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A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder

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Abstract

Generalized and persistent anxiety, accompanied by nervousness and other symptoms (Generalised Anxiety Disorder, GAD) is frequent in the general population and leads to benzodiazepine usage. Unfortunately, these substances induce sedation and have a high potential for drug abuse, and there is thus a need for alternatives. As the anxiolytic properties of lavender have already been demonstrated in pharmacological studies and small-scale clinical trials, it was postulated that lavender has a positive effect in GAD. A controlled clinical study was then performed to evaluate the efficacy of silexan, a new oral lavender oil capsule preparation, versus a benzodiazepine. In this study, the efficacy of a 6-week-intake of silexan compared to lorazepam was investigated in adults with GAD. The primary target variable was the change in the Hamilton Anxiety Rating Scale (HAM-A-total score) as an objective measurement of the severity of anxiety between baseline and week 6. The results suggest that silexan effectively ameliorates generalized anxiety comparable to a common benzodiazepine (lorazepam). The mean of the HAM-A-total score decreased clearly and to a similar extent in both groups (by 11.3+/-6.7 points (45%) in the silexan group and by 11.6+/-6.6 points (46%) in the lorazepam group, from 25+/-4 points at baseline in both groups). During the active treatment period, the two HAM-A subscores "somatic anxiety" (HAM-A subscore I) and "psychic anxiety" (HAM-A subscore II) also decreased clearly and to a similar extent in both groups. The changes in other subscores measured during the study, such as the SAS (Self-rating Anxiety Scale), PSWQ-PW (Penn State Worry Questionnaire), SF 36 Health survey Questionnaire and Clinical Global Impressions of severity of disorder (CGI item 1, CGI item 2, CGI item 3), and the results of the sleep diary demonstrated comparable positive effects of the two compounds. In conclusion, our results demonstrate that silexan is as effective as lorazepam in adults with GAD. The safety of silexan was also demonstrated. Since lavender oil showed no sedative effects in our study and has no potential for drug abuse, silexan appears to be an effective and well tolerated alternative to benzodiazepines for amelioration of generalised anxiety.

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... Flowers of several species of lavender are known for their wide therapeutic use for centuries. The major components of lavender oil are linalool, 1.8-cineole, linalyl acetate, -ocimene, terpinen-4-ol and camphor [6]. Among them the main components are linalool, a sedative agent which is found to affect gamma-amino butyric acid receptors of the central nervous system and linalyl acetate, a narcotic agent [7]. ...
... Silexan, an oral preparation of lavender essential oil administered in the dosage of 80 mg daily for six weeks has shown a reduction in the state of Generalized Anxiety Disorder (GAD) response by at least 50% in the HAM-A total score between the baseline and the end of week 6 similar to the effect of traditional anxiolytic drugs such as lorazepam and paroxetine [6,12]. The advantage with the use of silexan is that it has no potential for abuse and causes no hangover like symptoms associated with the use traditional anxiolytic drugs. ...
... In the silexan group, a causal relationship to the study medication could not be ruled out for 11 adverse events in 10 patients. Nine of the eleven adverse events were gastrointestinal namely, nausea: 4 adverse events, eructation/ breath odour: 3 adverse events and dyspepsia: 2 adverse events [6]. ...
... The positive control in an abuse liability study is typically a controlled substance from the same pharmacological class with a comparable indication as the investigational product. Lorazepam was chosen because Silexan was shown to have similar therapeutic effects as lorazepam in a double-blind, randomized trial in patients with GAD (Woelk and Schläfke, 2010), also indicating that the appropriate pharmacological class for a positive control in this study was the sedative (benzodiazepine) class. ...
... Silexan may thus be an interesting therapeutic option for the pharmacotherapy of anxiety-related disorders. While the herbal active substance was demonstrated to have similar effects as lorazepam and paroxetine in the treatment of patients with GAD (Woelk and Schläfke, 2010;Kasper et al., 2014), no sedative, addictive, or withdrawal effects have been reported to date in controlled clinical trials (Kumar, 2013;Silenieks et al., 2013;Müller et al., 2015;Gastpar et al., 2017;Kasper et al., 2018) even prior to a human abuse potential study. This study was designed to close this gap by investigating whether there is an abuse potential of Silexan in a sample of recreational drug users with a history of CNS depressant abuse. ...
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Background Silexan is a lavender essential oil with established anxiolytic and calming efficacy. Here we asked whether there is a potential for abuse in human patients. Methods We carried out a phase I abuse liability single-center, double-blind, 5-way crossover study in healthy users of recreational central nervous system depressants. They received single oral doses of 80 mg (therapeutic dose) and 640 mg Silexan, 2 mg and 4 mg lorazepam (active control) and placebo in randomized order, with 4- to 14-day washout periods between treatments. Pharmacodynamic measures included validated visual analogue scales assessing positive, negative, and sedative drug effects and balance of effects; a short form of the Addiction Research Center Inventory; and a drug similarity assessment. The primary outcome measure was the individual maximum value on the drug liking visual analogue scale during 24 hours post-dose. Results Forty participants were randomized and 34 were evaluable for pharmacodynamic outcomes. In intraindividual head-to-head comparisons of the drug liking visual analogue scale maximum value, both doses of Silexan were rated similar to placebo whereas differences were observed between Silexan and lorazepam and between placebo and lorazepam (P < .001). These data were supported by all secondary measures of positive drug effects and of balance of effects. Differences between placebo and both doses of Silexan were always negligible in magnitude. Moreover, Silexan showed no sedative effects and was not perceived to be similar to commonly used drugs that participants had used in the past. Conclusions Silexan did not exhibit any abuse potential in a standard abuse potential detection screen study and is unlikely to be recreationally abused.
... Subsequently, Kasper et al. in 2015 41 investigated the effect of 80 mg silexan daily and used placebo for the reference group. The study design was a randomized, double-blind trial with 28.2% of the study's 179 participants being male 38 . In this study, 86 participants were assigned to the silexan 80 mg group. ...
... Details on study characteristics are available inTable 1.Although the recruitment criteria for all 5 studies included participants of both genders and of any ethnicity, less than 31% of participants in each study were male and almost all were Caucasian. Woelk & Schlafke38 ...
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A systematic review and network-meta analysis (NMA) were performed to estimate significance of the anxiolytic effect of lavender essential oil taken as silexan capsules versus other comparators (i.e., placebo/paroxetine/lorazepam). The outcome of interest was Hamilton Anxiety Scale (HAMA). Weighted mean differences (WMD) were calculated to estimate the treatment effect at the confidence interval of 95%. League tables were generated using treatment effect, for all pairwise comparisons, where WMD < 0 favors the column-defining treatment. Five studies were identified with a total of 524 participants receiving treatment with silexan 80 mg and 121 participants taking silexan 160 mg. The NMA results indicated that consumption of silexan 160 mg resulted in higher decline of HAMA score [WMD −1.14 (−1.10, 3.39)] in comparison to silexan 80 mg, placebo [−2.20 (−4.64, 0.24)] and paroxetine [−1.24 (−5.34, 2.85)]. The effect of silexan 80 mg was observed to be same as that of paroxetine. Overall, silexan 160 mg was noticed to be a more efficient treatment giving significant decline in HAMA score across other comparators. However, no improvements in HAMA score was observed for the group receiving lorazepam 0.5 mg when compared to silexan 160 mg, silexan 80 mg, paroxetine 20 mg, and placebo.
... Lavender essences have been recognized for their calming and sedative properties dating back centuries [7,8]. Several small studies have been conducted evaluating the effects of lavender oils on various types of both acute and chronic anxiety [9][10][11][12][13][14][15][16][17]. The active substance is typically produced through steam distillation of Lavandula angustifolia flowers, or English lavender, though other species may be used [8]. ...
... Woelk, et al. [13] 6 weeks 77 11.3 ± 6.7 ...
... Lavender essential oil is best known for its calming, sedative and anxiolytic effects and is therefore popular in the treatment of restlessness, sleep disorders, and anxiety (Schilcher et al., 2016). The efficacy and safety of a patented essential oil produced from Lavandula angustifolia flowers for oral administration has been demonstrated in adult patients with generalized anxiety disorder in several trials (Woelk and Schläfke, 2010;Kasper et al., 2014). ...
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When confronted with non-psychotic mental disorders, pregnant women often refrain from using synthetic drugs and resort to herbal medicines such as St. John’s wort, California poppy, valerian, lavender, and hops. Nevertheless, these herbal medicines have not yet been officially approved in pregnancy due to lack of safety data. Using a variety of in vitro methods (determination of cytotoxicity, apoptosis induction, genotoxicity, effects on metabolic properties, and inhibition/induction of differentiation) in a commonly used placental cell line (BeWo b30), we were previously able to show that extracts from these plants are likely to be safe at the usual clinical doses. In the present work, we wanted to extend our safety assessment of these herbal medicines by 1) looking for possible effects on gene expression and 2) using the same in vitro methods to characterize effects of selected phytochemicals that might conceivably lead to safety issues. Proteomics results were promising, as none of the five extracts significantly affected protein expression by up- or down-regulation. Protopine (contained in California poppy), valerenic acid (in valerian), and linalool (in lavender) were inconspicuous in all experiments and showed no adverse effects. Hyperforin and hypericin (two constituents of St. John’s wort) and valtrate (typical for valerian) were the most obvious phytochemicals with respect to cytotoxic and apoptotic effects. A decrease in cell viability was evident with hypericin (≥1 µM) and valtrate (≥10 µM), whereas hyperforin (≥3 µM), hypericin (30 µM) and valtrate (≥10 µM) induced cell apoptosis. None of the tested phytochemicals resulted in genotoxic effects at concentrations of 0.1 and 1 µM and thus are not DNA damaging. No decrease in glucose consumption or lactate production was observed under the influence of the phytochemicals, except for valtrate (at all concentrations). No compound affected cell differentiation, except for hyperforin (≥1 µM), which had an inhibitory effect. This study suggests that extracts from St. John’s wort, California poppy, valerian, lavender, and hops are likely to be safe during pregnancy. High plasma concentrations of some relevant compounds—hyperforin and hypericin from St. John’s wort and valtrate from valerian—deserve special attention, however.
... V dvojitě slepé studii byl srovnáván účinek přípravku s obsahem levandule (Silexan) a lorazepamu u pacientů s generalizovanou úzkostnou poruchou. Jejich účinek na odstranění příznaků úzkosti byl srovnatelný, levandule se tedy jeví jako bezpečnější alternativa k benzodiazepinům (Woelk, Schläfke, 2010). ...
... Of the 2131 participants in the included studies, 992 participants used lavender aromatherapy, 957 used oral lavender, and only 182 used lavender massage. The studies tested lavender's anxiolytic efficacy in cardiac patients [10,22,[30][31][32][33][34], in patients with anxiety disorder [8,17,18,[35][36][37], in healthy patients under stressful circumstances [14,[38][39][40][41][42], in pregnant women [12,34,43], in critically ill patients in intensive care [9,21], in hemodialysis patients [44,45], in dental patients [19,46], in post-partum patients [20] and in patients undergoing peripheral venous cannulation [9]. Notably, all of our included studies used L. angustifolia extract. ...
Article
Background There is preliminary evidence for lavender as an anxiolytic agent through various routes of administration. Our goal is to elucidate the best route of administration for lavender as a treatment for anxiety. Methods Thirteen electronic search engines were systematically scanned for relevant publications. The relevant articles were included after the title and abstract screening followed by the full-text screening. This study included randomized control trials reporting lavender for the treatment of anxiety. The protocol was registered in PROSPERO (CRD42017076711). Frequentist network meta-analysis and Bayesian meta-regression were conducted to report the best treatment modality and the effect of covariates on the effectiveness as an anxiolytic. Treatment arms were ordered according P-scores, where higher P-score indicates better treatment choice. Results Forty studies were eligible for qualitative analysis, and 32 were included in quantitative analysis. Lavender aromatherapy was the best approach for the treatment of anxiety among other lavender modalities at the first week recording [Standardized Mean Difference (SMD) = −0.57, 95% CI (−1.14–0.01), P-score = 0.72], in addition to achieve at the first time points [SMD = −0, 95% CI (−0.97 ̶ -0.16), P-score = 0.69], compared to placebo; however, lavender massage along with foot bath were found to be the most efficacious for anxiety treatment at the study endpoint [SMD = −1.10, 95% CI = (−7.41 ̶ 5.21), P-score = 0.65]. Furthermore, network meta-regression revealed that the duration of therapy influenced treatment, suggesting Silexan (oral lavender) 80 mg (first rank probability = .116) as the favorable option for anxiety in long-term treatment. Conclusions Lavender aromatherapy is, clinically, superior in short-duration, while Silexan (oral lavender) 80 mg is preferable for long-term treatment of anxie
... It has been also proven that LEO has beneficial immunomodulatory effects on wound healing [13]. In addition, this oil has various pharmacological effects described in the available literature, such as antibacterial, antifungal, antioxidant, anxiolytic, anticonvulsant, and anticholinesterase properties [14][15][16][17][18][19]. According to Malcolm and Tallian [20], LEO is classified as Generally Recognized as Safe (GRAS) by the Food and Drugs Administration (FDA) (21CFR182.20 ...
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In the post-antibiotic era the issue of bacterial resistance refers not only to antibiotics themselves but also to common antiseptics like octenidine dihydrochloride (OCT). This appears as an emerging challenge in terms of preventing staphylococcal infections, which are both potentially severe and easy to transfer horizontally. Essential oils have shown synergisms both with antibiotics and antiseptics. Therefore the aim of this study was to investigate the impact of lavender essential oil (LEO) on OCT efficiency towards methicillin-resistant S. aureus strains (MRSA). The LEO analyzed in this study increased the OCT’s susceptibility against MRSA strains. Subsequent FTIR analysis revealed cellular wall modifications in MRSA strain cultured in media supplemented with OCT or LEO/OCT. In conclusion, LEO appears to be a promising candidate for an efficient enhancer of conventional antiseptics.
... It also acts as acaricidal repellent (Rivas da Silva et al., 2012). Another important active principle of the lavender essential oil, pinene, is a bicyclic monoterpene with positive enantiomers, α-pinene and β-pinene, respectively, that was found to have antimicrobial effects on Candida albicans, Cryptococcus neoformans, Rhizopus oryzae (Inouye et al., 2001) and gram-positive bacteria (Leite et al., 2007;Woelk et al., 2010;Woronuk et al., 2011). ...
Article
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An increasing market demand concerning lavender essential oil is reported. Identification and characterization of the main compounds of this oil is needed, in order to identify chemotypes. This information is useful for further uses of the produced oil. Essential oil extracted from two Lavandula angustifolia L. varieties, cultivated in different areas of Transylvania, Romania, was analysed from the point of view of qualitative and quantitative composition, using gas-chromatography. Basic statistics was used for calculation of essential oil compounds means and dispersion parameters, while the profile of the essential oil composition was emphasized using Box-Plot diagrams and cluster analysis. Nine compounds, in different amounts were quantified, and two chemotypes, corresponding to ‘Mailette’ and ‘Vera’ varieties were established (linalool, and linalyl acetate, respectively). Differences in essential oil composition are recorded in ‘Vera’ variety corresponding to ‘Vera’ linalyl acetate chemotype, function of specific condition of lavender cultivation area.
... Lavender has a long history of medicinal use as antidepressive, anxiolytic, sedative, and calming therapy (Cavanagh and Wilkinson, 2002;Koulivand et al., 2013), properties that have been confirmed by some recent clinical trials (Akhondzadeh et al., 2003;Woelk and Schläfke, 2010;Conrad and Adams, 2012) as well as preclinical works explaining molecular mechanisms of action (López et al., 2017). Neuropathic pain has been associated with a worse quality of life than general population (Doth et al., 2010), largely due to the presence of comorbidities, such as poor sleep, anxiety, and depression, producing a high socioeconomic impact on society (Langley et al., 2013;Torta et al., 2017). ...
Article
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Low treatment efficacy represents an important unmet need in neuropathic pain patients and there is an urgent need to develop a more effective pharmacotherapy. An increasing number of patients choose complementary medicine to relieve pain. Lavender essential oil (LEO) is approved by the European Medicines Agency as herbal medicine to relieve anxiety and stress. However, the capability of LEO to relieve other nervous system disorders such as neuropathic pain has never been established. Our work aimed to evaluate the antineuropathic properties of lavender on a spared nerve injury (SNI) model of neuropathic pain in mice. An acute oral administration of LEO (100 mg/kg) alleviated SNI-induced mechanical allodynia, evaluated in the von Frey test, with an intensity comparable to the reference drug pregabalin. Investigations into the mechanism of action showed that LEO markedly decreased the phosphorylation of ERK1, ERK2, and JNK1, and decreased the levels of iNOS in the spinal cord; involvement of the endocannabinoid system was also detected using in vitro inhibition of the FAAH and MALG enzymes as well as in vivo experiments with the CB1 antagonist. Conversely, no effect on P38 phosphorylation and NF-kB activation was detected. These antihyperalgesic effects appeared at the same dose able to induce antidepressant-like, anxiolytic-like, and anorexic effects. In addition, gavage with LEO did not significantly alter animals’ gross behavior, motor coordination, or locomotor activity, nor impaired memory functions. Oral administration of LEO could represent a therapeutic approach in the management of neuropathic pain states.
... • • Peer-to-peer cognitive self-therapy (den Boer et al., 2007); • • Meta-cognitive therapy (van der Heiden et al., 2012;Wells et al., 2010); • • CBT targeting intolerance of uncertainty (Dugas et al., 2010); • • Short-term and internet psychodynamic psychotherapy (Andersson et al., 2012;Ferrero et al., 2007;Riskind et al., 2006); • • Alternative therapies (Kasper et al., 2010;Lakhan and Vieira, 2010;Sarris et al., 2011;Sarris and Kavanagh, 2009;Woelk and Schlafke, 2010). ...
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Objective To provide practical clinical guidance for the treatment of adults with panic disorder, social anxiety disorder and generalised anxiety disorder in Australia and New Zealand. Method Relevant systematic reviews and meta-analyses of clinical trials were identified by searching PsycINFO, Medline, Embase and Cochrane databases. Additional relevant studies were identified from reference lists of identified articles, grey literature and literature known to the working group. Evidence-based and consensus-based recommendations were formulated by synthesising the evidence from efficacy studies, considering effectiveness in routine practice, accessibility and availability of treatment options in Australia and New Zealand, fidelity, acceptability to patients, safety and costs. The draft guidelines were reviewed by expert and clinical advisors, key stakeholders, professional bodies, and specialist groups with interest and expertise in anxiety disorders. Results The guidelines recommend a pragmatic approach beginning with psychoeducation and advice on lifestyle factors, followed by initial treatment selected in collaboration with the patient from evidence-based options, taking into account symptom severity, patient preference, accessibility and cost. Recommended initial treatment options for all three anxiety disorders are cognitive–behavioural therapy (face-to-face or delivered by computer, tablet or smartphone application), pharmacotherapy (a selective serotonin reuptake inhibitor or serotonin and noradrenaline reuptake inhibitor together with advice about graded exposure to anxiety triggers), or the combination of cognitive–behavioural therapy and pharmacotherapy. Conclusion The Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder provide up-to-date guidance and advice on the management of these disorders for use by health professionals in Australia and New Zealand.
... Lavender (Lavandula) has been studied in recent years for its effects on anxiety and sleep in adults. In 2010, in a RCT [213], 80 mg of oral lavender oil supplements (silexan) administered for 6 weeks were shown to be as effective as a common benzodiazepine (lorazepam) in adults with generalized anxiety disorder, improving both anxiety scores and subjectively reported sleep quality. Moreover, two other RCT [214,215] confirmed the anxiolytic effect of 80 mg/day of silexan for 10 weeks, also suggesting its effectiveness in reducing anxiety-related disturbed sleep, as measured by the Pittsburgh Sleep Quality Index (PSQI). ...
Article
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Autism Spectrum Disorders (ASD) are lifelong neurodevelopmental conditions characterized by abnormal social interaction, communication, and behavior. Sleep disturbances represent a common comorbidity in children and adolescents with ASD, with prevalence ranging from 50 to 80%. It has been proved that sleep disruption worsens the symptoms of autism and results in challenging behaviors. Improving sleep should therefore be a primary therapeutic goal. Treatment options range from lifestyle modifications to pharmacological therapy. Several reviews have been written on pharmacological treatments, but very few on the beneficial effects of non-pharmacological interventions, over-the-counter drugs, and nutritional supplements. This study consists of a narrative review of the literature, presenting the available evidence on the following treatments: sleep education, behavioral interventions, complementary and alternative medicine (special mattresses and blankets, massage, aromatherapy, yoga, physical activity), and commonly used over-the-counter medications and supplements (antihistamines, melatonin, tryptophan, carnosine, iron, vitamins, and herbal remedies). For some treatments—such as melatonin and behavioral interventions—effectiveness in ASD is well established in the literature, while other interventions appear of benefit in clinical practice, even if specific studies in children and adolescents with ASD are lacking. Conversely, other treatments only seem to show anecdotal evidence supporting their use.
... Therefore, the LA essential oil and linalool may be considered as useful alternative tools to the available traditional treatments for social stress-induced mental illnesses. Therefore, the alternative management of anxiety and other social consequences of stress is of great importance in contemporary urban life [5,6]. ...
Article
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Many vegetable extracts, essential oils, and their main constituents are active on the Central Nervous System (CNS). In fact, they have been used as sedatives, hypnotics, or tranquilizers for their activity in treating CNS disorders. In this research, we studied the possible activities of Lavandula angustifolia (LA) essential oil and of its main constituent, linalool, as anti-stress compounds on anxiety and social interaction and their in vitro effects on proteins (pERK and PKA) involved in the transmission of the signal. An acute intraperitoneal injection of linalool (100 mg/kg) and of LA essential oil (200 mg/kg) reduced motor activity without any anxiolytic effect, but significantly increased social interaction. Stressed mice, after being exposed to a social defeat encounter, showed heightened anxiety and social avoidance. Acute administration of LA essential oil blocked stress-induced anxiety, while linalool showed no effects. However, both compounds were capable of reversing social aversion, acting as antidepressant agents. Our results showed that linalool inhibits pERK and PKA expression in the SH-SY5Y cell, but no effect was detected with the LA essential oil. Therefore, the LA essential oil and linalool may be considered as useful alternative tools to the available traditional treatments for social stress-induced mental illnesses.
... However, the most explored activity of lavender essential oil is its use as an anxiolytic and as an adjuvant in the treatment of insomnia, even though there is no evidence that Lavender does not have a sedative effect, olfactory use can improve the quality of sleep reducing insomnia [12]. ...
... Long used in aromatherapy, silexan, an essential oil derived from lavender has been evaluated in adults with GAD. In one trial comparing the benzodiazepine lorazepam to silexan, comparable improvements were observed between lorazepam and silexan [118]. Additionally, in a randomized, doubleblind, double-dummy trial (N = 539) that was referenced to paroxetine, silexan (160 or 80 mg/day) was superior to placebo in reducing symptoms of anxiety (HAM-A) total score, p < 0.01); paroxetine trended toward significance (p = 0.10). ...
Article
Introduction: Generalized anxiety disorder (GAD) often begins during adolescence or early adulthood and persists throughout the lifespan. Randomized controlled trials support the efficacy of selective serotonin and selective serotonin norepinephrine reuptake inhibitors (SSRIs and SNRIs, respectively), as well as benzodiazepines, azapirones, anti-adrenergic medications, melatonin analogs, second-generation antipsychotics, kava, and lavender oil in GAD. However, psychopharmacologic treatment selection requires clinicians to consider multiple factors, including age, co-morbidity, and prior treatment. Areas covered: The authors review the literature concerning pharmacotherapy for pediatric and adult patients with GAD with specific commentary on the efficacy and tolerability of selected agents in these age groups. The authors describe an algorithmic approach to the pediatric and adult patient with GAD and highlight considerations for the use of selected medications in these patients. Expert opinion: In adults with GAD, SSRIs and SNRIs represent the first-line psychopharmacologic treatment while second-line pharmacotherapies include buspirone, benzodiazepines, SGAs, and pregabalin. In pediatric patients with GAD, SSRIs should be considered the first line pharmacotherapy and psychotherapy enhances antidepressant response.
... Досліджувалася ефективність нового антидепресанту вортіоксетину в лікуванні пацієнтів з ГТР, однак не виявлено його вірогідної ефективності порівняно з плацебо [20]. У декількох дослідженнях продемонстровано ефективність перорального прийому препаратів на основі лавандової олії в лікуванні пацієнтів із ГТР і тривожно-депресивними розладами [25,26,28,63]. Однак не встановлено, чи препарати на основі лаванди є такими ж дієвими, як і стандартне лікування. ...
... For instance, a study in Germany on 538 patients with generalized anxiety disorder showed that the oral use of 80-and 160-mg lavender essential oil capsules for 10 suc-cessive days significantly alleviated anxiety (21). Another study showed that the daily intake of 80 mg lavender essential oil was as effective as lorazepam in alleviating anxiety among patients with generalized anxiety disorder (30). Similarly, a study indicated that the oral intake of 300-mg lavender essential oil capsules was as effective as diazepam in anxiety alleviation (22). ...
... Lavender has a long traditional use in treating nervous system disorders, in principle due to its bioactive volatile oils (Felter & Lloyd, 2006[1898). The psychopharmacology underpinning any potential antidepressant activity is currently unknown; however, its anxiolytic effects are well-known, and this in part is due to the volatile component linalool (Woelk & Schlafke, 2010). An initial small study assessed lavender's antidepressant activity. ...
Article
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.
... The current study also showed no difference in trait anxiety levels among patients in the tea tree oil and control groups at the first and second assessments, whereas the trait anxiety levels of patients in the lavender group decreased by the second assessment. Published studies have reported that, because of its anxiolytic and sedative effects (Conrad & Adams, 2012;Fismer & Pilkington, 2012;Kianpour et al., 2016;Maddocks-Jennings & Wilkinson, 2004;Woelk & Schläfke, 2010), lavender provides spiritual comfort and physical and emotional well-being (Franco et al., 2016;Hur, Song, Lee, & Lee, 2014;Koulivand et al., 2013;Redstone, 2015). Ovayolu et al. (2014) found that aromatherapy massage and aromatherapy with lavender oil maintain physical comfort in the short term and that lavender oil can be used to manage psychological problems in the long term. ...
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Background: A cancer diagnosis is a serious stressor that is associated with anxiety, depression, sleep disorders, and inability to fulfill daily routines. Many pharmacologic and nonpharmacologic options are available to help patients with cancer manage anxiety. Objectives: This randomized, controlled trial examined the effects of lavender oil aromatherapy on anxiety and sleep quality in patients undergoing chemotherapy. Methods: 70 patients were randomly assigned to a lavender oil group, a tea tree oil group, and a control group with no oil. A patient identification form, the State-Trait Anxiety Inventory, and the Pittsburgh Quality Sleep Index (PSQI) were used to measure anxiety and sleep quality before and after chemotherapy. Findings: State anxiety before and after chemotherapy did not vary among groups. The authors compared trait anxiety values before and after chemotherapy and found a significant difference in the lavender group. In addition, a significant change in PSQI measurements before and after chemotherapy was observed.
... angustifolia), from the Lamiaceae family [16], has exhibited diverse neurological effects, such as anti-inflammatory, analgesic [17], neuroprotective [18], memory-enhancing, anxiolytic, and antidepressant [19], in various animal studies. There have also been a few welldesigned human clinical trials, showing promising effects of orally administered lavender for different anxiety disorders [20][21][22][23]. Further, other trials have shown positive effects of lavender, mostly as an adjunct to conventional treatment, on depressive disorders [24,25]. ...
Article
Background Major depressive disorder (MDD) accompanied by anxious distress is a chronic and disabling disorder. Its conventional drug therapies often have low patient compliance due to drug-related side effects. In Persian medicine, lavender-dodder syrup is one formula often recommended for such disorders. Objective This study compares the effects of lavender-dodder syrup to the standard drug, citalopram, for treating MDD with anxious distress. Design, setting, participants and intervention This six-week, double-blind, randomized, clinical trial was carried out in a psychiatric outpatient clinic. During the six-week intervention period, patients in citalopram group received citalopram tablets 20 mg/d plus 5 mL placebo syrup every 12 h; patients in group B received placebo tablets once daily plus 5 mL of lavender-dodder herbal syrup every 12 h. Main outcome measures Primary outcome measures, depression and anxiety, were evaluated using the Hamilton Depression/Anxiety Rating Scales, and were scored at the beginning of the study and at weeks three and six. Secondary outcome measures including response to treatment and remission rates were also compared between the two groups. Results Fifty-six participants with MDD and anxious distress were randomly assigned to two groups. Mean depression scores significantly decreased in citalopram and herbal groups at weeks three and six (time effect: P < 0.001), although the observed changes were not significantly different between the groups (intervention effect: P = 0.61). Mean anxiety scores were not significantly different between the two groups at week three (P = 0.75). However, at the end of week six, the observed decrease was significantly higher in the herbal syrup group than the citalopram group (intervention effect: P = 0.007). Conclusion The herbal syrup is an effective and tolerable supplement for treating MDD with anxious distress.
... In 2010, Woelk and collaborators showed in a double-blind, randomised study with 77 subjects that silexan, an oral lavender oil capsule preparation, is as effective as lorazepam in adults with generalised anxiety disorder (GAD). Hamilton Anxiety Rating Scale (HAM-A) scores for anxiety and sleep diary scores demonstrated comparable positive effects [43]. Two studies from Kasper et al. in 2010 [44] and 2015 [45] with a dose of 80 mg of silexan showed significant improvement in sleep quality (PSQI) and anxiety (HAM-A) compared to placebo. ...
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Background. Sleep complaints are common health issues in the general population. These conditions are associated with poorer physical and psychological activity, and they may have important social, economic, and personal consequences. In the last years, several food supplements with different plant extracts have been developed and are currently taken for improving sleep. Study Objectives. The aim of this study is to systematically review recent literature on oral plant extracts acting on sleep disorders distinguishing their action on the different symptoms of sleep complaints: difficulty in initiating or maintaining sleep, waking up too early, and quality of sleep. Methods. We searched the PubMed database up to 05/03/2020 based on data from randomized, double-blind, placebo-controlled trials, noncontrolled trials, and cohort studies conducted in children and adult subjects. The search words used contained the following terms: oral food supplement and sleep disorders and the like. The most studied compounds were further analyzed with a second search using the following terms: name of the compound and sleep disorders. We selected 7 emerging compounds and 38 relevant reports. Results. Although nutraceutical natural products have been used for sleep empirically, there is a scarcity of evidence on the efficacy of each product in clinical studies. Valerian and lavender were the most frequently studied plant extracts, and their use has been associated (with conflicting results) with anxiolytic effects and improvements in quality and duration of sleep. Conclusions. Sleep aids based on plant extracts are generally safe and well tolerated by the population. More high-quality research is needed to confirm the effectiveness of food supplements containing plant extracts in sleep complaints; in particular, it would be interesting to evaluate the association between plant extracts and sleep hygiene guidelines and to identify the optimal products to be used in a specific symptom of sleep complaint, giving more appropriate tools to the medical doctor. 1. Introduction Insomnia is defined as dissatisfaction with sleep quality or quantity in addition to at least one other symptom among difficulty initiating sleep, difficulty maintaining sleep, or early morning awakening with inability to return to sleep [1]. Occasional insomnia is a very common disturb that has been reported to be experienced by about 30% of the U.S. general population [1–3]. Sleep disorders have an important societal and economic impact, with a consequent reduction in labour productivity or increased risk of accidents [4–6]. Chronic insomnia is also a risk factor for a variety of significant health problems, such as cardiovascular disease [7, 8], diabetes [9], and obesity [10], as well as bad mood and cognitive dysfunction [11–13]. Almost half of the individuals with sleep problems had never taken any steps to resolve them, and the majority of respondents had not spoken with a physician about their problems. Of those individuals who had consulted a physician, drug prescriptions had been given to approximately 50% in Western Europe and the USA [14]. The commonly used sleep aids based on benzodiazepine and non-benzodiazepine hypnotic drugs are often related to negative side effects such as daytime drowsiness, dependency, depression, hypnotic-withdrawal insomnia, and even excess mortality [15]. Moreover, there are limited data on long-term efficacy of hypnotic drugs [16]. Given these concerns and an increasing patient preference for nonpharmacological treatments [17], it is important to offer patients with insomnia evidence-based nonpharmacologic alternatives that may improve their sleep. As defined in the Dietary Supplement Health and Education Act of 1994 (DSHEA), a dietary supplement is “a product (other than tobacco) intended to supplement the diet that bears or contains one or more dietary ingredients, including a vitamin, a mineral, an herb or other botanical, an amino acid, a dietary substance for use by humans to supplement the diet by increasing the total dietary intake of any of the aforementioned ingredients [18].” A growing body of evidence has shown promising results for these compounds in supporting health and body functions [19]. In particular, several dietary supplements are popularly used for sleep disorders [20], also in addition to other remedies (e.g., sleep hygiene and mind-body therapies) [21]. Moreover, no golden standard therapy is recommended to treat mild sleep disorders related to specific sleep stages (starting, maintaining, and ending sleep) [22, 23]. Our aim in this study was to systematically review recent literature on plant extracts and nutraceuticals administered orally and acting on sleep-related disorders. In particular, we differentiated the interventions and the outcomes of the studies based on the different sleep disorders (difficulty in initiating or maintaining sleep, quality and quantity of sleep, and waking up too early) and reviewed the available clinical data of the 7 most studied natural products: valerian, lavender, chamomile, hop, St. John’s wort, hawthorn, and rosemary. 2. Materials and Methods A literature search was performed using a primary medical search engine the PubMed database considering all articles published up to 05/03/2020; the registered review protocol can be found at: https://www.crd.york.ac.uk/PROSPEROFILES/126991_PROTOCOL_20190301.pdf. The review was registered on PROSPERO (international prospective register of systematic reviews in https://www.crd.york.ac.uk/prospero/), registration number CRD42019126991. The inclusion criteria were randomized, double-blind, placebo-controlled trials, noncontrolled trials, and cohort studies. We used the following search terms to search the PubMed register: (Oral food supplement) OR (Oral nutraceutical) OR (Oral natural products) AND (Sleep disorders) OR (Insomnia) AND “humans” [Filter] AND “English”[Filter]. The most studied compounds were singled out and further analyzed with a second search using the terms: (name of the compound) AND (Sleep disorders) OR (Insomnia) AND “humans”[Filter] AND “English”[Filter]. Only articles written in English and only studies conducted on humans were selected for this review. Additionally, the same research criteria were applied also for the Spanish language but no additional references were found. We contacted the study authors to retrieve the full article where only the abstract was available. We selected 7 emerging compounds and 35 relevant reports, excluding duplicates, nonrelevant articles, reviews, and works with no full article available (Figure 1). Information was extracted from each included trial in view of: (1) type of food supplement for sleep disorders (herbal component, dose, length of the treatment, and additional substances) and (2) clinical endpoints considering the different stages of sleep and sleep problems: sleep latency, sleep maintenance, quality of sleep, and quantity of sleep. Finally, the risk of bias of individual studies was considered both at study or outcome level, and the Jadad scale [24] for quality rating was used to assess the quality of works. Parameters considered were randomization, blinding, withdrawals, sample size, quality of data reported, and statistical analysis. Publication bias and selective reporting within studies are likely to be affecting the selected literature for this review.
... The extracts and Lavandula angustifolia essential oil have various pharmacological effects described in the literature, such as anticonvulsant [5], anxiolytic [6], antioxidant, anticholinesterase [7,8], antimicrobial [9], and antifungal activities [10]. Additionally, various constituents in the oil also have valuable pharmacological properties, such as antiinflammatory, antioxidant, and antimicrobial [11][12][13][14]. ...
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Lavandula angustifolia is a plant of Lamiaceae family, with many therapeutic properties and biological activities, such as anticonvulsant, anxiolytic, antioxidant, anti-inflammatory, and antimicrobial activities. The aim of this study was to evaluate the effect of Lavandula angustifolia Mill. essential oil (LEO) on acute inflammatory response. LEO was analyzed using gas chromatography-mass spectrometry (GC-MS) and nuclear magnetic resonance spectroscopy (NMR) methods and showed predominance of 1,8-cineole (39.83%), borneol (22.63%), and camphor (22.12%). LEO at concentrations of 0.5, 1, 3, and 10 μ g/ml did not present in vitro cytotoxicity. Additionally, LEO did not stimulate the leukocyte chemotaxis in vitro . The LEO topical application at concentrations of 0.25, 0.5, and 1 mg/ear reduced edema formation, myeloperoxidase (MPO) activity, and nitric oxide (NO) production in croton oil-induced ear edema model. In carrageenan-induced paw edema model, LEO treatment at doses of 75, 100, and 250 mg/kg reduced edema formation, MPO activity, and NO production. In dextran-induced paw edema model, LEO at doses of 75 and 100 mg/kg reduced paw edema and MPO activity. In conclusion, LEO presented anti-inflammatory activity, and the mechanism proposed of LEO seems to be, at least in part, involving the participation of prostanoids, NO, proinflammatory cytokines, and histamine.
... Sedative property of lavender EO was mediated by its anxiolytic effects (Seifritz et al., 2019). When taken orally, the lavender extract can be as effective as low-dose benzodiazepines for attenuating anxiety in generalized anxiety disorder (Woelk and Schläfke, 2010). ...
Article
Ethnopharmacological relevance Lavandula angustifolia Mill. essential oil (Lavender EO) has a long history of medicinal use and is particularly claimed to possess anxiolytic and sedative properties. Lavender EO aromatherapy has been used to reduce distress and improve insomnia naturally. Increasing evidence appeared to show similarities between the effects of lavender EO and the anxiolytic drugs, benzodiazepines. However, its effects on sleep-wake and electrical brain patterns in comparison to that of the standard anxiolytic, diazepam, remained to be explored. Aim of the study The aim of this work was to investigate electroencephalography (EEG) profiles and sleep-pattern elicited by lavender EO inhalation compared to that of diazepam, a standard anxiolytic drug in in vivo rat model. Materials and methods Adult male Wistar rats were anesthetized for electrode implantation on the frontal and parietal skulls. EEG signals were recorded for 180 mins following intraperitoneal injection of diazepam (10 mg/kg) or during continuous inhalation of lavender EO (200 μL) or distilled water (control). Fast Fourier transform was used for the analyses of EEG power spectra and sleep-wake parameters. Results During a 30-60 min period, diazepam and lavender EO significantly increased frontal powers of 0.78-45.31 and 7.03-18.36 Hz, respectively. Both treatments also increased parietal powers with lower magnitudes of significant change. Significant increases in some frequency ranges remained until a 60-90 min period. Sleep-wake analyses also revealed that diazepam significantly reduced time spent in wake, increased time spent in non-rapid eye movement (NREM), increased episode duration of NREM, decreased numbers of wake episode and decreased rapid eye movement (REM) sleep latency. On the other hand, lavender EO only significantly decreased wake episodes and latency to REM sleep. Lavender EO inhalation reduced numbers of wake episode but maintain normal time spent in wake, NREM and REM sleeps. Conclusions These findings might suggest beneficial and distinct anxiolytic-like effects of lavender EO for sleep enhancing purposes.
... Anxiety disorder (GAD) for daily single doses of 80 mg and 160 mg (Woelk and Schläfke, 2010;Kasper et al., 2014;Kasper et al, 2017). Moreover, evidence for antidepressant-like properties of Silexan ® have been observed in anxious patients suffering from comorbid depressive symptoms and in patients with mixed anxietydepression disorder (ICD-10 F41.2) (Kasper and Dienel, 2013;Kasper et al, 2016) which may indicate intrinsic antidepressant-like properties independent of its anxiolytic activity (Friedland et al., 2020). ...
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Silexan®, a proprietary essential oil manufactured by steam distillation from Lavandula angustifolia flowers showed pronounced anxiolytic effects in patients with subthreshold anxiety disorders and was also efficacious in patients with Generalized Anxiety disorder (GAD). Moreover, evidences for antidepressant-like properties of Silexan® have been observed in anxious patients suffering from comorbid depressive symptoms and in patients with mixed anxiety-depression disorder (ICD-10 F41.2). In accordance with the clinical data Silexan® is active in several behavioural models in rodents at rather low concentrations indicating potent anxiolytic and antidepressive properties. As possible mechanism of action a moderate inhibition of voltage dependent calcium channels (VDCC) has been found showing some similarities to the anxiolytic drug pregabalin. However, while pregabalin mainly inhibits P/Q-type channels by binding to a modulatory subunit, Silexan® moderately inhibits mainly T-type and N-type channels and to some extent P/Q-type channels. Unlike pregabalin Silexan® is free of hypnotic or sedative side effects and seems to be devoid of any abuse potential. With respect to its specific antidepressant like properties Silexan® improves several aspects of neuroplasticity which seems to be the common final pathway of all antidepressant drugs. As a potential mechanism of its effects on neuroplasticity an activation of the transcription factor CREB via activation of intracellular signaling kinases like PKA and MAPK has been found. Since the concentrations of Silexan® needed to inhibit VDCC function and to improve neuroplasticity are quite similar, the effects of Silexan® on PKA or MAPK could constitute a common intracellular signaling cascade leading to VDCC modulation as well as CREB activation and improved neuroplasticity.
... Furthermore, the effects of inhaling terpenic volatiles on blood pressure in humans were studied, and it was discovered that these EO-volatiles quickly reduced the elevated systolic blood pressure to normal levels after the jogging tour was completed (Romine et al., 1999;Suzuki and Aoki, 1994). Moreover, the extracts and EO of L. angustifolia have a variety of pharmacological effects described in the literature, including anxiolytic (Bradley et al., 2007;Woelk and Schläfke, 2010), antioxidant (Spiridon et al., 2011), anticholinesterase (Costa et al., 2011), antimicrobial (Danh et al., 2013), and antifungal (Behmanesh et al., 2015) activities. As an insect repellent, spike lavender is found in a number of veterinary shampoos and other products, particularly for fleas. ...
Article
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Lavender is a very old herb that has been used for centuries as an antiseptic and relaxant. The demand for its essential oil continues to grow on a global scale. The fact remains that harvesting at the right time of growth is critical to maximizing the rate of active ingredients found in the plant. Thus, in the current study, L. angustifolia plants were collected at various growth stages (pre-flowering, mid-flowering, and post-flowering) from Adana, Turkey in order to determine the most suitable harvest time for the highest amount of essential oils and its important compounds. The highest flower essential oil content (7.50 mL 100 g-1) was obtained at mid-flowering of the third year of plantation. The major compounds for L. angustifolia were linalyl acetate (25.63-31.63%), linalool (16.33-24.79%), nerol (8.83-13.43%), beta-farnesene (3.67-5.70%), β-cis-ocimene (1.76-8.14%), respectively. The obtained data have been inquired by principal components analysis (PCA), allowing differentiation of plantation ages and growth stages. Compared to the plantation ages, essential oil content and linalool content increased significantly in the third year of cultivation. As a result, the most suitable harvest time may be considered as mid-flowering in terms of essential oil content and in terms of high linalyl acetate and linalool content.
... Patients treated with silexan showed a total score decrease of 59.3% for the HAMA and of 44.7% for the PSQI compared to 35.4% and 30.9% in the placebo group (p < 0.01) [126]. Similar results were obtained in another double-blind, randomized study of 6-week-intake of silexan compared to lorazepam [194]. Bradley, et al. (2009) investigated the effect of orally administered lavender capsules (containing sunflower oil and 100 or 200 µL of organic Lavandula angustifolia oil) on responses to anxiety-provoking film clips (low anxiety). ...
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Anxiety and insomnia are among the most common mental health disorders and are a major cause of disability around the world. Traditional herbal medicines are receiving significant attention in global health debates. Several Italian regions maintain rural traditions and are among the most extensively studied areas of Europe regarding medicinal plant uses. The present overview aims to highlight the use of wild and cultivated plants, specifically as sedatives and for insomnia treatment in Italy, and to collect, analyze, and summarize the available literature about their pharmacological activity as well as clinical and pre-clinical studies concerning the most cited plants. In total, 106 wild taxa are used in Italy for sedative purposes. The plant species belong to 76 genera and 32 families, of which the most cited are Asteraceae (24.2%) and Lamiaceae (21.1%). Leaves (29%) and flowers (27%) are the plant parts mostly used as infusion (70%) and decoction (25%). Out of 106 taxa documented, only the most cited are analyzed in this overview (A. arvensis L., C. nepeta L., C. monogyna Jacq., H. lupulus L., L. nobilis L., L. angustifolia Mill., M. sylvestris L., M. chamomilla L., M. officinalis L., O. basilicum L., P. rhoeas L., P. somniferum L., R. officinalis L., T. platyphyllus Scop., and V. officinalis L.). Among the fifteen species selected, only seven have been studied for their pharmacological activity as hypnotic-sedatives. Future pre-clinical and clinical studies are needed to better clarify the mechanism of action of bioactive compounds and confirm the potential of these alternative therapies.
... Застосування Лазеї свідчило про відсутність побічних ефектів, характерних для бензодіазепінів, таких як сонливість і звикання. За висновками дослідження, Лазея рекомендована як альтернатива препаратам групи бензодіазепінового ряду з метою зменшення вираженості генералізованих тривожних розладів у дорослих [8]. ...
... It effectively treats anxiety [16], general restlessness, and difficulty falling asleep [15]. In adults with generalized anxiety disorder, the anxiolytic effect was comparable to that of a benzodiazepine (low-dose lorazepam [17] and the SSRI paroxetine [18]), and fewer adverse effects were reported than with the synthetic drugs. ...
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Pregnancy is a critical period for medical care, during which the well-being of woman and fetus must be considered. This is particularly relevant in managing non-psychotic mental disorders since treatment with central nervous system-active drugs and untreated NMDs may have negative effects. Some well-known herbal preparations (phytopharmaceuticals), including St. Johnʼs wort, California poppy, valerian, lavender, and hops, possess antidepressant, sedative, anxiolytic, or antidepressant properties and could be used to treat mental diseases such as depression, restlessness, and anxiety in pregnancy. Our goal was to assess their safety in vitro, focusing on cytotoxicity, induction of apoptosis, genotoxicity, and effects on metabolic properties and differentiation in cells widely used as a placental cell model (BeWo b30 placenta choriocarcinoma cells). The lavender essential oil was inconspicuous in all experiments and showed no detrimental effects. At low-to-high concentrations, no extract markedly affected the chosen safety parameters. At an artificially high concentration of 100 µg/mL, extracts from St. Johnʼs wort, California poppy, valerian, and hops had minimal cytotoxic effects. None of the extracts resulted in genotoxic effects or altered glucose consumption or lactate production, nor did they induce or inhibit BeWo b30 cell differentiation. This study suggests that all tested preparations from St. Johnʼs wort, California poppy, valerian, lavender, and hops, in concentrations up to 30 µg/mL, do not possess any cytotoxic or genotoxic potential and do not compromise placental cell viability, metabolic activity, and differentiation. Empirical and clinical studies during pregnancy are needed to support these in vitro data.
... The results suggest that silexan effectively ameliorates generalized anxiety at a comparable degree to that of lorazepam (0.5 mg/day) administration. [192] linalol, linalyl acetate, terpinene-4ol, ocimene, cineole (Lavandula angustifolia) ...
Article
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Alzheimer’s disease (AD) is the leading cause of dementia and cognitive function impairment. The multi-faced character of AD requires new drug solutions based on substances that incorporate a wide range of activities. Antioxidants, AChE/BChE inhibitors, BACE1, or anti-amyloid platelet aggregation substances are most desirable because they improve cognition with minimal side effects. Plant secondary metabolites, used in traditional medicine and pharmacy, are promising. Among these are the monoterpenes—low-molecular compounds with anti-inflammatory, antioxidant, enzyme inhibitory, analgesic, sedative, as well as other biological properties. The presented review focuses on the pathophysiology of AD and a selected group of anti-neurodegenerative monoterpenes and monoterpenoids for which possible mechanisms of action have been explained. The main body of the article focuses on monoterpenes that have shown improved memory and learning, anxiolytic and sleep-regulating effects as determined by in vitro and in silico tests—followed by validation in in vivo models.
... Tansiyon üzerinde, sistolik ve diastolik kan basıncını azalttığı ve kalp atım hızını yavaşlattığı gösterilmiştir 27 .Lavanta uçucu yağının uyku bozukluklarında etkili olduğu uzun zamandan beri bilinmektedir.Uyku sorunu olan 67 yaşlı vaka ile yapılan bir çalışmada lavanta uçucu yağı kullanımının, 4 haftalık uygulama sonunda uyku hormonu olan melatoninin kan düzeyini, kontrol grubuna göre anlamlı oranda arttırdığı gösterilmiştir28 .In vitro ve in vivo laboratuvar çalışmaları, linalol ve linalil asetat içeren lavanta uçucu yağının, serotonin taşıyıcı, MAO-A, GABA-A ve NMDA iyonotropik reseptörleri ile etkileşime girebileceğini göstermektedir. Uçucu yağın anksiyolitik, antidepresan ve rahatlatıcı etkisi bu mekanizma ile açıklanmaktadır29,30 . Ayrıca, lavanta uçucu yağının demanslı bireylerde zorlu davranışları azaltmada etkili olduğu belirtilmiştir 31 .Lavanta uçucu yağı koklayan deneklerde koklama sonrası kendilerini daha rahat hissetme, kaygı durumunda azalma ve matematiksel hesaplamalarda başarıda artış olduğu da tespit edilmiştir 32 .Lavanta uçucu yağı cilde doğrudan uygulanabilen nadir uçucu yağlardan birisidir. ...
... Lavender oil also has anxiolytic effects in clinical trials in which it can both reduce anxiety associated with stressful event such as surgeries and recovery and also reducing anxiety in anxiety disorders [49][50][51][52][53][54][55][56][57][58][59][60][61][62][63]. Targets for lavender oil include the 5-HT1A serotonin receptor, the NMDA receptor and the serotonin transporter (SERT) [64,65]. ...
Chapter
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Diet impacts anxiety in two main ways. First anxiety can be caused by deficiencies in antioxidants, neurotransmitter precursors, amino acids, cations and vitamins and other cofactors. Second, anxiety can be reduced by anxiolytic nutraceuticals which are food molecules that bind to molecular targets of the amygdala and the hypothalamus-pituitary–adrenal axis (HPA-axis). Anxiety is a feeling of fear that arises from a perceived threat and can be a beneficial coping mechanism to threats and stressors. However excessive anxiety is a disorder that interferes with healthy responses to stressors. The amygdala is responsible for assigning value to a threat or stressor and triggering the HPA-axis to support the body wide system responses to the threat. The amygdala also communicates with the neuroplastic learning and memory centers of the hippocampus to fix or set a learned value to the threat. Interestingly, many anxiolytic nutraceuticals that show benefits in human clinical trials have neurotrophic activity and increase neuronal plasticity. Moreover, anxiolytic nutraceuticals either act like the neurotrophins, nerve growth factor (NGF), brain derived neurotrophic factor (BDNF and neurotrophin-3 (NT3) by either directly binding to or potentiating the tyrosine receptor kinase (TRK) family of receptors (TRKA, TRKB and TRKC) and activating the ERK1/2 signal transduction pathway associated with neurite outgrowth and neural plasticity. This chapter will explore the neuritogenic activity of clinically proven plant-based anxiolytic nutraceuticals and examine the commonality of TRKA-C receptors and the ERK1/2 signaling pathway in the pharmacological and nutraceutical treatment of anxiety disorders.
Article
Background Anxiety disorder is a common psychiatric illness. Medicinal herbs have become a field of interest in the treatment of anxiety. This study aimed to evaluate and compare the efficacy and acceptability of all possible medicinal herbs for the treatment of anxiety. Methods A Bayesian network meta-analysis was conducted for adults with diagnosed or subthreshold anxiety in randomized controlled trials identified in PubMed, EMBASE, the Cochrane Library, and Web of Science, searched between Jan 1, 1987, and Dec 31, 2021. The outcomes included efficacy (measured by endpoint Hamilton Anxiety Scale [HAMA] Scores) and acceptability (discontinuation by ineffectiveness, worsening of the symptoms, or adverse events). Results A total of 29 trials were reviewed, comparing 12 medicinal herbs. Silexan (mean difference [MD]: -3.84, 95% credible interval [CrI]: -6.31 to -1.34) displayed a significant effect on anxiety, and possibly benefitted the treatment of depression (standard mean difference [SMD]: -0.37, 95% confidence interval [CI]: -0.53 to -0.20) and insomnia (SMD: -0.48, 95% CI: -0.76 to -0.21). Kava was found to be an effective anxiolytic (MD: -2.46, 95% CrI: -4.47 to -0.32) but possibly ineffective in patients with generalized anxiety disorder (MD: -0.17, 95% CrI: -2.55 to -1.97). Ginkgo biloba (MD: -4.63, 95% CrI: -9.01 to -0.23) and Withania somnifera (MD: -4.90, 95% CrI: -9.70 to -0.17) were efficacious, as measured by HAMA scores but the trials were limited by their small sample sizes. Galphimia glauca (MD: -1.23, 95% CrI: -4.68 to 2.23) and Manasamitravn Vataka (MD: -1.35, 95% CrI: -7.39 to 4.68) exhibited the same anxiolytic effect as standard treatments, but both were absent from trials that were rated low risk, highlighting that confidence in their ability to provide an anxiolytic effect requires additional study. Conversely, although Passionflower (MD: -4.20, 95% CrI: -8.82 to 0.16) and Saffron (MD: -2.71, 95% CrI: -6.06 to 0.57) did not reduce HAMA scores significantly in the summary network, both were worthy of further study because of support from separate networks. There was insufficient evidence to confirm the effectiveness of Valerian (MD: 0.95, 95% CrI: -6.57 to 8.42) in standard-controlled estimation or the ineffectiveness of Chamomile (MD: 0.54, 95% CrI: -5.13 to 6.25) compared with a placebo for anxiety. Gamisoyo-san (MD: -0.98, 95% CrI: -6.48 to 4.54) and L-theanine (MD: -0.49, 95% CrI: -6.54 to 5.57) did not outperform a placebo for the treatment of anxiety in terms of statistical certainty. All medicinal herbs were well-tolerated and exhibited a good safety profile compared with control groups. When all herbs were compared, there was no statistical evidence to suggest any comparison significantly reduced HAMA scores except Ginkgo biloba vs Kava (MD: -4.41, 95% CrI: -8.32 to -0.35), although Ginkgo biloba was ranked as worst due to its poor tolerability. Conclusion Medicinal herbs may be promising for the treatment of anxiety. However, these results should be considered preliminary because of the unconvincing sample sizes, together with the potential effectiveness of placebos.
Chapter
English lavender and true lavender are common names of L. officinalis. The plant belongs to the family Lamiaceae and is native to the Mediterranean.
Article
Purpose The recent evidence suggested substantial anxiolytic efficacy of lavender. The aim of this study is to examine the efficacy of lavender for anxiety, depression and physiological parameters and to elucidate the differential effects of lavender on anxiety and depression by study characteristics. Methods A systematic review and meta-analysis was performed following the PRISMA guidelines. We searched PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index of Nursing and Allied Health Literature databases for randomized controlled trials investigating the efficacy of lavender on anxiety, depression or physiologic parameters in humans. We assessed risk of bias within studies with the revised Cochrane risk of bias tool for randomized trials. We used random effect model to estimate the average effect and computed bias corrected standardized mean difference as effect size metric, Hedges’ ĝ for all outcomes. Results Lavender was superior to placebo or no treatment in reducing anxiety (Hedges’ ĝ= -0.72, 95% CI; -0.90 to -0.55, p-value<.001), depression (Hedges’ ĝ= -0.43, 95% CI; -0.59 to -0.27, p-value<.001) and systolic blood pressure (Hedges’ ĝ=-0.23, 95% CI; -0.41to -0.05, p-value=.01). The moderator analysis by meta-regression indicated that route of administration accounted 6.5% (p-value=.187) for the heterogeneity in anxiolytic effects, sessions of treatment accounted 13.2% (p-value=.055), and participants’ health state accounted 8.9% (p-value=.131) for the variance in anxiolytic effects. Conclusions Lavender aromatherapy showed substantial effect in reducing anxiety and depression, and sessions of administration increased the anxiolytic effects. The effects on physiological parameters showed small with inconsistent significances and randomized controlled trials on effect of lavender on depression were scarce. Future trials on depression and physiologic parameters are recommended and increasing the sessions of administration is recommended.
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Little is known about the treatment of mild mental disorders and/or symptoms (MDS) during pregnancy. Our main purpose was to compare the use of herbal medicines during pregnancy in women with and without MDS. A questionnaire consisting of 21 multiple-choice questions was distributed in the participating obstetrics clinics or birth centers in the Canton of Zurich, in Switzerland, from August 2018 to March 2019; 398 questionnaires were considered in the analysis. The use of any type of herbal medicines–including pharmaceutical herbal products as well as teas–during pregnancy was reported by 358 women (out of 398, 89.9%). Of these, 272 participants used pharmaceutical herbal products, whereby ginger (49.2%), raspberry leaf (42.7%), bryophyllum (37.8%), chamomile (27.2%), lavender (22%) and iron-rich herbs (12.3%) were the ones most commonly mentioned. More than half (207/398, 52.0%) of all participants reported suffering from MDS during pregnancy; only a few took (synthetic) psychoactive medications (5/398, 1.3%). The percentage of use of pharmaceutical herbal medicines was higher among women reporting MDS than among the remaining women (90.0 vs 75.9%; p < 0.001). At the same time, the prevalence of MDS was higher among users of pharmaceutical herbal products than among non-users (59.6 vs 34.0%; p = 0.001). Specific questions on candidate herbal medicines for the treatment of mild MDS revealed that bryophyllum (mentioned by 107 women), lavender (56 women) and valerian (20 women) were used to reduce stress, restlessness, sleep disorders and others, in part with perceived good to very good effectiveness and tolerability. The large majority of the pregnant women participating in the survey make use of herbal medicines. The particularly high prevalence of MDS among herbal medicine-users and the very rare use of synthetic psychoactive medications suggest that pregnant women rely on herbal medicines for treatment of mild MDS. The reported good effectiveness and tolerability of a few candidate herbal medicines deserve particular attention.
Article
Zusammenfassung Psychische Erkrankungen und Belastungen sind weltweit auf dem Vormarsch. Aktuell beherrschen Ängste und deren Folgen ganze Bevölkerungsgruppen. Im Rahmen einer multimodalen Therapie können Phytopharmaka, für die es in den letzten Jahren zunehmend wissenschaftliche Belege gibt, neben Gesprächs- und Verhaltenstherapien eine wertvolle Hilfe sein. Der Beitrag geht auf die bekannten Phytotherapeutika ein und zeigt jedoch auch weniger bekannte Heilpflanzen mit anxiolytischer Wirkung auf.
Article
Sleep disorders are common among the general population and can generate health problems such as insomnia and anxiety. In addition to standard drugs and psychological interventions, there are different complementary plant-based therapies used to treat insomnia and anxiety. This review aimed to find and examine the most recent research on the use of herbal medicines for treating anxiety and insomnia as compiled from clinical trials, as well as to assess the safety and efficacy of these medicines and to elucidate their possible mechanisms of action. The process entailed a search of PubMed, Scopus, and the Cochrane Library databases from 2010 to 2020. The search terms included “sleep disorder”, “insomnia”, “sedative”, “hypnotic”, “anxiety”, “anxiolytic”, and “clinical trial”, combined with the search terms “herbs” and “medicinal plants”, in addition to individual herbal medicines by both their common and scientific names. This updated review, which focuses mainly on clinical trials, includes research on 23 medicinal plants and their combinations. Essential oils and their associations have also been reviewed. The efficacy of medicinal plants depends on treatment duration, types of study subjects, administration route, and treatment method. More clinical trials with an adequate, standardized design are necessary, as are more preclinical studies to continue studying the mechanisms of action. As a result of our work, we can conclude that the 3 plants with the most potential are valerian, passionflower, and ashwagandha, with the combination of valerian with hops and passionflower giving the best results in the clinical tests.
Article
Background Preoperative anxiety is very common in adults awaiting all types of surgical procedures, which can interfere with the start and completion of surgery and increase the risk of postoperative complications. In this context, many researchers and clinical practitioners have attempted to use aromatherapy to help adults reduce preoperative anxiety. Objective To investigate systematically the efficacy of aromatherapy on preoperative anxiety in adults. Design A systematic review and meta-analysis of randomized controlled trials was undertaken. Data sources PubMed, Embase, Cochrane Library, Web of Science, PsycINFO and CINAHL were comprehensively searched from their inception to June 2020. Review methods Studies on the use of aromatherapy for treating preoperative anxiety in adults were included. Two reviewers assessed the risk of bias of the included studies independently using the Cochrane Collaboration ‘Risk of Bias’ tool. Overall meta-analysis and five subgroup analyses regarding the type of control, the type of aroma preparations, delivery mode, session length and surgery type were performed using RevMan 5.3. The Higgins’ I² (%) statistic was used to measure heterogeneity. A funnel plot and Egger's test were used to evaluate publication bias. Results Twenty studies comprising 1717 participants were included. The meta-analysis indicated that aromatherapy could significantly ameliorate preoperative anxiety (standard mean difference=-0.57, 95% confidence interval [-0.75, -0.39], p<0.00001) for adults awaiting surgical procedures, compared to placebo control, conventional care and no intervention. The subgroup analysis based on the surgery type showed that aromatherapy had a great improvement on preoperative anxiety for patients awaiting cardiac surgery and relatively low-risk surgery. Lavender oil, citrus species preparations and rose oil were the three most commonly used aroma preparations that could significantly improve preoperative anxiety. Most delivery modes of aromatherapy, including inhalation, massage, and oral administration, were effective. Moreover, short length (≤20 minutes per session) aromatherapy showed a better effect on preoperative anxiety (mean difference=-5.84, 95% confidence interval [-8.09, -3.59], p<0.00001) than aromatherapy lasting more than 20-minutes per session (mean difference=-2.15, 95% confidence interval [-3.81, -0.49], p=0.01). Conclusion Aromatherapy is an effective intervention for reducing preoperative anxiety in adults. Short-length aromatherapy inhalation seems to be more worthy of being recommended in clinical settings. More well-designed randomized controlled trials containing a wider range of surgical types and participants from more countries are needed to verify our findings before we can make strong recommendations.
Article
Sleep deprivation leads to various disorders, and abnormal anxiety is one of the most important among those. Although hypnotics, such as lorazepam, are effective in this regard, the respective agents have numerous side effects. Nutritional treatments (such medicinal herbs) are sometimes better than chemical medicine and can be recommended for this purpose. In our study, we compared the effects of ethanolic extracts of three medicinal herbs (orange blossom, violet, and marjoram) and lorazepam on the level of anxiety related to sleep deprivation in mice. Fifty male mice were assigned to five groups, the control (C), lorazepam (L), orange blossom (OB), violet (V), and marjoram (M). Animals in each group were treated orally with these herbal extracts, Lorazepam, or water for 10 days. The sleep deprivation protocol was then performed for all groups using a water column set with platforms. Twenty-four hours after the start of the sleep deprivation protocol, the effects of the above agents on the anxiety level were compared using the elevated plus maze, light/dark box, and marble burying tests. In addition, the effects of these agents on the plasma cortisol level were analyzed. It was found that extracts of orange blossom and marjoram were more effective than the violet extract and lorazepam solution in reducing anxiety caused by sleep deprivation. Among the herbal extracts, the orange blossom extract was the most effective in this regard.
Chapter
Prescription of a selective serotonin reuptake inhibitor (SSRI) is the usually recommended first‐line pharmacological intervention, based on efficacy, tolerability, and safety in randomized placebo‐controlled trials of short‐term and long‐term treatment. The efficacy of pharmacological treatment in generalized anxiety disorder can only be established through conducting randomized placebo‐controlled trials. Benzodiazepines have limited effects in relieving coexisting depressive symptoms, and many unwanted side‐effects including drowsiness, disturbances of memory, and impaired psychomotor function. Pregabalin has a low potential for withdrawal symptoms, and has been found to be beneficial in reducing withdrawal symptoms from benzodiazepines and zolpidem. Treatment‐emergent sexual dysfunction is probably the most common complication of SSRI treatment in patients with major depressive disorder. In depressed patients, sexual interest and desire may improve as depressive symptoms resolve, but other aspects of sexual function may worsen. Many patients who do not respond to pharmacological treatment will be offered supplementary psychological interventions.
Article
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Background Anxiety is one of the uprising psychiatric disorders of the last decades and lavender administration has been traditionally suggested as a possible treatment. The objective of this review is to assess the efficacy of lavender, in any form and way of administration, on anxiety and anxiety-related conditions. Methods The PRISMA guidelines were followed. Retrieved data were qualitatively and quantitatively synthesized. Randomized Controlled Trials (RCTs) and Non-Randomized Studies (NRSs) which investigated the efficacy of lavender, in any form and way of administration, on patients with anxiety, involved in anxiety-inducing settings or undergoing anxiety-inducing activities, compared to any type of control, without language restrictions, were identified through electronic database searches. Medline via PubMed, Scopus, Web of Science, Cochrane Library, EMBASE, and Google Scholar were systematically searched. All databases were screened up to November, 2018. Risk of bias was assessed with the Cochrane risk-of-bias tool and the following domains were considered: randomisation, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases. Results 65 RCTs (7993 participants) and 25 NRSs (1200 participants) were included in the qualitative synthesis and 37 RCTs (3964 participants) were included in the quantitative synthesis. Overall, the qualitative synthesis indicated that 54 RCTs and 17 NRSs reported at least a significant result in favor of lavender use for anxiety. The quantitative synthesis showed that lavender inhalation can significantly reduce anxiety levels measured with any validated scale (Hedges’ g = − 0.73 [95% CI − 1.00 to − 0.46], p < 0.00001, 1682 participants), as well as state anxiety (Spielberger's state-trait anxiety inventory (STAI)-State mean difference = − 5.99 [95% CI − 9.39 to − 2.59], p < 0.001, 901 participants) and trait anxiety (STAI-Trait mean difference = − 8.14 [95% CI − 14.44 to − 1.84], p < 0.05, 196 participants). Lavender inhalation did not show a significant effect in reducing systolic blood pressure as a physiological parameter of anxiety. A significant effect in diminishing anxiety levels was also found in favor of the use of oral Silexan® 80 mg/die for at least 6 weeks (Hamilton Anxiety Scale mean difference = − 2.90 [95% CI − 4.86 to − 0.95], p = 0.004, 1173 participants; Zung Self-rating Anxiety Scale mean difference = − 2.62 [95% CI − 4.84 to − 0.39], p < 0.05, 451 participants) or of the administration of massage with lavender oil (Hedges’ g = − 0.66 [95% CI − 0.97 to − 0.35], p < 0.0001, 448 participants). Discussion The most important limitation of this review is the low average quality of available studies on the topic. The majority of included RCTs were characterized by a high overall risk of bias. Another limitation regards the heterogeneity of study designs, especially with regard to non-oral ways of administration. Overall, oral administration of lavender essential oil proves to be effective in the treatment of anxiety, whereas for inhalation there is only an indication of an effect of reasonable size, due to the heterogeneity of available studies. Lavender essential oil administered through massage appears effective, but available studies are not sufficient to determine whether the benefit is due to a specific effect of lavender. Further high-quality RCTs with more homogeneous study designs are needed to confirm these findings. Available information outlines a safe profile for lavender-based interventions, although more attention should be paid to the collection and reporting of safety data in future studies. Considering these findings, since treatments with lavender essential oil generally seem safe, and, in the case of inhalation, also simple and inexpensive, they are a therapeutic option which may be considered in some clinical contexts. Other The present systematic review was not funded and was registered in PROSPERO under the following number: CRD42019130126.
Article
Linalool is an enanitomer monoterpene compound identified as the pharmacologically active constituent in a number of essential oils and has been reported to display anxiolytic properties in humans and in animal models and to exert both GABAergic and glutamatergic effects. In Experiment 1 linalool (100, 200, and 300, i.p.) had no significant effects compared with saline in an activity tracker with C57BL/6j mice. Experiment 2 assessed the effects on operant extinction with mice of chlordiazepoxide at a dose (15 mg/kg, i.p.) previously shown to facilitate extinction, and the same doses of linalool, compared with saline. Linalool had a dose-related facilitatory effect on extinction. While the effects of the highest dose of linalool most closely resembled the effects of chlordiazepoxide, the pattern of results suggested that linalool may affect both the acquisition of extinction learning, which is influenced by glutamatergic processes, and the expression of extinction, known to be affected by GABAergic agents such as chlordiazepoxide.
Article
This study explores essential oils' use by health care professionals for health maintenance. A qualitative, descriptive design was employed, and a convenience sample of 10 participants was interviewed. Four themes were identified: an essential oils' community, essential oils' use, essential oils' acceptance, and essential oils' benefits and harms.
Article
The widespread use of complementary products poses a challenge to clinicians in the perioperative period and may increase perioperative risk. Because dietary supplements are regulated differently from traditional pharmaceuticals and guidance is often lacking, the Society for Perioperative Assessment and Quality Improvement convened a group of experts to review available literature and create a set of consensus recommendations for the perioperative management of these supplements. Using a modified Delphi method, the authors developed recommendations for perioperative management of 83 dietary supplements. We have made our recommendations to discontinue or continue a dietary supplement based on the principle that without a demonstrated benefit, or with a demonstrated lack of harm, there is little downside in temporarily discontinuing an herbal supplement before surgery. Discussion with patients in the preoperative visit is a crucial time to educate patients as well as gather vital information. Patients should be specifically asked about use of dietary supplements and cannabinoids, as many will not volunteer this information. The preoperative clinic visit provides the best opportunity to educate patients about the perioperative management of various supplements as this visit is typically scheduled at least 2 weeks before the planned procedure.
Chapter
Complementary and alternative medicine (CAM) encompasses a wide range of different nonmainstream therapies that have been increasingly used for treatment or adjunctive treatment of various ailments with anxiety/anxiety disorders being one of the commonly CAM (self)-medicated conditions. Thousands of published papers refer to use of CAM in various psychiatric disorders or in healthy or medically ill patients with mood or anxiety difficulties. In this chapter we focus specifically on clinically diagnosed (in line with the standard criteria) anxiety disorders and overview evidence of efficacy/safety of a range of CAM modalities: biologically based therapies (typically herbal preparations and less so nutraceuticals); manipulative and body-based therapies (acupuncture, aerobic exercise, massage, therapeutic touch, repetitive transcranial magnetic stimulation, balneotherapy, and others); mind-body therapies (yoga, Morita therapy, Tai Chi, reiki, Chinese cognitive therapy, religious and spiritual interventions, relaxation, mediation, and mindfulness-based interventions); and alternative medical systems (Ayurveda, homeopathy). We focus exclusively on randomized controlled trials and attempt to evaluate the existing body of evidence in the same manner that is applied to mainstream treatments.
Article
Zusammenfassung Hintergrund: Der Einsatz von Phytotherapeutika hat in den letzten Jahren auch in der Behandlung psychiatrischer Erkrankungen erheblich an Bedeutung gewonnen. Methodik: Dieser narrative Überblick fasst die bisherige Evidenzlage zu Wirkungen und Nebenwirkungen pflanzlicher Arzneimittel bei der Behandlung von depressiven Störungen, Angstzuständen, Schlafstörungen und Hyperaktivitäts- und Aufmerksamkeitsstörungen auf Basis von Metaanalysen und systematischen Übersichtsarbeiten zusammen. Ergebnisse: Bei der Behandlung von leichten bis mittelschweren depressiven Episoden ist Johanniskraut evidenzbasiert und gut verträglich. Wechselwirkungen mit anderen Medikamenten sollten unbedingt beachtet werden. Für andere Phytotherapeutika ist die Datenlage bisher weniger ausreichend, um konkrete Aussagen treffen zu können. Schlussfolgerungen: Phytotherapeutika stellen in der Behandlung psychiatrischer Erkrankungen möglicherweise eine gute Alternative oder Ergänzung zu konventionellen Psychopharmaka dar. Sie sind im Vergleich oft nebenwirkungsärmer, gut verträglich und haben eine große therapeutische Breite. Weitere randomisiert kontrollierte Studien sind allerdings dringend indiziert.
Article
Unter dem Namen Silexan wird ein Lavendelöl-Extrakt angeboten, das sich bei eindeutig definierten Angststörungen als ähnlich wirksam wie z.B. Lorazepam gezeigt hat. Ob damit die aktuell propagierten Indikationen «Ängstlichkeit» und «Unruhe» genügend dokumentiert sind, muss in Frage gestellt werden.
Article
We reviewed 20 randomized controlled trials concerning the intervention methods and effects of lavender essential oil on adults' sleep quality. Fourteen showed positive intervention effects. A mixture of subjective and objective indicators was used. Lavender essential oil was associated with improved sleep quality before insomnia or other sleep disorders occurred.
Chapter
The number of animal temperament and/or personality studies has undergone a marked increase in recent years. Once studied predominantly by psychologists, animal personality is now examined by researchers in a wide range of fields, including neuroscience, agricultural science, and behavioral management. Further, individual differences in personality have been found in species ranging from insects to fish to birds to nonhuman and human primates. The breadth of these studies underscores the importance of this trait. Studies of animal personality can provide insight into the relation between human personality and health outcomes. Such studies can also be used to help us better care for animals in captivity. In this chapter, I review studies of personality and temperament across the animal kingdom. I compare some of the tests commonly used to assess personality across various animal groups. Finally, I discuss some of the current research in animal personality, with a focus on translational and applied research.
Article
Essential oils are usually used in aromatherapy to alleviate anxiety symptoms. Compared to traditional drugs, essential oils have fewer side effects and more diversified application ways including inhalation. This review provides a comprehensive overview of studies on anxiolytic effects of essential oils in preclinical and clinical trials. Most of the essential oils that used in clinical researches had been proved to be anxiolytic in animal models. Inhalation and oral administration were two common methods for essential oil administration in preclinical and clinical trials. Massage was only used in the clinical trials while intraperitoneal injection was only used in the preclinical trails. In addition to essential oils that are commonly used in aromatherapy, essential oils from many folk medicinal plants have also been reported to be anxiolytic. More than 20 compounds derived from essential oils have shown anxiolytic effect in rodents, while two-thirds of them are alcohols and terpenes. Monoamine neurotransmitters, amino acid neurotransmitters and hypothalamic-pituitary-adrenal axis are thought to play important roles in the anxiolytic effects of essential oils.
Article
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The sedative properties of the essential oil of Lavender (Lavandula angustifolia Miller) and of its main constituents--linalool and linalyl acetate--were investigated in mice followed up in a series of experimental procedures. The significant decrease in the motility of female and male laboratory animals under standardized experimental conditions is found to be closely dependent on the exposure time to the drugs. Nevertheless after an injection of caffeine into mice a hyperactivity was observed which was reduced to nearly a normal motility only by inhalation of these fragrance drugs. In particular the correlation of the motility of the animals to linalool in serum is experimentally proven, thus furnishing evidence of the aromatherapeutical use of herbal pillows employed in folk medicine since ancient times in order to facilitate falling asleep or to minimize stressful situations of man.
Article
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For the past 20 years, benzodiazepines have been the most commonly prescribed psychotropic drugs. It is now difficult to imagine the excitement produced by this new class of compounds. Existing anti-anxiety drugs, mainly the barbiturates, were known to be dangerous in overdosage, tend to cause addiction, and have many side-effects. Previous compounds, including opium, alcohol, chloral, and bromides, were similarly burdened. The benzodiazepine era began almost 30 years ago, in style. “Four hours after being given chlordiazepoxide on New Year's day 1958, one of 12 chronically anxious but therapeutically recalcitrant patients previously studied by Tobin and N. D. C. Lewis telephoned that for the first time in many years he was totally free from symptoms” (Hordern, 1968). The early studies were all enthusiastic and confirmed the therapeutic potential of the drug (Tobin et al, 1960; Jenner et al, 1961). In the ‘tranquilliser decade’ of the 1970s, prescriptions of benzodiazepines increased at a rate that was perceived as alarming, ‘the relentless march of the psychotropic drug juggernaut’ (Trethowan, 1975). This concern was related more to the inappropriate use of these drugs for treating personal problems than to the demonstration of dangers with these compounds. The dangers, however, appeared to be remarkably few; the drugs were safe in overdose, had greater efficacy than the barbiturates (Lader et al, 1974), and had virtually no unwanted effects, apart from sedation when given in excessive dosage. It was therefore hardly surprising that they proved so popular with clinicians. As Priest (1980) commented when benzodiazepine prescription was at its peak: “it is a tremendous boon to the medical profession to have active weapons in the fight against misery that are not only effective but are relatively safe when abused by despairing and desperate patients”.
Article
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Complementary therapies have been embraced by many nurses, but the effectiveness of such regimes on the wellbeing of patients has never been researched successfully. This article describes a pilot study which evaluated their effects on long-stay neurology patients.
Article
Abstract Effects of aromatherapy (odorless condition, lavender, and hiba oil) on mood and anxiety were investigated in 14 female patients who were being treated with chronic hemodialysis. A control period consisting of natural hospital smells was established before each test session, and then aromatic test conditions were systematically evaluated for odorless conditions as well as aromatic conditions containing lavender and hiba oil aromas. The effects of aromatherapy were measured using the Hamilton rating scale for depression (HAMD) and the Hamilton rating scale for anxiety (HAMA). Hiba oil aroma significantly decreased the mean scores of HAMD and HAMA, and lavender aroma significantly decreased the mean scores of HAMA. The mean scores of HAMD and HAMA in an odorless condition were not significantly different from those of the control conditions. These results indicate that in chronic hemodialysis patients hiba oil is an effective, non-invasive means for the treatment of depression and anxiety, and that lavender alleviates anxiety.
Article
The aim of this study was to link the effects of odorants with the emotional process, through autonomic nervous system (ANS) responses. Taking Ekman's data and our previous results into account, we tried to verify a possible evocation by odorants of some basic emotions, i.e. anger, fear, sadness, surprise, disgust and happiness. The question investigated was: would it be possible to associate any of these emotions with a pattern of autonomic responses? A total of 15 subjects inhaled five odorants: lavender, ethyl aceto acetate, camphor, acetic acid and butyric acid acting as olfactory stimuli. After inhaling the odorant, subjects were requested to fill out an 11-point hedonic scale to rate its `pleasantness' vs. `unpleasantness'. ANS parameters monitored were skin potential and resistance, skin blood flow and temperature, instantaneous respiratory frequency and instantaneous heart rate. Simultaneous recording of these six autonomic parameters permitted the analysis of phasic responses through specific ANS patterns. An analysis of variance made it possible to differentiate among the five odorants. Two-by-two odorant comparisons for autonomic responses using Tukey's HSD multiple comparison test only permitted differentiation between `pleasant' and `unpleasant' odors. Camphor was differentiated from both types. For instance, long duration responses were associated with `unpleasant' odors whereas camphor elicited intermediate responses. Taking into account each subject's preferential channel, it was possible to associate each ANS pattern with a basic emotion by means of a decision tree. The computation of subjects' responses made it possible to associate an odorant with a basic emotion, over the whole group: lavender elicited mostly `happiness', as did, to a lesser degree ethyl aceto acetate; camphor induced either `happiness', `surprise' or `sadness' according to subjects' past histories; butyric and acetic acids mainly induced negative emotions: `anger' and `disgust'. A high correlation was evidenced between subjects' hedonic evaluation and autonomic estimation of basic emotions. These results obtained from 15 subjects were compared to those observed in two similar experiments. These approaches showed comparable results. Thus, more than 60 subjects showed similar autonomic responses which can be transcribed into basic emotions. Thus, a multiparametric autonomic analysis allows the identification of the quality of the response, i.e. the type of basic emotion in addition to the intensity.
Article
There is widespread belief that the use of aromatherapy and massage in an intensive care environment offers a means of increasing the quality of sensory input that patients receive, as well as reducing levels of stress and anxiety. Despite a wealth of anecdotal evidence in support of these claims, there have been few objective studies to evaluate the effects of these therapies. In this experimental study 122 patients admitted to a general intensive care unit were randomly allocated to receive either massage, aromatherapy using essential oil of lavender, or a period of rest. Both pre- and post-therapy assessments included physiological stress indicators and patients' evaluation of their anxiety levels, mood and ability to cope with their intensive care experience. Ninety-three patients (77%) were able to complete subjective assessments. There were no statistically significant differences in the physiological stress indicators or observed or reported behaviour of patients' ability to cope following any of the three interventions. However, those patients who received aromatherapy reported significantly greater improvement in their mood and perceived levels of anxiety. They also felt less anxious and more positive immediately following the therapy, although this effect was not sustained or cumulative.
Article
EEG activity, alertness, and mood were assessed in 40 adults given 3 minutes of aromatherapy using two aromas, lavender (considered a relaxing odor) or rosemary (considered a stimulating odor). Participants were also given simple math computations before and after the therapy. The lavender group showed increased beta power, suggesting increased drowsiness, they had less depressed mood (POMS) and reported feeling more relaxed and performed the math computations faster and more accurately following aromatherapy. The rosemary group, on the other hand, showed decreased frontal alpha and beta power, suggesting increased alertness. They also had lower state anxiety scores, reported feeling more relaxed and alert and they were only faster, not more accurate, at completing the math computations after the aromatherapy session.
Article
To study the effects of perfume and phytoncid on GABAA receptors, ionotropic GABAA receptors were expressed in Xenopus oocytes by injecting mRNAs that had been prepared from rat whole brain. Essential oil, perfume and such phytoncid as leaf alcohol, hinokitiol, pinene, eugenol, citronellol and citronellal potentiated the response in the presence of GABA at low concentrations (10 and 30 microM), possibly because they bound to the potentiation-site in GABAA receptors and increased the affinity of GABA to the receptors. Since it is known that the potentiation of GABAA receptors by benzodiazepine, barbiturate, steroids and anesthetics induces the anxiolytic, anticonvulsant and sedative activity or anesthetic effect, these results suggest the possibility that the intake of perfume or phytoncid through the lungs, the skin or the intestines modulates the neural transmission in the brain through ionotropic GABAA receptors and changes the frame of the human mind, as alcohol or tobacco does.
Article
Patients with generalized anxiety disorder experience worry or anxiety and a number of physical and psychologic symptoms. The disorder is frequently difficult to diagnose because of the variety of presentations and the common occurrence of comorbid medical or psychiatric conditions. The lifetime prevalence is approximately 4 to 6 percent in the general population and is more common in women than in men. It is often chronic, and patients with this disorder are more likely to be seen by family physicians than by psychiatrists. Treatment consists of pharmacotherapy and various forms of psychotherapy. The benzodiazepines are used for short-term treatment, but because of the frequently chronic nature of generalized anxiety disorder, they may need to be continued for months to years. Buspirone and antidepressants are also used for the pharmacologic management of patients with generalized anxiety disorder. Patients must receive an appropriate pharmacologic trial with dosage titrated to optimal levels as judged by the control of symptoms and the tolerance of side effects. Psychiatric consultation should be considered for patients who do not respond to an appropriate trial of pharmacotherapy.
Article
Generalized anxiety disorder (GAD) is a chronic and highly prevalent disorder in the adult population, yet it remains a relatively poorly understood condition. Clinicians may be familiar with the symptoms of enduring excessive worrying, anxiety, and hypervigilance that are characteristic of GAD, but may not necessarily recognize that these are usually symptoms of a distinct psychiatric disorder. Despite changes in diagnostic criteria, estimates of prevalence for GAD are remarkably consistent across epidemiologic studies. Lifetime prevalence in the general population is estimated at 5% (DSM-III and/or DSM-III-R criteria), with rates as high as 10% among women aged 40 years and above, and cross-sectional rates among primary care attenders are about 8%, making GAD the most prevalent anxiety disorder in primary care. The age at onset of GAD differs from that of other anxiety disorders: prevalence rates are low in adolescents and young adults but increase substantially with age. Females are at greater risk than males, and the disorder is correlated with being unemployed or a housewife or having a chronic medical illness. GAD is frequently associated with comorbid depression and other anxiety and somatoform disorders. Significant GAD-specific disability occurs even when comorbidity is not present.
Article
The paper reviews available epidemiological evidence for the existence of and the implications of comorbidity of anxiety and depressive disorders and mixed anxiety-depressive (MAD) disorders. Using epidemiolological evidence of prevalence and incidence and data relating to time-course of illness, risk factor and outcome, it is concluded: (1) that anxiety-depression comorbidity is quite frequent in epidemiological and clinical settings throughout the world; (2) this comorbidity is diagnosis-specific and is associated with increased vulnerabilities and risks as well as poorer outcome and marked disabilities; and (3) no such evidence was found for MAD disorders. Contrary to what was predicted, the prevalence of MAD disorders was quite low even when using the more recent criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. (4) Furthermore, there was quite a heterogeneous pattern in terms of risk, severity and outcome making it questionable whether this disorder, as currently defined, is a clinical entity. These findings are discussed in terms of two perspectives, the 'lumpers' with their dimensional view and the 'splitters' with their categorical view. It is concluded that although comorbidity of threshold anxiety and depressive disorders seems to be an important phenomenon, no such evidence is provided for MAD disorders. Copyright 2001 John Wiley & Sons, Ltd.
Lavendulae flos. Lavendelbï uten. BAnz vom 5.12.1984 und 13.03.1990. Drug Monograph Lorazepam
  • Drug Monograph
  • Germany
Drug Monograph (Germany): Lavendulae flos. Lavendelbï uten. BAnz vom 5.12.1984 und 13.03.1990. Drug Monograph Lorazepam; Internet Mental Health (Canada) copyright& 1995-2003 by Phillip W. Long, URL: http://www.mentalhealth.com/drug/p30-a04. html (accessed Sept. 23 2008).
Replacement of drug treatment for insomnia by ambient odor Psychological effects of aromatherapy on chronic hemodialysis patients
  • M Hardy
  • M D Kirk-Smith
  • D D T Stretch
  • H Amayasu
  • M Kuribayashi
Hardy, M., Kirk-Smith, M.D., Stretch, D.D., 1995. Replacement of drug treatment for insomnia by ambient odor. Lancet. ARTICLE IN PRESS Itai, T., Amayasu, H., Kuribayashi, M., et al., 2000. Psychological effects of aromatherapy on chronic hemodialysis patients. Psychiatry Clin. Neurosci. 54, 393–397.
Replacement of drug treatment for insomnia by ambient odor
  • Hardy