-κBand NLRP3-related inflammatory pathways. ...
Although there are a number of clinically effective treatments for depression, many patients exhibit treatment-resistance. Recent clinical and preclinical studies reveal that peripheral and brain immune changes and inflammation are involved in the pathophysiology of depression. This “Inflamed Brain” research provides critical clues for understanding of disease pathophysiology and many candidate molecules that are potentially useful for identifying novel drug targets for the treatment of depression. In this review, we will present clinical evidence on the role of inflammation in the pathophysiology of depression. We will also summarize current clinical trials which test drugs targeting inflammation for the treatment of patients with depression. Furthermore, we will briefly provide preclinical evidence demonstrating altered immune system function and inflammation in stress-induced animal models and will discuss the future potential of inflammation-related drug targets. Collectively, inflammatory signatures identified in clinical and preclinical studies may allow us to stratify depressive patients based on biotypes, contributing to the development of novel mechanism-based interventions that target specific patient populations.
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... • Depression: Hypericum perforatum and Crocus sativus [32,33]. Montes., et al. (2015) noted that Ginkgo biloba extract, derived from Ginkgo biloba tree leaves, is reputed to help cognitive decline. ...
Psychological disorders are various in their causes and manifestations. Due to exhaustive efforts, the Diagnostic and Statistical Manual of Mental Disorders, 5 th Edition (DSM-V) developed operational definitions of distinct psychological conditions, disorders, determining specific criteria for their diagnoses and treatments. The World Health Organization (through the Mental Health Gap Action Programme and World Mental Health survey) investigated the prevalence of individual psychological conditions and correlations between them. Determining an accurate diagnosis remains the most significant challenge in effectively addressing mental disorders. Also, considering the latest research particularly in epigenetics, more specialized and individualized treatment programs are needed to improve treatment outcomes, ameliorate symptoms, and aid in the recovery from the condition. Medical research has determined that multiple factors can be at play in specific conditions, such as genetics, physiology (hormones), physical environment, social environment, diet, and lifestyle. Not all patients with the same condition and treatment respond similarly. Thus, non-pharmacological methods and modalities are being considered, researched, and applied as monotherapy or adjuncts to conventional pharmaceutical treatment and psychotherapy. In dietary modifications or nutritional supplementation, nutritional intervention is one of the most straightforward methods of addressing nutrition-related mental disorders. Also, proven and time-tested complementary therapies-including acupuncture, aromatherapy, eye movement desensitization reprocessing, herbal medicine, homeopathy, phototherapy, massage therapy, meditation , spiritual healing and prayer, therapy pets, and yoga-can be invaluable aids in lessening symptoms of particular psychological conditions and disorders, as reported herein.
... A gyulladásos fo lyamatokat moduláló készítményekkel kapcsolatban még számos dolog tisztázandó. Ezek közé tartozik a természetes, növényi hatóanyagok használata, amivel kapcsolatban nagyobb nyitottság, szemléletváltás figyelhetô meg a farmakológiában (35,36). Ez abban is megmutatkozik, hogy emelkedik a növényi extraktumokat vizsgáló publikációk száma, és több gyógyszergyár forgalmaz ilyen hatóanyagokat (például levendula-, rózsagyökér-kivonatok). ...
A Covid-19-fertôzés vizsgálata kezdetben-amely leginkább az akut és viszonylag behatárolható idôtartamú szomatikus tüneteket jelentette-a pandémia terjedése folyamán kiterjedt az elhúzódó, szövôd-ményként értelmezhetô tünetekre is. Gyûlnek az adatok a keringést, légzést, véralvadást érintô, valamint a reumatoló-giai, a bôrgyógyászati, a szemészeti követ-kezményekre vonatkoztatva csakúgy, mint a központi idegrendszeri elváltozások okozta akut és elhúzódó tünetekkel kap-csolatban. Eleinte szórványos esetközlé-sek, majd populációs vizsgálatok, állatmo-dellek eredményei voltak olvashatók, a közlemény írásakor pedig már rendszere-zést ígérô, áttekintô írások is megjelentek. A központi idegrendszerben okozott elvál-tozások megnyilvánulhatnak neurológiai tünetekben, megbetegedésekben, és pszi-chiátriai panaszokban, szindrómákban egyaránt. A tüneti skála széles, a patome-chanizmust még nem térképezték fel töké-letesen; ebbôl fakadóan a terápiás próbál-kozások még gyerekcipôben járnak. A neu-ropszichiátriai szövôdmények epidemioló-giai adatai egyelôre hiányosak, de gyors ütemben pontosodnak. Mértéktartó becs-lések szerint is több tízmillió személy érin-tettségét feltételezik világszerte. Az elhú-zódó tünetek gyógyulásának vagy perzisz-tálásának megítéléséhez még nem telt el elég idô. Mindezek miatt jelenleg a legfon-tosabb feladat a vírusterjedés minél haté-konyabb megakadályozásán túl a vírus okozta központi idegrendszeri kórfolya-matok mind pontosabb megismerése és hatékony terápiájuk kidolgozása. Jelenlegi ismereteink szerint a neuropszichiátriai szö vôdmények patomechanizmusa multi-faktoriális. A vírus közvetlen neuron-és gliamûködést károsító hatásán túlmenôen sokkal inkább számolnunk kell az agyi keringészavar, a hiányos oxigenizáció ká-ros következményeivel, valamint kiterjedt szisztémás, elhúzódó immunfolyamatok-kal, amelyek kimutatható módon károsít-ják az agyszövetet, beleértve a neurono-NEUROPSYCHIATRIC COMPLICATIONS OF COVID-19 INFECTION Initially, the studies of COVID-19 infection focused primarily on the acute and subacute somatic symptoms of limited duration, but later on with the spread of the pandemic the scope was extended to prolonged symptoms recognized as complications. Data are mounting about after-effects in circulation, respiration, coagulation, problematic outcomes in rheumatology, dermatology, ophthalmo-logy, as well as about the acute and prolonged symptoms of the dysfunctional central nervous system. Initially, sporadic case reports, later results of population based studies and animal models were available, and the first systematic review articles were emerging during preparation of our survey. Lesions of the central nervous system may manifest themselves both in neurological symptoms and diseases or psychiatric complaints and syndromes. The scale of symptoms is broad, the pathomechanisms are not perfectly mapped thus all therapeutic approaches are in their infancy yet. Epidemiological data of neuropsychiatric complications are incomplete for the time being though they have been rapidly becoming more accurate. Conservative estimates assume tens of millions of people affected worldwide. More time is necessary to assess the persistence or improvement of the prolonged symptoms. Besides every efforts to block the spread of the virus, the utmost importance is to analyze the effects of the virus on the central nervous system and to develop effective treatment strategies. According to our current knowledge, the pathomechanism of neuropsychiatric complications is multifactorial. Beyond the direct deleterious effect of the virus on neuronal and glial functions, more important is that the serious consequences of cerebrovascular dysfunction and poor oxygenation have to be taken into consideration together with extended and prolonged systemic immunological processes , which markedly harm the brain tis-dr. FRECSKA Ede (levelezô szerzô/correspondent): Érkezett: 2021. március 23. Elfogadva: 2021. június 17. h t t p s : / / d o i. o r g / 1 0. 3 3 6 1 6 / l a m. 3 1. 0 1 9 Az alábbi dokumentumot magáncélra töltötték le az eLitMed.hu webportálról. A dokumentum felhasználása a szerzôi jog szabályozása alá esik.
... It has traditional uses as a relaxant (and an inebriant at higher doses) and is used in modern phytotherapy as a treatment for anxiety [219]. ...
Solanum is one of the largest genera of the family Solanaceae comprising > 2000 species distributed mostly in the tropical and subtropical regions of Australia, Africa, and some parts of Asia, such as China, India, and Japan. The nutraceutical and pharmaceutical values of the Solanum species are due to the presence of bioactive phyto-constituents such as steroidal saponins, steroidal alkaloids, terpenes, flavonoids, lignans, sterols, phenolic compounds, coumarins, etc. Among them, the presence of steroidal alkaloids and glycoalkaloids serves as major chemical markers of this genus. Steroidal alkaloids and glycoalkaloids have a special status in traditional and modern systems of medicine possessing a wide range of bioactivities, viz., antimicrobial, analgesic, hepatoprotective, immunomodulatory, anticancer, neurogenetic, etc. Steroidal alkaloids (STAs) are the major class of secondary metabolites found not only in plants but also in higher animals as well as in some aquatic invertebrates. They have a steroidal (cyclopentanophenanthrene) backbone skeleton with a nitrogen atom. The biosynthesis of these alkaloids takes place from steroids or triterpenoid pathway, on the basis of which they are further divided into different classes and subclasses. The present review is focused on the occurrence and biosynthesis of steroidal alkaloids in Solanaceae family. These compounds are mainly triterpene-derived molecules that are involved in various defense responses participating also in formulations of a wide range of phyto-pharmaceuticals. The addition of sugar moieties to the base skeleton by glycosyltransferases resulted in the formation of steroidal glycoalkaloids (STGAs), possessing a wide range of pharmacological values. The accumulation of these bioactive metabolites has been shown to be highly influenced by environmental and geographical factors. Hence, their production via tissue culture always offers an attractive alternate production platform. The current trends and biotechnological tools recently developed for the sustainable production and up-scaling of these bioactive constituents are focused in the present review.
... Research conducted among people with anxiety and mood disorders has shown that nearly half of them use so-called complementary medicine [67]. Their use can often prolong the poor functioning of patients and delay the initiation of adequate treatment based on the principles of EBM (Evidence-Based Medicine) [68,69]. This publication is an example of a population study, the results of which enable the identification of new risk factors for the described disorders and the planning of changes in the scope of health policy, including targeted interventions. ...
The aim of this study was the identification of the risk modifying factors of anxiety and depressive disorders based on a population study. This study was conducted in a randomly selected group of 1659 adult inhabitants of the Żywiec district. Anonymous questionnaires consisting of a proprietary questionnaire and the Hospital Anxiety and Depression Scale (HADS) were used to collect the data. The conducted analysis revealed that the factors increasing the risk of depressive disorders in the studied population were female gender, age over 60, retirement period, primary and vocational education, unemployment, mental work and absolute lack of physical activity, but also daily and intensive sports, heavy smoking, chronic somatic diseases and misuse of sleeping pills and over-the-counter sedatives. Anxiety disorders occurred more often in the group of unemployed, self-employed or retired people. They also occurred more often in the group of people who do not perform any physical activity and use alcohol every day, but also among those who maintain abstinence, regularly smoke tobacco and use stimulants, suffer from somatic diseases and overuse sleeping drugs. Disease preventive factors for anxiety disorders and depression were a constant form of employment, moderate and regular physical activity, avoiding the use of psychoactive substances and the regular treatment of comorbid somatic diseases and insomnia.
... Traditional Chinese medicine can treat anxiety [18][19][20]. The mechanism is intricate and reportedly involves HPA axis regulation or BDNF [21,22]. ...
Chronic stress is a critical factor in the aetiology of anxiety disorders; however, in the clinic, enduring and preventive measures are not available, and therapeutic drugs are associated with inevitable side effects. Our study established an anxiety rat model using chronic restraint stress (CRS) and assessed these animals using the open-field test, elevated plus-maze test, and light-dark box test. Jie-Yu-He-Huan capsule (JYHH), a Chinese medicine formula, was used as a preventative drug. The HPA axis-mediated release of corticotropin-releasing hormone, adrenocorticotropic hormone, and corticosterone from the hypothalamus was tested. In the hippocampus and prefrontal cortex, concentrations of 5-HT and its metabolite 5-hydroxyindoleacetic acid, as well as monoamine oxidase A, glucocorticoid receptor, and 5-HT1A receptor expression levels, were measured. Furthermore, we examined protein and mRNA expression of cAMP-PKA-CREB-BDNF pathway components. The results showed that JYHH had a significant preventative effect on the anxiety-like behaviour induced by CRS and prevented abnormal changes in the HPA axis and 5-HT system. Furthermore, CRS inhibited the cAMP-PKA-CREB-BDNF pathway, which returned to normal levels following JYHH treatment. This might be the underlying molecular mechanism of the antianxiety effect of JYHH, which could provide a new clinical target for preventative anxiolytic drugs for chronic stress.
... It has traditional uses as a relaxant (and an inebriant at higher doses) and is used in modern phytotherapy as a treatment for anxiety [219]. ...
Genus Styrax belongs to the family Styracaceae, which is widely distributed in tropical and subtropical regions and has been applied in pharmacological uses and food chemical products. Original research articles related to Styrax plants are now abundant, but there has not been an overview account to demonstrate the highlights in phytochemical and pharmacological aspects of Styrax constituents. This chapter compiles a full list of secondary metabolites from this genus, along with their pharmacological effects. Herein, 165 isolated compounds are summarised with diverse chemical structures, and lignans and triterpenoids can be seen as major components. Pharmacological studies have introduced the use of Styrax components in anticancer, antioxidant, anti-inflammation, antimycobacterial, antiaging, antivirus HIV, and antischistosomicidal activities, estrogenic biosynthesis, etc. Regarding food chemistry, several Styrax plants can also be good candidates to provide essential oils and nutrient content of protein, especially benzoin resins.
... Medicinal plants represent a wide source of bioactive phytochemicals that play a key role in preventing chronic diseases such as cancer and diabetes [66]. In recent years, herbs have been considered an alternative approach for the treatment of neuropsychiatric disorders, and in particular of anxious and cognitive disorders, due to their good safety profile compared to current approved drugs [67]. ...
Rescue of cognitive function represents an unmet need in the treatment of neurodegenerative disorders such as Alzheimer’s disease (AD). Nutraceuticals deliver a concentrated form of a presumed bioactive(s) agent(s) that can improve cognitive function alone or in combination with current approved drugs for the treatment of cognitive disorders. Nutraceuticals include different natural compounds such as flavonoids and their subclasses (flavan-3-ols, catechins, anthocyanins, and flavonols), omega-3, and carnosine that can improve synaptic plasticity and rescue cognitive deficits through multiple molecular mechanisms. A deficit of transforming growth factor-β1 (TGF-β1) pathway is an early event in the pathophysiology of cognitive impairment in different neuropsychiatric disorders, from depression to AD. In the present review, we provide evidence that different nutraceuticals, such as Hypericum perforatum (hypericin and hyperforin), flavonoids such as hesperidin, omega-3, and carnosine, can target TGF-β1 signaling and increase TGF-β1 production in the central nervous system as well as cognitive function. The bioavailability of these nutraceuticals, in particular carnosine, can be significantly improved with novel formulations (nanoparticulate systems, nanoliposomes) that increase the efficacy and stability of this peptide. Overall, these studies suggest that the synergism between nutraceuticals targeting the TGF-β1 pathway and current approved drugs might represent a novel pharmacological approach for reverting cognitive deficits in AD patients.
... As previously mentioned, several compounds of kava, such as kavain, dihydrokavain, methysticin, desmethoxyyangonin and yangonin are able to cross the blood-brain barrier in in vivo studies [39]. Kava generally generates a soothing and relaxing sensation [11,79,80]. In view of this, it has been primarily employed in clinical trials to treat anxiety. ...
Kava (Piper methysticum) has been widely consumed for many years in the South Pacific Islands and displays psychoactive properties, especially soothing and calming effects. This plant has been used in Western countries as a natural anxiolytic in recent decades. Kava has also been used to treat symptoms associated with depression, menopause, insomnia, and convulsions, among others. Along with its putative beneficial health effects, kava has been associated with liver injury and other toxic effects, including skin toxicity in heavy consumers, possibly related to its metabolic profile or interference in the metabolism of other xenobiotics. Kava extracts and kavalactones generally displayed negative results in genetic toxicology assays although there is sufficient evidence for carcinogenicity in experimental animals, most likely through a non-genotoxic mode of action. Nevertheless, the chemotherapeutic/chemopreventive potential of kava against cancer has also been suggested. Both in vitro and in vivo studies have evaluated the effects of flavokavains, kavalactones and/or kava extracts in different cancer models, showing the induction of apoptosis, cell cycle arrest and other antiproliferative effects in several types of cancer, including breast, prostate, bladder, and lung. Overall, in this scoping review, several aspects of kava efficacy and safety are discussed and some pertinent issues related to kava consumption are identified.
... Complementary and alternative medicine (CAM) treatments are now recognized as an efficient alternative treatment [9]. Herbal medicine as a part of CAM is beneficial to the GAD, with an abundance of researchers highlighting the molecular mechanisms, signaling pathways, and neurotrophic factors in mental disorders [10][11][12]. Novel approaches like pharmacogenetics and pharmacoepigenetics are safer and may improve the treatment response while reducing the socioeconomic burden [13]. A meta-analysis revealed Jiu Wei Zhen Xin Formula (JWZXF) and concluded that a formulated herbal granule is less effective than SSRIs but is safer [14]. is research intends to construct a pharmacological network on JWZXF and GAD genetic targets and reveal their relationship. ...
Currently, there are many effective pharmacological treatments for generalized anxiety disorder (GAD), formulated herbal granule is also an alternative way. Our research intends to construct a pharmacological network on genetic targets and pathways between Jiu Wei Zhen Xin Formula (JWZXF) and GAD.
Through TCMSP database, we collected the active ingredients of JWZXF and potential targets of the active ingredients. The GAD-related proteins collected from GeneCards database and DisGeNET database were combined. Component-Target protein networks were constructed and visualized using Cytoscape 3.8.2 software to comprehensively clarify the relationships between ingredients, components, and targets. The intersection targets were imported into STRING database, and the protein-protein interaction (PPI) network was constructed. We constructed and analyzed the visualized“drug-target-disease” network. Gene Ontology (GO) enrichment together with Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis on the common target were conducted through R language.
Forty-one effective components and 106 potential targets of JWZXF were found. There were top ten hub genes and multiple important signaling pathways involved in the treatment of GAD with JWZXF.
This study expounded the pharmacological actions and molecular mechanisms of JWZXF in treating GAD from a holistic perspective. The potential pharmacological effects of JWZXF are closely related to regulated Not only does it comprehensively analyze the possible mechanism of JWZXF treatment of GAD, but it can also facilitate further in-depth research and provide a theoretical basis for the clinical expansion of its application.
... Research has demonstrated the efficacy of CM approaches, such as yoga, to address mental health symptoms such as stress, anxiety and low mood [20][21][22]. There is also strong evidence for ingestible CM, such as the herbal medicines St John's wort and Saffron in treating mild to moderate depression [23][24][25][26]. Nutritional interventions (e.g., Mediterranean diet, probiotics) have also gained empirical support for the prevention and treatment of depression [27][28][29][30]. ...
Background
Psychologists, and their clients, are engaging with complementary medicine (CM). Increasing evidence for CM approaches, such as improved nutrition and St John’s wort, has led to their inclusion in the Royal Australian New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. This research aims to determine in what ways, and to what extent, Australian psychology regulatory bodies and associations consider CM relevant to psychology practice. Specifically, how these regulatory bodies and professional association’s ethical and practice guidelines engage with CM.
Methods
Documents from Australian regulatory bodies and professional associations, that relate to the governance or guidance of psychologists’ clinical practice, were systematically searched for key terms relating to CM.
Results
There were no direct references to CM in the 58 ethical and practice guidelines reviewed. There was also no reference to the relevance of CM to ethnocultural groups, such as Aboriginal and Torres Strait Islander traditional healing practices.
Conclusion
While other mental health care disciplines are working toward integrating CM, the discipline of psychology in Australia is not currently engaged in such developments. Given the exponential rise of CM use amongst those with mental health problems, psychology associations should consider developing resources and guidelines to assist psychologists in navigating CM in relation to clinical practice to help minimise risks, such as patient safety associated with concurrent CM use.
... This species has long been used in traditional medicine by the indigenous people of North America [2]. It still holds an important position in the USA where it is used as a sedative and an anticonvulsant for the treatment of epilepsy, hysteria, and various neurotic ailments [3][4][5][6]. The raw material utilised from this species is the herb [7]. ...
Studies carried out using three different in vitro assays and a biological setting (Escherichia coil) demonstrated the antioxidant activity of Scutellaria lateriflora microshoot extract. Moreover, the extract exhibited no toxicity in a brine shrimp lethality bioassay. These results indicated that microshoots are a rich, safe source of antioxidants, which encouraged us to enhance their production in vitro. In agar and agitated cultures, two biotechnological strategies were applied: feeding the cultures with the biogenetic precursors of the phenolics—phenylalanine and tyrosine, and eliciting them with methyl jasmonate. Specific Scutellaria flavonoids and verbascoside were analysed by HPLC. Feeding with precursors (1 g/L) in agar cultures decreased the production of the metabolites. In agitated cultures, different concentrations of precursors (1.0–2.5 g/L) and the elicitor (10; 50; 100 µM) were tested. Additionally, parallel feeding with the precursor and elicitor in a concentration of 50 µM were applied. The best strategy for total flavonoid and verbascoside production was phenylalanine feeding (1.5 g/L), max. 3765 and 475 mg/100 g DW, respectively, after 7 days. This is the first report documenting the high antioxidant production in S. lateriflora microshoots after feeding with phenylalanine. Moreover, for the first time, bioreactor cultures were successfully maintained, obtaining attractive results (max. total flavonoid content 2348 and verbascoside 485 mg/100 g DW).
... 32,91,92 Patients may also use herbal remedies for the treatment or management of psychiatric disorders, although there is a lack of double-blind randomized controlled studies to demonstrate a clear efficacy, and such remedies may have unknown drug-drug interactions and interactions with metabolic enzymes. 93,94 Future clinical therapeutics are being developed to improve the selectivity of the therapeutics used in the treatment and management of anxiety and depression. 95 New therapies for the treatment of depression are aimed at the glutamate system, with antagonists such as ketamine that target N-methyl-D-aspartate receptors, able to act quickly, and nasal esketamine sprays have been approved for individuals with depression that is not controlled by current therapies, 20,96 although the long-term possible side effects of their use are yet to be fully evaluated. ...
Paul A Constable, Dalia Al-Dasooqi, Rhiannon Bruce, Mallika Prem-Senthil Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, AustraliaCorrespondence: Paul A Constable, Flinders University, GPO Box 2100, Adelaide, 5001, South Australia, Australia, Tel + 61 8 7221 8398, Email paul.constable@flinders.edu.auAbstract: This review of commonly prescribed psychotropic drugs aims to update the clinician on possible ophthalmic side effects that may include dry eye, diplopia, mydriasis, and cataracts. This review summarizes our current knowledge of known ocular side effects of psychotropic drugs based on reviews, case reports, case-control studies, a case series, and cross-sectional observational studies reported in the recent literature. The review covers disorders related to depression, anxiety, and stress which are commonly encountered within society and can have debilitating impacts on an individual’s quality of life that may require chronic therapeutic management. The main medications used in the treatment and management of these conditions typically target receptors, metabolic enzymes, or transport pumps that alter the pre- and/or post-synaptic levels of neurotransmitters such as serotonin, norepinephrine, dopamine, gamma-aminobutyric acid, and opioids to improve mood and/or relieve pain and anxiety. Novel non-therapeutic options are undergoing clinical trials, and some patients may seek alternative therapies or have associated substance abuse issues to alleviate their symptoms. This review summarizes some of the clinical signs of depression and the main therapeutic options and their reported ocular side effects which may be pertinent today given the rise in use of psychotropic medications used to manage depression, anxiety, and stress.Keywords: drugs, ocular, psychotropic, side effects
... Thus, the search for new therapeutic alternatives is very relevant, and, in this context, therapy research based on the use of plants has increased worldwide (Hou et al., 2020;Kim and Song, 2012;Kim et al., 2017;Rahbardar and Hosseinzadeh, 2020). In this sense, there is consistent evidence of the effectiveness of several plants in the treatment of psychiatric disorders (Sarris, 2018), highlighting the genus Passiflora (Aman et al., 2016;da Cunha et al., 2021;Dantas et al., 2017;Giovannini and Howes, 2017;Janda et al., 2020;Kim et al., 2019), especially Passiflora incarnata, used to treat insomnia and anxiety (Kim et al., 2019;Miroddi et al., 2013;Patel et al., 2009;Schäfer et al., 2021). The anxiolytic activity seems to be due to flavonoids, which would act on the GABAergic system (Fonseca et al., 2020). ...
... Ayurveda, proposed by the Indian government during the COVID-19 crisis, could positively influence immunity with possible direct effects on symptoms of depression or anxiety [179]. A potential modulation of monoamine function, stress axis response, and autonomic activity, paired with a reduction of anxiety and depressive symptomatology, has been postulated to be associated with ayurveda traditional practices [180]. Therefore, such a traditional practice could be beneficial both in terms of psychological effect and in terms of moderating the risk or severity of SARS-CoV-2 infection, and its safety and efficacy should be tested in future studies [181]. ...
The Coronavirus Disease 2019 (COVID-19) pandemic is still spreading worldwide over 2 years since its outbreak. The psychopathological implications in COVID-19 survivors such as depression, anxiety, and cognitive impairments are now recognized as primary symptoms of the “post-acute COVID-19 syndrome.” Depressive psychopathology was reported in around 35% of patients at short, medium, and long-term follow-up after the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. Post-COVID-19 depressive symptoms are known to increase fatigue and affect neurocognitive functioning, sleep, quality of life, and global functioning in COVID-19 survivors. The psychopathological mechanisms underlying post-COVID-19 depressive symptoms are mainly related to the inflammation triggered by the peripheral immune-inflammatory response to the viral infection and to the persistent psychological burden during and after infection. The large number of SARS-CoV-2-infected patients and the high prevalence of post-COVID-19 depressive symptoms may significantly increase the pool of people suffering from depressive disorders. Therefore, it is essential to screen, diagnose, treat, and monitor COVID-19 survivors’ psychopathology to counteract the depression disease burden and related years of life lived with disability. This paper reviews the current literature in order to synthesize the available evidence regarding epidemiology, clinical features, neurobiological underpinning, and pharmacological treatment of post-COVID-19 depressive symptoms.
... Shugan Jieyu Capsule (SG), a traditional Chinese drug compound made from Hypericum perforatum and Acanthopanax, have been widely approved for the treatment of depression in China since 2008 (7). Hypericum perforatum effectively inhibits the reabsorption of neurotransmitters such as norepinephrine, 5-hydroxytryptamine, and dopamine, thus counteracting the effects of depression (8,9). Acanthopanax senticosus suppresses resorption of central serotonin and increases concentration of monoamine transmitters in the synaptic cleft to achieve antidepressant effects (10). ...
Regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuation (fALFF) were used to detect the neuroimaging mechanism of Shugan Jieyu Capsule (SG) in ameliorating depression of post-stroke depression (PSD) patients. Fifteen PSD patients took SG for 8 weeks, completed the 24-item Hamilton Depression Scale (HAMD) assessment at the baseline and 8 weeks later, and underwent functional magnetic resonance imaging (fMRI) scanning. Twenty-one healthy controls (HCs) underwent these assessments at the baseline. We found that SG improved depression of PSD patients, in which ReHo values decreased in the left calcarine sulcus (CAL.L) and increased in the left superior frontal gyrus (SFG.L) of PSD patients at the baseline. The fALFF values of the left inferior parietal cortex (IPL.L) decreased in PSD patients at the baseline. Abnormal functional activities in the brain regions were reversed to normal levels after the administration of SG for 8 weeks. Receiver operating characteristic (ROC) analysis found that the changes in three altered brain regions could be used to differentiate PSD patients at the baseline and HCs. Average signal values of altered regions were related to depression in all subjects at the baseline. Our results suggest that SG may ameliorate depression of PSD patients by affecting brain region activity and local synchronization.
... Stress, anxiety, mood disorders, sleep problems, and cognitive dysfunction are the most common mental health problems for which herbal products constitute a reasonable treatment option with minor side effects and low toxicity [1,2]. The pathogenesis of mental disorders is complex and generally thought to be linked to genetic, immune-related, humoral, neural, and environmental factors. ...
... Physiologically, the amygdala seems to be the brain region with major neurofunctional implications in social processing, especially in the processing of visual social stimuli (Adolphs, Sears, and Piven 2001). Among the broad spectra of PDNs with the ability to act on this NCD (Sarris 2018), there are three PDNs with remarkable modulatory capacities. These nootropics, which are exhaustively reviewed in this paper, include Ashwagandha, Curcuma longa L. (turmeric), Gb. ...
Substances with modulatory capabilities on certain aspects of human cognition have been revered as nootropics from the dawn of time. The plant kingdom provides most of the currently available nootropics of natural origin. Here, in this systematic review, we aim to provide state-of-the-art information regarding proven and unproven effects of plant-derived nootropics (PDNs) on human cognition in conditions of health and disease. Six independent searches, one for each neurocognitive domain (NCD), were performed in parallel using three independent scientific library databases: PubMed, Cochrane and Scopus. Only scientific studies and systematic reviews with humans published between January 2000 and November 2021 were reviewed, and 256 papers were included. Ginkgo biloba was the most relevant nootropic regarding perceptual and motor functions. Bacopa monnieri improves language, learning and memory. Withania somnifera (Ashwagandha) modulates anxiety and social-related cognitions. Caffeine enhances attention and executive functions. Together, the results from the compiled studies highlight the nootropic effects and the inconsistencies regarding PDNs that require further research.
... Stress, anxiety, mood disorders, sleep problems, and cognitive dysfunction are the most common mental health problems for which herbal products constitute a reasonable treatment option with minor side effects and low toxicity [1,2]. The pathogenesis of mental disorders is complex and generally thought to be linked to genetic, immune-related, humoral, neural, and environmental factors. ...
Background:
Various neurocognitive and mental health-related conditions have been associated with the gut microbiome, implicating a microbiome-gut-brain axis (MGBA). The aim of this systematic review was to identify, categorize, and review clinical evidence supporting medicinal plants for the treatment of mental disorders and studies on their interactions with the gut microbiota.
Methods:
This review included medicinal plants for which clinical studies on depression, sleeping disorders, anxiety, or cognitive dysfunction as well as scientific evidence of interaction with the gut microbiome were available. The studies were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Results:
Eighty-five studies met the inclusion criteria and covered thirty mental health-related medicinal plants with data on interaction with the gut microbiome.
Conclusion:
Only a few studies have been specifically designed to assess how herbal preparations affect MGBA-related targets or pathways. However, many studies provide hints of a possible interaction with the MGBA, such as an increased abundance of health-beneficial microorganisms, anti-inflammatory effects, or MGBA-related pathway effects by gut microbial metabolites. Data for Panax ginseng, Schisandra chinensis, and Salvia rosmarinus indicate that the interaction of their constituents with the gut microbiota could mediate mental health benefits. Studies specifically assessing the effects on MGBA-related pathways are still required for most medicinal plants.
In the past decades, phytoconstituents have appeared as critical mediators for immune regulations among various diseases, both in eukaryotes and prokaryotes. These bioactive molecules, showing a broad range of biological functions, would hold tremendous promise for developing new therapeutics. The discovery of phytoconstituents’ capability of functionally regulating immune cells and associating cytokines, suppressing systemic inflammation, and remodeling immunity have rapidly promoted the idea of their employment as anti-inflammatory agents. In this review, we discuss various roles of phyto-derived medicines in the field of inflammatory diseases, including chronic inflammation, autoimmune diseases, and acute inflammatory disease such as COVID-19.
Nevertheless, traditional phyto-derived medicines often concurred with their clinical administration limitations, such as their lack of cell specificity, inefficient cytoplasmic delivery, and rapid clearance by the immune system. As alternatives, phyto-derived nano-approaches may provide significant benefits. Both unmodified and engineered nanocarriers present the potential to serve as phytoconstituent delivery systems to improve therapeutic physio-chemical properties and pharmacokinetic profiles. Thus, the development of phytoconstituents’ nano-delivery designs, their new and perspective approaches for therapeutical applications are elaborated herein.
Purpose
The present study was performed to determine the prevalence, characteristics, perceived benefits, and predictors of complementary health approaches use (CHA) in Turkish patients with mental disorders.
Design and Methods
The present study was performed with 413 patients with mental disorders.
Findings
In the present study, 62.2% of the patients had used CHA in the last 12 months. The most common types of CHA used were religious/spiritual activities and herbs. According to the multivariate logistic regression model, sex, education level, marital status, employment status, medical diagnoses, and duration of diagnoses were significantly associated with increased CHA use.
Practice Implications
The CHA use by patients should be investigated, and education and counseling should be provided by health professionals to improve patient safety and patient outcomes.
A ansiedade é frequentemente relatada por pacientes que buscam tratamentos alternativos ou complementares, como a Homeopatia, por exemplo. A matéria médica compreende grande variedade de medicamentos homeopáticos e evidenciou o uso em pessoas sadias. Contudo, os estudos clínicos carecem de informações sobre os efeitos alcançados. O extrato da planta Ginkgo biloba mostrou efeitos ansiolíticos em animais roedores, assim como Gelsemium sempervirens, Ignatia amara, Achilea milefolium e outras substâncias de origem vegetal. A busca pelo medicamento individual é um diferencial do tratamento homeopático, no intuito de encontrar o Simillimum ideal para o paciente que sofre ao seu modo determinado sintoma. Este projeto se propõe a levantar evidências sobre o uso da Homeopatia no tratamento de transtornos de ansiedade por meio de casos clínicos no intuito de contribuir para o uso de medicamentos homeopáticos na melhora da saúde dos indivíduos.
Herbal food supplements are commonly used and can be an important part of patient self-care. Like all other bio-active and therapeutic products, they have a benefit/risk balance. These products are not without adverse effects and potentially interact with other therapies. Educating patients and providing information for health professionals about the risk of herb–drug interactions is key. One of the purposes of the biomedical literature is to inform prescribers. Scientific literature accessible on databases such as PubMed is dense and careful reading is time consuming. We propose a reading aid tool named “HDI highlighter” to help readers to find key information in clinical studies and case reports describing herb–drug interactions. It uses natural language processing algorithms (artificial intelligence) with a pharmaceutical focus. Semantic relation extraction for herb–drug interactions from the biomedical literature are overexpressed using keywords. We have tested it to review 120 published articles over the last 10 years. In these articles, we have shown that case reports often involved long-term or semi-long-term treatments such as cancer or human immunodeficiency virus therapies, antiepileptic drugs, or central nervous system drugs. Similarly, these classes of drugs are more extensively targeted by clinical studies. Herb–drug interactions described in case reports are identified in medicinal, recreational, and alimentary uses. They also usually lack a rigorous description of the herb(s) involved. Typically, clinical studies provide a complete description of protocols and dosages, with a few exceptions explained by patients’ needs. Clinical studies on herbs are nevertheless conducted on a limited number of patients. All these limitations make the interpretation of herb–drug interactions complicated, but the HDI highlighter provides a quick overview of the herb–drug interaction literature.
Neurodegenerative diseases (NDs) represent one of the most important public health problems, and worldwide, hundreds of millions of people are affected by NDs, displaying strong evidence to these diseases is one of the most significant challenges to public health. Neurological disorders include several common diseases of the central and peripheral nervous system such as Alzheimer's disease and other dementia, epilepsy, headache disorders, multiple sclerosis, Parkinson's disease, and others. The discovery of substances capable of preventing or treating neurological disorders has been the goal of researchers for several years. New therapies and new molecules should be explored. In this context, natural compounds represent an important source for the development of new drugs. For example, between 1981 and 2014, from a total of 12 new approved molecules for the treatment of Parkinson's disease, only one was a synthetic drug, being the others biological, derived or inspired in a natural product. In the same line, > 50% of all new antidepressant molecules were synthetic/mimetic of a natural product.
Anticholinesterases like physostigmine and neostigmine, opioids alkaloids, galantamine, are some examples of drugs utilized from derived plants for the treatment of neurological disorders, highlighting the relevance of studying and searching for new natural products for the treatment of neurological disorders. This chapter aimed to summarize the most important compounds originated from natural sources that were targets of clinical studies, associated with neurological and psychiatric disorders, obtaining a total of 13 articles, in the last 10 years. Also, we characterized these compounds structurally. Considering the vast diversity of plants, few herbal medicines or botanical drugs were approved for human use, in the last centuries, only few innovative therapeutic products have been developed, especially in the field of neurological diseases.
The genus Passiflora L. is widely cultivated in tropical and subtropical regions. The major species, Passiflora edulis Sims, is known as ‘passion fruit’ and is widely used in processed foods as well as eaten raw. P. edulis fruits are eaten for their pulp together with the seeds; however, the seeds are often discarded when used in processed foods. P. edulis seeds contain a variety of nutrients and functional components, and their industrial use is desirable from the perspective of waste reduction. Previous studies have analyzed the constituents of P. edulis and their physiological functions. P. edulis seeds contain various types of polyphenols, especially those rich in stilbenes (e.g., piceatannol). P. edulis seed extracts and isolated compounds from seeds have been reported to exhibit various physiological functions, such as antioxidant effects, improvement of skin condition, fat-burning promotion effects, and hypoglycemic effects. This review summarizes the nutritional characteristics, polyphenol content, and physiological functions of P. edulis seeds.
Ethnopharmacological relevance
The burden of disease caused by mental and neurological disorders is increasing globally, to a disproportionate degree in Latin America. In contrast to the many psychoactive plants with a use history in Mesoamerican cultures, the translation to the wider population of knowledge around numerous botanicals used contemporarily by indigenous Mesoamerican societies to treat psychological and neurological disorders did not receive the same attention.
Material and methods
We used the previously published Mesoamerican Medicinal Plant Database to extract species and associated botanical drugs used as treatments for illnesses associated with the nervous system by Mesoamerican cultures in Belize, Guatemala, and Mexico. With the critical use of published pharmacological literature, the cross-culturally most salient genera are systematically reviewed.
Results
From 2188 plant taxa contained in the database 1324 are used as treatments for illnesses associated with the nervous system. The ethnomedical data was critically confronted with the available biomedical literature for the 58 cross-culturally most salient genera. For a considerable proportion of the frequently used taxa, preclinical data are available, mostly validating ethnomedicinal uses.
Conclusion
This quantitative approach facilitates the prioritization of taxa for future pre-clinical, clinical and treatment outcome studies and gives patients, practitioners, and legislators a fundamental framework of evidence, on which to base decisions regarding phytomedicines.
Introduction: Breast cancer is one of the most important neoplasms affecting one out of eight women. Despite new therapeutic methods, the breast cancer mortality rate is increasing annually. Medicinal plants are considered important sources of anti-cancer compounds. The present study was conducted to evaluate the cytotoxic effects of hydroalcoholic extract of Mentha Pulegitim L. and Satureja hortensis L. on MCF-7 and MCF-10 breast cancer cell lines in vitro.
Materials and Methods: This study was performed in the laboratory of Boroujerd Azad University, Boroujerd, Iran, in 2020. After the preparation of hydroalcoholic extracts of Mentha Pulegitim L. and Satureja hortensis L., the effect of different concentrations of 3, 7, 15, 30, 60, 125, and 500 g/ml of both plants were examined on cell lines prepared at the tumor section of the Department of Cell Bank of Pasteur Institute of Iran, Tehran, Iran, for 24, 28, and 72 h. The effect of cytotoxicity was evaluated using an MTT assay. The light absorption was determined at 570 nm wavelengths using an enzyme-linked immunosorbent assay reader. In this study, a one-way analysis of variance was utilized. The identification of the compounds was performed using the Gas Chromatography-Mass Spectrometry method.
Results: The highest percentages of inhibition of MCF-7 and MCF-10 breast cancer cell lines were found in the 500 μg/ml concentrations of the hydroalcoholic extracts of Satureja hortensis L. and Mentha Pulegitim L.at 96.558% and 88.547%, respectively.
Conclusion: The results of the present study showed that the hydroalcoholic extracts of Satureja hortensis L. and Mentha Pulegitim L. leaves had significant cytotoxicity effects on the breast cancer cell line and prohibited their growth extensively.
O aprender fazendo frente às diversas nuances da educação a cada
dia tem se destacado, pois as práticas vividas consolidam competências,
tornando o cotidiano um laboratório de criatividade que reverbera em
ações que engendram o conhecimento.
A promoção da saúde mental é um grande desafio em todos os cenários
da saúde, e muitos profissionais ao se depararem com situações que requerem
procedimentos voltados para essa área acabam buscando informações
nas literaturas e materiais disponíveis, principalmente eletrônicos, mas o
que se percebe de forma empírica é a intensidade de pesquisa frente aos
saberes vivenciados por outros profissionais.
Abstract
Introduction: Breast cancer is one of the most important neoplasms affecting one out of eight women. Despite new therapeutic methods, the breast cancer mortality rate is increasing annually. Medicinal plants are considered important sources of anti-cancer compounds. The present study was conducted to evaluate the cytotoxic effects of hydroalcoholic extract of Mentha Pulegitim L. and Satureja hortensis L. on MCF-7 and MCF-10 breast cancer cell lines in vitro.
Materials and Methods: This study was performed in the laboratory of Boroujerd Azad University, Boroujerd, Iran, in 2020. After the preparation of hydroalcoholic extracts of Mentha Pulegitim L. and Satureja hortensis L., the effect of different concentrations of 3, 7, 15, 30, 60, 125, and 500 g/ml of both plants were examined on cell lines prepared at the tumor section of the Department of Cell Bank of Pasteur Institute of Iran, Tehran, Iran, for 24, 28, and 72 h. The effect of cytotoxicity was evaluated using an MTT assay. The light absorption was determined at 570 nm wavelengths using an enzyme-linked immunosorbent assay reader. In this study, a one-way analysis of variance was utilized. The identification of the compounds was performed using the Gas Chromatography-Mass Spectrometry method.
Results: The highest percentages of inhibition of MCF-7 and MCF-10 breast cancer cell lines were found in the 500 μg/ml concentrations of the hydroalcoholic extracts of Satureja hortensis L. and Mentha Pulegitim L.at 96.558% and 88.547%, respectively.
Dendrobium nobile Lindl. alkaloid (DNLA) is effective against animal models of Alzheimer's disease. This study further examined its effect on anxiety and depression produced by chronic unpredictable stress (CUS). Rats were subjected to CUS for 42 days, followed by DNLA treatment (20 mg/kg/day, po) for 28 days. The behavioral tests, histopathology, neurotransmitters and RNA-Seq were examined. DNLA attenuated body weight loss and CUS-induced anxiety/depressive-like behaviors, as evidenced by the elevated-plus-maze test, open-field test and sucrose preference. DNLA alleviated neuronal damage and loss and increased Nissl bodies in the hippocampus CA2 region and cortex. DNLA decreased CUS-elevated 5-hydroxytryptamine, dopamine and monoamine oxidase and catechol-O-methyltransferase activities in the brain. DNLA attenuated HPA activation by decreasing adrenocorticotropic hormones and the expression of corticotropin-releasing hormone receptor-1, and increased the expression of glucocorticoid receptor in the brain. RNA-Seq revealed distinct gene expression patterns among groups. Gene ontology revealed the cell projection assembly, postsynapse and centrosome as top biological processes, and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment showed the cAMP, cGMP-PKG, glutamatergic synapse and circadian as major pathways for DNLA effects. Using DESeq2, CUS modulated 1700 differentially expressed genes (DEGs), which were prevented or attenuated by DNLA. CUS-induced DEGs were highly correlated with the Gene Expression Omnibus (GEO) database for anxiety and depression and were ameliorated by DNLA. Taken together, DNLA attenuated anxiety/depression-like behavior and neuronal damage induced by CUS in rats. The mechanisms could be related to regulation of the monoamine neurotransmitters and the HPA axis, and modulation of gene expression in the hippocampus.
Background
There is an increasing demand to improve personal health and reduce the social burden in children with autism spectrum disorder (ASD). A comprehensive review of ASD interventions from the point of view of efficacy, safety, and compliance is needed. The purpose of this study was to evaluate the efficacy and safety of East Asian Herbal Medicine (EAHM) in the treatment of ASD.
Materials and methods
Eleven databases (PubMed, Cochrane Library, CINAHL, EMBASE, KISS, RISS, OASIS, KCI, CNKI, Wanfang data, and CiNii) were searched from their respective inception to July 2021. A search was conducted by combining the keywords Autism Spectrum Disorder and Herbal medicine. We included a randomized controlled trial in which oral administration of EAHM was combined with conventional treatment for pediatric ASD patients. The primary outcomes were the clinical efficacy rate and the improvement in Childhood Autism Rating Scale (CARS) score.
Results
A total of 7 studies involving 462 children with ASD were included. The results suggest that EAHM as part of a combined therapy enhances the CARS score (MD [95% confidential interval] =4.47[5.89,3.05], p<0.01) and the clinical efficacy rate (RR=1.31[1.14,1.51], p<0.01) in comparison to the control group using only conventional therapy. Safety information was reported in 4 of the 7 included studies, and there were no adverse events or the difference in the incidence of side effects between the two groups was not significant.
Conclusion
This meta-analysis shows that EAHM may improves the clinical efficacy rate and CARS score in children with ASD. However, in that the quality of the included studies is not generally high and the numbers are difficult to be considered sufficient, larger scale and rigorously designed randomized controlled trials need to be conducted to strengthen the evidence.
Objective
Around 30% of patients with Attention-Deficit/Hyperactivity Disorder (ADHD) do not respond to Ritalin or cannot tolerate its side effects, which necessitates the consideration of alternative options. Previous studies have shown the beneficial effects of Crocus sativus (saffron) in children with ADHD. However, its potential therapeutic effects in adults with ADHD is unknown. This study aimed to evaluate the efficacy and safety of saffron as an adjuvant to Ritalin for improving symptoms in adults with ADHD.
Design
This was a randomized, double-blind, placebo-controlled clinical trial.
Methods
Fifty-six patients diagnosed with ADHD were assigned into two parallel groups to receive Ritalin (30 mg/day) plus placebo or Ritalin plus saffron (15 mg twice daily) for six weeks. The patients were assessed with Conners' Adult ADHD Rating Scales (CAARS) and the Adult ADHD Self-Report Scale (ASRS) at baseline, week 3 and week 6.
Results
Forty-four patients completed the trial. GLM repeated-measure analysis demonstrated significant time × treatment interaction effect for ASRS (df=2, F=3.455, and P-value=0.036) and CAARS (df=1.584, F=3.939, and P-value=0.033) score from baseline to the study endpoint. We found a significantly greater reduction in ASRS scores in the saffron group compared with the placebo group from baseline to the study endpoint (week 6) (P-value=0.024). However, the change score from baseline to week 3 was not significantly different between trial groups (P-value=0.269). There was no significant difference in the improvement of CAARS scores between saffron and placebo from baseline to week 3 or 6 (P-value=0.564 and 0.089, respectively). There was no significant difference between the two groups in baseline parameters and frequency of side effects.
Conclusions
Saffron combination therapy with Ritalin can effectively improve symptoms of patients with ADHD. However, further studies with larger sample sizes and longer follow-up treatment are needed to confirm our findings.
This trial was registered with the Iranian Registry of Clinical Trials (www.irct.ir; No IRCT20090117001556N111).
Objetivos:
Rever a evidência existente quanto à eficácia, tolerabilidade e segurança do hipericão no tratamento da perturbação depressiva (PD).
Fontes de dados:
NICE, Canadian Medical Association Infobase, PubMed - Clinical Queries, The Cochrane Library, BMJ, Bandolier e DARE - Centre for Reviews and Dissemination.
Métodos:
Foi realizada a pesquisa de artigos científicos em plataformas online de medicina baseada na evidência, com as palavras-chave Hypericum e Depressive Disorder. A seleção dos artigos foi feita com base no título, ano de publicação e resumo.
Resultados:
Foram incluídas nesta revisão duas normas de orientação clínica (NOC), três meta-análises (MA), duas revisões sistemáticas (RS) e um artigo original (AO). Uma NOC referiu que o hipericão pode ser usado como primeira linha na PD major ligeira a moderada e como tratamento adjuvante de segunda linha na PD major moderada a grave. A outra NOC não aconselha o seu uso. As MA e as RS concluíram que o hipericão apresenta uma eficácia superior ao placebo no tratamento da PD, sendo que duas MA e as RS acrescentaram que não há aumento dos efeitos adversos. As duas RS referiram o risco de interações com outros fármacos. O AO também afirma a eficácia do hipericão nas mulheres na pós-menopausa.
Conclusão:
Existe evidência quanto à eficácia do hipericão na PD ligeira a moderada. Os dados disponíveis parecem ser consistentes quanto à sua boa tolerabilidade, mas também quanto ao risco de interações com outros fármacos. As limitações da recomendação prendem-se essencialmente com o facto dos mecanismos de ação não estarem completamente esclarecidos.
Introduction:
Major depressive disorder is a chronic disease which may be associated with other mental illnesses. Lavandula officinalis and venlafaxine, herbal and chemical drugs respectively, are used to treat depression. Despite pharmacotherapy, major depressive disorder has a complicated pattern of resistance and recurrence.
Aim:
The aim of this study was to determine the effect of L. officinalis and venlafaxine in treating depression.
Materials and methods:
For this study, 120 patients referred to the psychiatry clinic of the Shahrekord University of Medical Sciences, Shahrekord, Iran, were randomly selected. The participants were randomly assigned to three groups: venlafaxine (Control Group), venlafaxine + L. officinalis (L. officinalis Group), and venlafaxine + placebo (Placebo Group). All the patients underwent treatment for six weeks. Depression test was administered to the three groups at different time intervals before the treatment, four weeks after the treatment and at completion of the treatment. The data were analysed by SPSS version17.0.
Results:
Depression scores of all the groups decreased over time (p=0.001). The depression scores were significantly different between the control and L. officinalis groups (p=0.004), and the control and placebo groups (p=0.002), but were not significantly different between the L. officinalis and placebo groups (p=0.95).
Conclusion:
Adding L. officinalis or a placebo is equally effective in decreasing mean depression score and venlafaxine obviously decreased this score.
Background:
Anxiety symptoms are frequently observed in dental patients, whether they are undergoing simple or more invasive procedures such as surgery. This research aimed to compare the effects of Passiflora incarnata and midazolam for the control of anxiety in patients undergoing mandibular third molar extraction.
Material and methods:
Forty volunteers underwent bilateral extraction of their mandibular third molars in a randomized, controlled, double-blind, crossover clinical trial. Passiflora incarnata (260 mg) or midazolam (15 mg) were orally administered 30 minutes before surgery. The anxiety level of participants was evaluated by questionnaires and measurement of physical parameters, including heart rate (HR), blood pressure (BP), and oxygen saturation (SpO2).
Results:
Considering each procedure independently, there were no significant differences between the protocols in BP, HR, and SpO2. Over 70% of the volunteers responded that they felt quiet or a little anxious under both protocols. With midazolam, 20% of the participants reported amnesia (not remembering anything at all), while Passiflora showed little or no ability to interfere with memory formation.
Conclusions:
Passiflora incarnata showed an anxiolytic effect similar to midazolam, and was safe and effective for conscious sedation in adult patients who underwent extraction of their mandibular third molars.
Chronic stress has been associated with a number of illnesses, including obesity. Ashwagandha is a well-known adaptogen and known for reducing stress and anxiety in humans. The objective of this study was to evaluate the safety and efficacy of a standardized root extract of Ashwagandha through a double-blind, randomized, placebo-controlled trial. A total of 52 subjects under chronic stress received either Ashwagandha (300 mg) or placebo twice daily. Primary efficacy measures were Perceived Stress Scale and Food Cravings Questionnaire. Secondary efficacy measures were Oxford Happiness Questionnaire, Three-Factor Eating Questionnaire, serum cortisol, body weight, and body mass index. Each subject was assessed at the start and at 4 and 8 weeks. The treatment with Ashwagandha resulted in significant improvements in primary and secondary measures. Also, the extract was found to be safe and tolerable. The outcome of this study suggests that Ashwagandha root extract can be used for body weight management in adults under chronic stress.
This trial evaluated the impact of a Rhodiola rosea L. extract on self-reported anxiety, stress, cognition, and other mood symptoms. Eighty mildly anxious participants were randomized into two different groups of either Rhodiola rosea L (2 × 200 mg dose Vitano®, 1 tablet taken before breakfast and 1tablet before lunch) or a control condition (no treatment). Self-report measures and cognitive tests were completed at four testing sessions over a period of 14 days. Relative to the controls, the experimental group demonstrated a significant reduction in self-reported, anxiety, stress, anger, confusion and depression at 14 days and a significant improvements in total mood. No relevant differences in cognitive performance between the groups were observed. Rhodiola rosea L (Vitano®) presented a favourable safety tolerability profile. Although this was a non-placebo controlled trial, it is unlikely that the findings were the result of placebo effects as changes appeared gradual and were specific to certain psychological measures. However, we cannot determine a causal relationship; further investigations are recommended to support the effects of Rhodiola rosea L. extract on stress related symptoms. Copyright © 2015 John Wiley & Sons, Ltd.
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It is extensively verified that continued oxidative stress and oxidative damage may lead to chronic inflammation, which in turn can mediate most chronic diseases including cancer, diabetes, cardiovascular, neurological, inflammatory bowel disease and pulmonary diseases. Curcumin, a yellow coloring agent extracted from turmeric, shows strong anti-oxidative and anti-inflammatory activities when used as a remedy for the prevention and treatment of chronic diseases. How oxidative stress activates inflammatory pathways leading to the progression of chronic diseases is the focus of this review. Thus, research to date suggests that chronic inflammation, oxidative stress, and most chronic diseases are closely linked, and the antioxidant properties of curcumin can play a key role in the prevention and treatment of chronic inflammation diseases.
Abstract Objective: To assess existing reported human trials of Withania somnifera (WS; common name, ashwagandha) for the treatment of anxiety. Design: Systematic review of the literature, with searches conducted in PubMed, SCOPUS, CINAHL, and Google Scholar by a medical librarian. Additionally, the reference lists of studies identified in these databases were searched by a research assistant, and queries were conducted in the AYUSH Research Portal. Search terms included "ashwagandha," "Withania somnifera," and terms related to anxiety and stress. Inclusion criteria were human randomized controlled trials with a treatment arm that included WS as a remedy for anxiety or stress. The study team members applied inclusion criteria while screening the records by abstract review. Intervention: Treatment with any regimen of WS. Outcome measures: Number and results of studies identified in the review. Results: Sixty-two abstracts were screened; five human trials met inclusion criteria. Three studies compared several dosage levels of WS extract with placebos using versions of the Hamilton Anxiety Scale, with two demonstrating significant benefit of WS versus placebo, and the third demonstrating beneficial effects that approached but did not achieve significance (p=0.05). A fourth study compared naturopathic care with WS versus psychotherapy by using Beck Anxiety Inventory (BAI) scores as an outcome; BAI scores decreased by 56.5% in the WS group and decreased 30.5% for psychotherapy (p<0.0001). A fifth study measured changes in Perceived Stress Scale (PSS) scores in WS group versus placebo; there was a 44.0% reduction in PSS scores in the WS group and a 5.5% reduction in the placebo group (p<0.0001). All studies exhibited unclear or high risk of bias, and heterogenous design and reporting prevented the possibility of meta-analysis. Conclusions: All five studies concluded that WS intervention resulted in greater score improvements (significantly in most cases) than placebo in outcomes on anxiety or stress scales. Current evidence should be received with caution because of an assortment of study methods and cases of potential bias.
Depression is one the most common mental disorders that can be seen all over the world. In traditional Persian medicine, some medicinal herbs are recommended for depression treatment. This study aimed to evaluate the effects of Cuscuta planiflora Ten. and Nepeta menthoides Boiss. & Buhse in patients with major depression.
This study is a randomized triple-blind controlled clinical trial conducted in the year 2010 in Shiraz University of Medical Sciences on patients with major depression. Pharmaceutical capsules of Cuscuta planiflora (500 mg) and Nepeta menthoides (400 mg) were prepared by a pharmacist. Patients were randomly assigned to 3 groups: group A (treated with Nepeta menthoides capsules and conventional drugs), group B (treated with Cuscuta planiflora capsules and conventional drugs), and group C (treated only with conventional drugs). The study period was 8 weeks and depression was measured before and after the study by Beck Depression Inventory and Hamilton Depression Inventory. The data were analyzed by SPSS version 20 and the P < .05 was considered statistically significant.
A total of 43 subjects participated in this study, of whom 81.4% were females (n = 35) and 18.6% were males (n = 8). The mean ± standard deviation of age of the participants was 38 ± 10.9 years. The majority of patients (65.1%, n = 28) were married. There were 15 patients (34.9%) in group A, 13 (30.29%) in group B, and 15 (34.9%) in group C. There was a significant decrease in mean scores of Beck and Hamilton depression inventories in the 3 groups after treatment (P < .01); moreover, there was more decrease in scores of the Beck and Hamilton depression inventories in groups A and B compared with group C after treatment (P < .01).
Despite the paucity of the population under study, the findings showed that Cuscuta planiflora and Nepeta menthoides capsules could be effective, affordable herbal medicines with improved cost-benefit in treatment of major depression and it is worth designing further and more extensive studies to get to a more accurate conclusion.
© The Author(s) 2014.
Statement of Problem: Oral premedication used to reduce the anxiety in patients undergoing dental treatment. Passion flower has been used as a sedative that can control the dental anxiety.
Purpose: This study determines the efficacy of Passion flower, in reducing anxiety during the dental procedures.
Material and Methods: In this randomized- one sided blind clinical trial, 63 patients, with moderate, high and severe anxiety(according to VAS score) in need of periodontal treatment were randomly divided into 3 groups of 21.The first group was given the drop Passion flower drop and the second group were given the drop of placebo and the third group; neither drug nor placebo were given (negative control group). Results were analyzed by Chi Square, Variance Analysis, Tucky and Paired-T using SPSS software.
Results: Mean anxiety level prior to the drug administration was 12.09±2.42 for the Passion flower group, 12.00±2.66 for the placebo group and 11.66±2.39 for the negative control group. After premedication, these values were: 8.47±2.58 for the Passion flower group, 10.52±2.11 for the placebo group and 11.23±2.34 for the negative control group. These results demonstrated a significant difference (p< 0.0001) in the anxiety levels before and after the Passion flower administration in the Passion flower group and also between the Passion flower group and the other two groups.
Conclusion: Results indicated that administration of Passion flower, as a premedication, is significantly effective in reducing the anxiety. Since this study is a pioneer on the subject, further trials with greater number of subjects are required to confirm our results.
Many herbs have been used to treat psychiatric disorders including anxiety and depression in traditional medicine.
This study was carried out to determine the effect of using Lavandula angustifilia infusion on depression in patients taking Citalopram.
Among all patients referred to the Hajar Hospital psychiatric clinic, Shahrekord, Iran, 80 patients who met the criteria of major depression according to the structured interviews and the Hamilton questionnaire for Depression were included in the study. They were randomly assigned into two groups of experimental treatment group and standard treatment group at this study. In standard treatment group, the patients were given Citalopram 20 mg. In experimental treatment group, the patients took 2 cups of the infusion of 5 g dried Lavandula angustifilia in addition to tablet Citalopram 20 mg twice a day. The patients were followed up for four and eight weeks of the study onset using Hamilton Scale questionnaire and treatment side effects form. Data were analyzed using student t-test, pair t-test and chi square.
After four weeks of the trial onset, the mean depression score according to the Hamilton Scale for Depression was 17.5 ± 3.5 in the standard treatment group and 15.2 ± 3.6 in the experimental treatment group (P < 0.05). After eight weeks, it was 16.8±4.6 and 14.8±4 respectively (P < 0.01). In addition, the most commonly observed adverse effects were nausea (12.8 %) and confusion (10%). In terms of side effects, there were no significant differences between two groups.
Considering the results of this study, Lavandula angustifilia infusion has some positive therapeutic effects on depressed patients most importantly decreases mean depression score and might be used alone or as an adjunct to other anti-depressant drugs.
Although St John’s wort has been subjected to extensive scientific studies in the last decade, there are still many open questions about its pharmacology and mechanism of action. Initial biochemical studies reported that St John’s wort is only a weak inhibitor of monoamine oxidase-A and -B activity but that it inhibits the synaptosomal uptake of serotonin, dopamine and noradrenaline (norepinephrine) with approximately equal affinity. However, other in vitro binding assays carried out using St John’s wort extract demonstrated significant affinity for adenosine, GABAa, GABAb and glutamate receptors. In vivo St John’s wort extract leads to a downregulation of β-adrenergic receptors and an upregulation of serotonin 5-HT2 receptors in the rat frontal cortex and causes changes in neurotransmitter concentrations in brain areas that are implicated in depression. In studies using the rat forced swimming test, an animal model of depression, St John’s wort extracts induced a significant reduction of immobility. In other experimental models of depression, including acute and chronic forms of escape deficit induced by Stressors, St John’s wort extract was shown to protect rats from the consequences of unavoidable stress. Recent neuroendocrine studies suggest that St John’s wort is involved in the regulation of genes that control hypothalamic-pituitary-adrenal axis function. With regard to the antidepressant effects of St John’s wort extract, many of the pharmacological activities appear to be attributable to the naphthodianthrone hypericin, the phloroglucinol derivative hyperforin and several flavonoids. This review integrates new findings of possible mechanisms that may underlie the antidepressant action of St John’s wort and its active constituents with a large body of existing literature.
We now know that depression is associated with a chronic, low-grade inflammatory response and activation of cell-mediated immunity, as well as activation of the compensatory anti-inflammatory reflex system. It is similarly accompanied by increased oxidative and nitrosative stress (O&NS), which contribute to neuroprogression in the disorder. The obvious question this poses is 'what is the source of this chronic low-grade inflammation?' DISCUSSION: This review explores the role of inflammation and oxidative and nitrosative stress as possible mediators of known environmental risk factors in depression, and discusses potential implications of these findings. A range of factors appear to increase the risk for the development of depression, and seem to be associated with systemic inflammation; these include psychosocial stressors, poor diet, physical inactivity, obesity, smoking, altered gut permeability, atopy, dental cares, sleep and vitamin D deficiency.
The identification of known sources of inflammation provides support for inflammation as a mediating pathway to both risk and neuroprogression in depression. Critically, most of these factors are plastic, and potentially amenable to therapeutic and preventative interventions. Most, but not all, of the above mentioned sources of inflammation may play a role in other psychiatric disorders, such as bipolar disorder, schizophrenia, autism and post-traumatic stress disorder.
Seasonal affective disorder (SAD) represents a subgroup of major depression with a regular occurrence of symptoms in autumn/winter and full remission in spring/summer. Light therapy (LT) has become the standard treatment of this type of depression. Apart from this, pharmacotherapy with antidepressants also seems to provide an improvement of SAD symptoms. The aim of this controlled, single-blind study was to evaluate if hypericum, a plant extract, could be beneficial in treating SAD patients and whether the combination with LT would be additionally advantageous. Patients who fulfilled DSM-III-R criteria for major depression with seasonal pattern were randomized in a 4-week treatment study with 900 mg of hypericum per day combined with either bright (3000 lux, n = 10) or dim (< 300 lux, n = 10) light condition. Light therapy was applied for 2 hours daily. We found a significant (MANOVA, P < .001) reduction of the Hamilton Depression Scale score in both groups but no significant difference between the two groups. Our data suggest that pharmacologic treatment with hypericum may be an efficient therapy in patients with seasonal affective disorder.
Prostatitis is a common prostate disease that could be promoted by bacterial or non-bacterial infectious agents. In addition, inflammatory pathways involved in prostatitis have been increasingly studied, and herbal extracts endowed with anti-inflammatory effects are under investigation, individually or in combination, for their efficacy in alleviating the burden of inflammation, with possible improvements in symptoms. Serenoa repens (Serenoa), in combination with Crocus sativus (Crocus) and Pinus massoniana (Pinus), has previously shown to improve sexual function and limit urinary symptoms in patients suffering from concomitant erectile dysfunction and lower urinary tract symptoms. In this context, the aim of the present study is to evaluate the efficacy of Serenoa, Crocus and Pinus extracts, either alone or in combination, on immortalized prostate cells (PC3) and in an experimental model of bacterial prostatitis constituted by ex vivo prostate specimens challenged with lipopolysaccharide (LPS). We found that the tested extracts were able to reduce ROS production by PC3 cells and NFkB and PGE2 activity in prostate specimens challenged with LPS. In addition, the pharmacological association of the extracts displayed synergistic effects indicating a rational use of the mixture of the tested extracts as a novel anti-oxidant and anti-inflammatory formulation in bacterial prostatitis. Finally, we performed analytical and in vitro evaluation to better characterize the phytochemical profile and the mechanism of action of selected secondary metabolites.
Introduction:
There is growing interest in the use of curcumin, a plant polyphenol with potent anti-inflammatory, anti-oxidant, and neuroprotective properties, as a novel antidepressant. Clinical trials have yielded conflicting conclusions pertaining to its effectiveness in depression. A meta-analysis of the topic, which has not been done until now, is therefore necessary to summarize current evidence and generate hypotheses for further research.
Methods:
Using the keywords [curcumin OR diferuloylmethane OR curcuminoid OR turmeric OR Indian saffron] AND [depression OR MDD OR suicide], a preliminary search on the PubMed, Ovid, Clinical Trials Register of the Cochrane Collaboration Depression, Anxiety and Neurosis Group (CCDANTR), and Cochrane Field for Complementary Medicine database yielded 2081 articles published in English between January 1, 1960, and August 1, 2016.
Results:
Six clinical trials with a total of 377 patients were reviewed, comparing the use of curcumin to placebo. In patients with depression, the pooled standardized mean difference from baseline Hamilton Rating Scale for Depression scores (pooled standardized mean difference -0.344, 95% confidence interval -0.558 to -0.129; P = .002) support the significant clinical efficacy of curcumin in ameliorating depressive symptoms. Significant anti-anxiety effects were also reported in 3 of the trials. Notably, no adverse events were reported in any of the trials. Most trials had a generally low risk of bias, except for an open trial of curcumin and a single-blinded study.
Limitations:
Because of the small number of studies available, a funnel plot or sensitivity analysis was not possible. Evidence on the long-term efficacy and safety of curcumin is also limited as the duration of all available studies ranged from 4 to 8 weeks.
Conclusions:
Curcumin appears to be safe, well-tolerated, and efficacious among depressed patients. More robust randomized controlled trials with larger sample sizes and follow-up studies carried out over a longer duration should be planned to ascertain its benefits.
Turmeric has been used in traditional medicine for centuries to treat a range of ailments. Its primary active constituent curcumin, can influence an array of biological activities. Many of these, such as its anti-inflammatory, antioxidant, neuroprotective, and monoaminergic effects are dysregulated in several neuropsychiatric disorders. In this systematic review, in vitro, animal, and human studies investigating the potential of curcumin as a treatment for neuropsychiatric disorders such as major depressive disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), bipolar disorder, psychotic disorders, and autism are reviewed, and directions for future research are proposed. It is concluded that curcumin is a promising, natural agent for many of these conditions, however, further research utilising robust, clinical designs are essential. The problem associated with the poor oral bioavailability of standard curcumin also requires consideration. Currently the greatest support for the efficacy of curcumin is for the treatment of major depressive disorder.
Background:
Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders treated in primary care, yet current therapies have limited efficacy and substantial side effects.
Purpose:
To evaluate long-term chamomile (Matricaria chamomilla L.) use for prevention of GAD symptom relapse.
Methods:
Outpatients from primary care practices and local communities with a primary diagnosis of moderate-to-severe GAD were enrolled for this two-phase study at a large US academic medical center. During Phase 1, eligible participants received 12 weeks of open-label therapy with chamomile pharmaceutical grade extract 1500mg (500mg capsule 3 times daily). During Phase 2, treatment responders were randomized to either 26 weeks of continuation chamomile therapy or placebo in a double-blinded, placebo-substitution design. The primary outcome was time to relapse during continuation therapy, analyzed using Cox proportional hazards. Secondary outcomes included the proportion who relapsed, treatment-emergent adverse events, and vital sign changes. This study is registered at ClinicalTrials.gov, identifier NCT01072344.
Results:
Between March 1, 2010, and June 30, 2015, we enrolled 179 participants. Of those, 93 (51.9%) were responders and agreed to continue in the double-blind randomized controlled trial. A numerically greater number of placebo-switched (n=12/47; 25.5%) versus chamomile-continuation (n = 7/46; 15.2%) participants relapsed during follow-up. Mean time to relapse was 11.4 ± 8.4 weeks for chamomile and 6.3 ± 3.9 weeks for placebo. Hazard of relapse was non-significantly lower for chamomile (hazard ratio, 0.52; 95% CI, 0.20-1.33; P = 0.16). During follow-up, chamomile participants maintained significantly lower GAD symptoms than placebo (P = 0.0032), with significant reductions in body weight (P = 0.046) and mean arterial blood pressure (P = 0.0063). Both treatments had similar low adverse event rates.
Conclusions:
Long-term chamomile was safe and significantly reduced moderate-to-severe GAD symptoms, but did not significantly reduce rate of relapse. Our limited sample size and lower than expected rate of placebo group relapse likely contributed to the non-significant primary outcome finding. Possible chamomile superiority over placebo requires further examination in large-scale studies.
Background:
Conventional drug treatments for Generalized Anxiety Disorder (GAD) are often accompanied by substantial side effects, dependence, and/or withdrawal syndrome. A prior controlled study of oral chamomile (Matricaria chamomilla L.) extract showed significant efficacy versus placebo, and suggested that chamomile may have anxiolytic activity for individuals with GAD.
Hypothesis:
We hypothesized that treatment with chamomile extract would result in a significant reduction in GAD severity ratings, and would be associated with a favorable adverse event and tolerability profile.
Study design:
We report on the open-label phase of a two-phase randomized controlled trial of chamomile versus placebo for relapse-prevention of recurrent GAD.
Methods:
Subjects with moderate to severe GAD received open-label treatment with pharmaceutical-grade chamomile extract 1500mg/day for up to 8 weeks. Primary outcomes were the frequency of clinical response and change in GAD-7 symptom scores by week 8. Secondary outcomes included the change over time on the Hamilton Rating Scale for Anxiety, the Beck Anxiety Inventory, and the Psychological General Well Being Index. Frequency of treatment-emergent adverse events and premature treatment discontinuation were also examined.
Results:
Of 179 subjects, 58.1% (95% CI: 50.9% to 65.5%) met criteria for response, while 15.6% prematurely discontinued treatment. Significant improvement over time was also observed on the GAD-7 rating (β=-8.4 [95% CI=-9.1 to -7.7]). A similar proportion of subjects demonstrated statistically significant and clinically meaningful reductions in secondary outcome ratings of anxiety and well-being. Adverse events occurred in 11.7% of subjects, although no serious adverse events occurred.
Conclusion:
Chamomile extract produced a clinically meaningful reduction in GAD symptoms over 8 weeks, with a response rate comparable to those observed during conventional anxiolytic drug therapy and a favorable adverse event profile. Future comparative effectiveness trials between chamomile and conventional drugs may help determine the optimal risk/benefit of these therapies for patients suffering from GAD.
Curcumin, a yellow pigment in the Indian spice Turmeric (Curcuma longa), which is chemically known as diferuloylmethane, was first isolated exactly two centuries ago in 1815 by two German Scientists, Vogel and Pelletier. However, according to the pubmed database, the first study on its biological activity as an antibacterial agent was published in 1949 in Nature and the first clinical trial was reported in The Lancet in 1937. Although the current database indicates almost 9000 publications on curcumin, until 1990 there were less than 100 papers published on this nutraceutical. At the molecular level, this multitargeted agent has been shown to exhibit anti-inflammatory activity through the suppression of numerous cell signalling pathways including NF-κB, STAT3, Nrf2, ROS and COX-2. Numerous studies have indicated that curcumin is a highly potent antimicrobial agent and has been shown to be active against various chronic diseases including various types of cancers, diabetes, obesity, cardiovascular, pulmonary, neurological and autoimmune diseases. Furthermore, this compound has also been shown to be synergistic with other nutraceuticals such as resveratrol, piperine, catechins, quercetin and genistein. To date, over 100 different clinical trials have been completed with curcumin, which clearly show its safety, tolerability and its effectiveness against various chronic diseases in humans. However, more clinical trials in different populations are necessary to prove its potential against different chronic diseases in humans. This review's primary focus is on lessons learnt about curcumin from clinical trials.
Linked articles:
This article is part of a themed section on Principles of Pharmacological Research of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.11/issuetoc.
Crocus sativus L. (C. sativus), commonly known as saffron, is used as a food additive, preservative, and medicinal herb. Traditionally, it has been used as an alternative treatment for different diseases. C. sativus' medicinal effects are related to its major constituents like crocins, crocetin, and safranal. According to the literature, C. sativus and its constituents could be considered as an effective treatment for neurodegenerative disorders, coronary artery diseases, asthma, bronchitis, colds, fever, diabetes, and so on. Recently, numerous studies have reported such medicinal properties and found that the underlying mechanisms of action may be mediated by antioxidant, inflammatory, and immunomodulatory effects. C. sativus enhances the antioxidant capacity and acts as a free radical scavenger. As an antiinflammatory and immunomodulatory agent, it modulates inflammatory mediators, humoral immunity, and cell-mediated immunity responses. This review highlights in vitro and animal findings regarding antiinflammatory, antioxidant, and immunomodulatory effects of C. sativus and its constituents. Present review found that the C. sativus and its main constituents such as safranal, crocins, and crocetin could be effective against various diseases because of their antioxidant, anti-inflammation, and immunomodulatory effects. Copyright © 2016 John Wiley & Sons, Ltd.
Background:
Depression and anxiety are prevalent serious psychiatric disorders. Several drugs are used to treat these conditions but these are often associated with serious side effects. For this reason alternative therapies, including herbal medication such as saffron, have been proposed. We aimed to assess the effects of saffron extract for the treatment of anxiety and depression using a 12-week double-blind, placebo-controlled trial design.
Methods:
Sixty adult patients with anxiety and depression were randomized to receive a 50 mg saffron capsule (Crocus sativus L. stigma) or a placebo capsule twice daily for 12 weeks. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) questionnaires were used at baseline, 6 and 12 weeks after initiating medication. 54 subjects completed the trial.
Results:
Saffron supplements had a significant effect on the BDI and BAI scores of subjects in comparison to placebo at the 12 week time-point (p<0.001).
Conclusions:
Saffron appears to have a significant impact in the treatment of anxiety and depression disorder. Side effects were rare.
Background
Depression is the most common psychiatric disorder in the world. The conventional medications for depression, however, often have significant side effects. These adverse effects of conventional therapies, have motivated researchers to study alternative options including complementary and traditional treatments for solving the problem.
Objective
To compare the efficacy of Nepeta menthoides Boiss. & Buhse freeze- dried aqueous extract with sertraline in the treatment of major depression.
Design and setting
From April to September of 2015, 72 patients from two psychiatry clinics of Shiraz University of Medical Sciences who met the criteria for major depression based on the structured clinical interview as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, participated in a two-armed double-blind randomized controlled trial.
Intervention
Subjects were randomly assigned to receive Nepeta menthoides or sertraline for four weeks.
Outcome measures
Patients were evaluated in terms of the Beck Depression Inventory-II (BDI-II) total score and common side effects of medications at the base line, the second and fourth weeks, and two weeks following the intervention (i.e. in the sixth week).
Results
The mean changes in the Beck Depression Inventory scores in Nepeta menthoides group were significantly higher in terms of the BDI-II scores diminution as compared to that of the control (p ≤ 0.001). Two weeks follow up after intervention showed a lower recurrence rate in the Nepeta menthoides group. (p ≤ 0.001)
Conclusion
Nepeta menthoides may have potential benefits in the control of mood in patients suffering from major depression. Sustention of antidepressant effect and delay in the recurrence of depression could be considered worthwhile using this herb.
BACKGROUND: Synthetic anxiolytic drugs are effective for anxiety, but they are burdened with adverse events. Constraints on resources and time often render treatments such as psychological interventions impracticable. Thus, an effective and safe oral medication would be of considerable interest and a welcome addition to the therapeutic repertoire. OBJECTIVES: To systematically review the evidence regarding the efficacy and safety of kava extract for the symptomatic treatment of anxiety. SEARCH STRATEGY: Computerized literature searches were performed in the databases Medline, Embase, Biosis, AMED, CISCOM and the Cochrane Library (all from their respective inception to June 1998). The search terms used were kava, kawa, kavain, Piper methysticum and Rauschpfeffer (German common name for Piper methysticum). Manufacturers of kava preparations and experts on the subject were contacted and asked to contribute published and unpublished material. In addition, our own files were searched and the bibliographies of all of the studies identified were scanned for further trials. There were no restrictions regarding the language of publication. SELECTION CRITERIA: Randomized, double-blind trials of oral kava extract mono-preparations for the treatment of anxiety were included. Trials comparing kava with placebo were included. Trials assessing kava as one of several active constituents in a combination preparation or as a part of a combination treatment were excluded. DATA COLLECTION AND ANALYSIS: All publications were blinded prior to assessment by a person not involved in the study. Data on patients, interventions, methods, results and adverse events were extracted systematically. Methodological quality of all trials was evaluated using the scoring system developed by Jadad and colleagues. The screening of studies, selection, data extraction and the assessment of methodological quality were performed independently by the two reviewers. Disagreements in the evaluation of individual trials were resolved through discussion. MAIN RESULTS: Seven trials met the inclusion criteria. All of the reviewed trials suggest superiority of kava extract over placebo. The meta-analysis of three studies using the Hamilton Anxiety Score as a common outcome measure suggests a significant differential treatment effect in favour of kava extract (weighted mean difference: 9.69, 95% confidence interval: 3.54 - 15.83). Adverse events as reported in the reviewed trials were mild, transient and infrequent. REVIEWER'S CONCLUSIONS: These data imply that kava extract is superior to placebo and relatively safe as a symptomatic treatment for anxiety. These findings warrant further and more rigorous investigations into the efficacy and safety of kava extract.
