Anxiolytic effects of Echium amoenum on the elevated plus-maze model of anxiety in mice

Evaluation of the effect of Echium amoenum on pain control after clinical crown lengthening surgery

Background

Pain after periodontal surgeries is one of the most common complications. Echium amoenum is among the important therapeutic herbs in Iranian traditional medicine. Various studies have shown its pain control properties. This study aimed to evaluate this herb's efficacy in controlling pain after periodontal surgeries.

Methods

In this randomized clinical trial, 50 patients referred to Tabriz Dental School for clinical crown lengthening surgery were divided into two equal groups: control and test. In the test group (using E. amoenum), 24 hours before surgery, E. amoenum was administered to the patient at home every 12 hours, and a dose of E. amoenum was administered one hour before the procedure. The postoperative pain was assessed using VAS 30 minutes, 1 hour, and 3 hours after the surgery and verbal rating scale (VRS) 24, 48, and 72 hours postoperatively. A chi-square test was used to compare the pain severity between the two groups.

Results

The VAS index was significantly lower in the E. amoenum group compared to the control group (30 minutes, 1 hour, and 3 hours after the procedure) (P<0.05). In both groups, pain severity increased significantly up to 3 hours postoperatively (P<0.05). In the first 24 hours, the VRS index of the E. amoenum group was significantly lower than that of the control group (P<0.05), with no significant differences between the two groups at 48 and 72 hours (P>0.05).

Conclusion

The E. amoenum herb reduced the pain severity after clinical crown lengthening surgeries.

The effect of infusion time on Echium amoenum extract -induced hepatotoxicity in vitro

Echium amoenum is an annual herb native to the northern mountains of Iran which has medicinal application. Petals of Echium amoenum (Gole-Gavzaban) is one of the most valuable medicinal plants in Iranian folk medicine. The dry petals of E. amoenum have long been used as a sedative, tonic, anxiolytic and as a treatment for sore throat, cough and inflammation. Previous studies have shown that petals of E. amoenum contain four toxic pyrrolizidine alkaloids but conflicting results have been acquired in experimental studies investigating the hepatotoxicy of E. amoenum. However, the direct effect of E. amoenum on liver cells and the complete mechanisms of its possible cytotoxic effects toward these cells remain to be defined. The main aim of this study was to assay the mechanisms underlying the toxic effects of E. amoenum toward hepG2 cells. E. amoenum extract was obtained by infusion of dried petals in hot water (90 centigrade) for 15 or 30 min. Cell viability and mechanistic parameters were determined following 12 h incubation of hepG2 with E. amoenum extract that was obtained after 15 or 30 min infusion. The results indicated that E. amoenum extract exerts cytotoxic effects on hepG2 cells, probably through mitochondrial and lysosomal damage induced by glutathione depletion and oxidative stress.

Echiumin E, an Aryl Dihydronaphthalene Lignan from the Australian Invasive Plant Paterson's Curse (Echium plantagineum)

A new aryl dihydronaphthalene lignan, echiumin E (1), and four known compounds, echiumin A, globoidnan A, (-)-rabdosiin, and rosmarinic acid (2-5), were isolated from the Australian invasive plant Echium plantagineum (Paterson's curse) for the first time. Echiumin E (1) was characterized by 1D/2D NMR spectroscopy and MS spectrometry, with its absolute configuration assigned through comparison of experimental and TDDFT-calculated ECD data. Echiumin E (1) along with compounds 3-5 were screened in vitro against three cancer cell lines (SH-SY5Y, HeLa, and PC-3) and a prostate stromal (normal) cell line (WPMY-1) using a resazurin reduction assay. Echiumin E (1) was found to be active toward HeLa cells (IC₅₀ 0.21 μM).

Powerful Stress Relieving Medicinal Plants for Anger, Anxiety, Depression, and Stress During Global Pandemic

Consideration and improvement for anxiety and depression are important during a global pandemic. Appropriate healthcare can be obtained by paying more attention to traditional medicinal sciences. The adverse effects of stress with various symptoms can be managed by introducing plants that boost mental health. The most relevant psychological reactions in the general population related to the global pandemic are pervasive anxiety, frustration and boredom, specific and uncontrolled fear, disabling loneliness, significant lifestyle changes, and psychiatric conditions. Ginseng, chamomile, passionflower, herbal tea, lavender, saffron, kava, rose, cardamom, Chinese date, and some chief formula like yokukansan, Dan-zhi-xiao-yao-san, so-ochim-tang-gamiband, and saikokaryukotsuboreito are notable herbal treatments for mental health problems. The most common medicinal plants that have been used in Iran for the cure of stress and anxiety are Viper's-buglosses, Dracocephalum, valerian, chamomile, common hop, hawthorns, and lavender. Medicinal plants and herbs can be used for the treatment and alleviation of the negative effects of stress, anger, and depression during the global pandemic.

Natural Products: Ray of Hope for Anxiety Disorders

Background:

Anxiety, a familiar form of psychiatric disorder, influences numerous persons throughout the world. These psychological disorders frequently need an enduring regime of recommended medicines and impose huge costs on human societies. For the last few decenniums, discovery in the field of natural neurophysiology garnered a lot of recognition because of its least side effects.

Objective:

Many people find it helpful to discover an effective herbal remedy for anxiety with fewer detrimental repercussions. The purpose of the present article is to report medicinal plant species used as anti-anxiety agents, which in turn, are helpful to develop new anti-anxiety herbal formulations.

Method:

An unlimited, semantic electronic and manual exploration of PubMed, Cumulative Index of Nursing and Allied Health Literature, ISI, Google Scholar, Elsevier's abstract and citation database, and the database libraries was carried using keywords such as medicinal plants, herbal drugs, traditional medicine, and anxiety for recognizing natural medications in the management of anxiety disorders.

Results:

Literary review collected the information of potential anti-anxiety plants. Data support the effectiveness of some popular herbal remedies by indicating high-quality scientific studies and support several clinically efficacious natural plants as anxiolytics.

Conclusion:

Evidence-based studies indicate that natural plant treatment is an efficient way to manage anxiety disorders; the benefits outweigh the risks.

A Comparison Study on Traditional Mixtures of Herbal Teas Used in Eastern Mediterranean Area

Multipurpose herbal teas with numerous ingredients, in which flowers are the main component, are common in the traditional medicine and pharmacy of Greece and the Eastern Mediterranean countries. In this study, we combine ethnobotany and ethnopharmacology field work techniques and botany and pharmacognosy laboratory methods for the study of traditional herbal mixtures with flowers, we identify their botanical ingredients and record the local medicinal uses of these mixtures, in Greece, Lebanon, Syria, Iran and Turkey. These, and their industrial versions, are analyzed, using morphological and multivariate analysis techniques in order to determine marker species, relevant patterns of combination and local styles. The medicinal properties attributed to the different flowers are discussed in relation with their role in the mixtures. These blends are consumed for their relaxing, digestive, and anti-infective properties. These mixtures are not consumed as a treatment when one is sick but rather to avoid getting sick, as a preventive measure. The formulations can reach forty ingredients (sarantha in Greek, arbain in Arabic language of Palestine), usually entire or coarsely chopped in the more traditional formulations, leading to extreme variability of individual doses. We ask what biological signification this randomness can have. To give an answer requires new and more comprehensive pharmacological approaches. The flowers of Rosaceae, Asteraceae, Lamiaceae, Malvaceae and Fabaceae species characterize these mixtures in which other materials (roots, leaves, and fruits) and other species are present as well. Flowers of some species, particularly of Fabaceae, are exclusively used in mixtures, and their use in monospecific herbal teas is not yet recorded. We draw attention on the urgent need in exhaustively recording in Greece and the Near East, the formulation and use of traditional herbal mixtures and their numerous local variants. To consider these mixtures and the contribution of flowers (most mixtures receive the general name of tea of flowers) merits further extensive study.

Traditional herbal medicines to overcome stress, anxiety and improve mental health in outbreaks of human coronaviruses

Mental health condition is including depression and anxiety, and they may impact wellbeing, personal relationships and productivity of both genders. Herbal medicines have been used to treatment of anxiety and depression symptoms for centuries. SARS, MERS and COVID-19 are related to coronavirus types. SARS (sever acute respiratory syndrome, China, 2002), MERS (Middle East respiratory syndrome, Saudi Arabia, 2012), and SARS-CoV-2 (2019-2020) are the main coronavirus outbreaks. Both anxiety and depression are more serious to be considered and improved for all general public during fight with these diseases. In this mini-review article, we have mentioned the key role some of the most important plants and herbs for treatment of stress and anxiety and improve mental health against SARS and SARS-CoV-2 on the basis of traditional Asian medicine, especially traditional Chinese and Persian medicine.

A Novel Optimization Algorithm for Echium amoenum Petals Drying

A novel multi-objective optimization algorithm was developed, which was successfully applied in the drying process. The effect of drying parameters (air velocity (vd), drying temperature (Td)) on the energy consumption (EC) and the quality parameters of Echium amoenum petals in fluidized drying were experimentally studied. The following quality parameters were examined: the color difference, the bioactive compounds as losses of total antioxidant capacity (TAC) and losses of phenolic (TPC), flavonoids (TFC) and anthocyanin (A). The six optimization objectives included simultaneous minimization of the quality parameters and energy consumption. The objective functions represent relationships between process variables and optimization objectives. The relations were approximated using an Artificial Neural Network (ANN). The Pareto optimal set with a nondominated sorting genetic algorithm was developed. No unequivocal solution to the optimization problem was found. Cannot be obtained E. amoenum petals characterized a low color change at low energy consumption due to its fluidized drying. Unique Pareto optimal solutions were found: Td = 54 °C and vd = 1.0 m/s–for the strategy in which the lower losses of TAC, TFC and A are most important, and Td = 59.8 °C and vd = 0.52 m/s–for the strategy in which the lower losses of TPC and TFC are important with accepted EC values. The results of this research are essential for the improvement of industrial dehydration of E. amoenum petals in order to maintain their high content of bioactive compounds with low energy consumption and low colour change

Effectiveness of Echium amoenum on premenstrual syndrome: a randomized, double-blind, controlled trial

Background

The present study aimed to evaluate the effect of Echium amoenum (EA) on the severity of premenstrual syndrome (PMS) in comparison with placebo.

Methods

The present study was a randomized double-blind controlled clinical trial. A checklist questionnaire was completed by 120, 18 to 35-year-old, college students. And then, 84 eligible women (20 to 35 years old) were enrolled in the trial; they were randomly assigned to two groups of intervention (EA) and control (placebo), with 42 participants in each group. Participants in the intervention group received 450 mg capsules of EA per day (three times a day) from the 21st day of their menstrual cycle until the 3rd day of their next cycle for two consecutive cycles. The severity of PMS was measured and ranked using the premenstrual symptoms screening tool (PSST). The generalized estimating equation was used to compare the total score of the severity of PMS between the two groups.

Results

Sixty-nine women with regular menstrual cycles suffering from PMS completed the study. The mean scores of the symptoms in the EA group were 35.3 and 16.1 (P ≤ 0.001) at baseline and after 2 months, respectively, while the mean scores of the symptoms in the placebo group were 31.0 and 28.3 (P = 0.09) at baseline and after 2 months, respectively. The evaluation of the first and the second follow-ups in the intervention group showed that, after being adjusted for age and body mass index (P ≤ 0.001), the mean scores of the premenstrual syndrome, using GEE analysis, have decreased to 6.2 and 11.6, respectively.

Conclusion

Based on the results, in comparison with the placebo group, EA was found to be more effective in improving the symptoms of PMS, and is highly recommended for treatment of this syndrome.

Trial registration

IRCT2015110822779N3; Registration date: 2015–11–27.

Antioxidant Properties and Reported Ethnomedicinal Use of the Genus Echium (Boraginaceae)

The genus Echium L. from the Boraginaceae family consists of 67 recognised species. The genus is widely distributed in the Mediterranean, having been documented in the traditional medicine of the area since 300 B.C. Current pharmacological studies have validated early ethnomedicinal properties showing that Echium spp. possesses antioxidant, analgesic, anxiolytic, anti-inflammatory, antibacterial, and antiviral effects. Nevertheless, only limited papers report specifically on the phytochemistry of this genus. Furthermore, the potential of utilising extracts from Echium species as natural antioxidant preparations has been significantly neglected. For the first time, this review comprehensively describes and discusses the presence of recorded Echium species with ethnomedicinal uses, their antioxidative properties in vitro and in vivo when available, and major phytochemical components recognised as potent antioxidants, as well as the possibilities and opportunities for future research.

Protective Effects of Echium amoenum on Oxidative Stress and Gene Expression Induced by Permethrin in Wistar Rats

Background: Echium amoenum (E. amoenum), as one of the most popular plants in Iran, is traditionally used to treat different types of disorders. Objectives: This experimental study aimed to evaluate the modulatory effects of E. amoenum on permethrin (PMN)-induced oxidative stress in rats and to determine the cytoprotective effect of E. amoenum on PMN in SK-Hep-1 cells. Methods: Twenty-four male Wistar rats were randomly divided into four equal groups, including the control (normal saline), orally treated PMN (125 mg/kg of PMN), E. amoenum (100 mg/kg), and E. amoenum + PMN groups for 28 days. The levels of alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST), lipid peroxidation (LPO), catalase (CAT), and glutathione peroxidase (GPx), as well as the expression of catalase (CAT) and glutathione peroxidase (GPx), were measured in the liver of all rats. Also, the cytoprotective effect of E. amoenum against PMN was evaluated in the treated SK-Hep-1 cells. Results: The results indicated that LPO increased significantly in the PMN-treated group, as evidenced by the high concentration of malondialdehyde (MDA) in the liver. Alterations of the antioxidant system were also confirmed by the significant decline in CAT and GPx activities (2.9 ± 0.14 and 0.5 ± 0.03, respectively; P < 0.05) and the significant downregulation of CAT (0.4 ± 0.02 folds) and GPx (0.3 ± 0.01 folds) mRNA expression in the liver (P < 0.05). PMN also stimulated significant changes in hepatic biomarkers and induced pathological changes in the liver. On the other hand, administration of E. amoenum significantly reduced abnormalities in biochemical markers, LPO, antioxidant enzymes, gene expression, and pathological complications induced by PMN (P < 0.05). E. amoenum also exhibited cytoprotective effects against cytotoxicity induced by PMN in SK-Hep-1 cells. Conclusions: The present results demonstrated that E. amoenum has significant antioxidant, gene-regulating, and cytoprotective effects.

A Close Look at Echium amoenum Processing, Neuroactive Components, and Effects on Neuropsychiatric Disorders

Pharmacological researches in the area of herbal medicine have considerably increased over the last two centuries. Echium amoenum (known as Gol-e-Gavzaban in Persian) is a medicinal plant that has been widely used in Iranian folk medicine. In this review, databases including PubMed, Scopus, and Google Scholar were searched up. Data collecting was completed by January 2019 and available scientific reports regarding the processing methods, main chemical constituents, and effects of E. amoenum on different neuropsychiatric disorders are summarized. Thirteen five studies met the inclusion criteria. According to results, the important phytochemicals of the plant was phenolic compounds, fatty acids, rosmarinic acid, anthocyanidins, and flavonoids. Also, experimental and clinical studies demonstrated the effectiveness of E. amoenum in the treatment of several neuropsychiatric disorders such as anxiety, depression, ischemic stroke, seizure, Alzheimer's disease, and pain. Many of these effects are, at least in part, due to its rosmarinic acid or polyphenolic compounds such as flavonoids and natural pigments such as anthocyanins. Also, fatty acids such as gamma-linolenic acid play critical role in neuroactive properties of this herb. Among these effects, only the antidepressant and anxiolytic properties of the plant extract have been examined both experimentally and clinically. There was some controversy over its toxicity effects. It seems that E. amoenum protects neurons via attenuation of oxidative stress and inflammation as well as blocking of apoptosis in the nervous system. However, more studies are necessary for assessing exact mechanisms of action in neuropsychiatric disorders, finding of bioactive ingredients, and processing methods of this plant.

Effect of hydroalcoholic Echium amoenum extract on scopolamine-induced learning and memory impairment in rats

CONTEXT

Scopolamine, a muscarinic receptor antagonist, causes memory loss that resembles Alzheimer's disease (AD). Echium amoenum L. (Boraginaceae) is a famous medicinal plant of Iran that is traditionally used as a sedative and mood enhancer.

OBJECTIVE

This study evaluates the effect of hydroalcoholic extract of E. amoenum flowers on scopolamine-induced memory impairment in rats.

MATERIALS AND METHODS

Fifty male Wistar rats were randomly divided into five groups. Control group received normal saline, model group received scopolamine (0.7 mg/kg, IP, daily for 21 days), and test groups received E. amoenum extract (50, 75, and 100 mg/kg, IP, daily for 21 days) 30 min before each scopolamine injection. The elevated plus maze (EPM), shuttle box, novel object and rotarod tests were performed after treatment. Brain levels of malondialdehyde (MDA) and total antioxidant capacity (TCA) were also determined.

RESULTS

Scopolamine-treated rats spent more time exploring the novel object compared to the control, and E. amoenum extract at all three doses significantly decreased the time spent exploring the novel object (p < 0.05). E. amoenum extract (75 and 100 mg/kg) significantly elongated the secondary latency in rats receiving scopolamine in the shuttle box test (p < 0.05). In addition, treatment with 75 and 100 mg/kg doses of E. amoenum extract significantly ameliorated scopolamine-induced motor in coordination in rotarod test (p < 0.05). It also significantly increased the time spent in the open arms and reduced the time spent in the closed arms of EPM (p < 0.05). Treatment of scopolamine-exposed rats with E. amoenum extract significantly increased TCA and reduced MDA level of brain (p < 0.05).

DISCUSSION AND CONCLUSIONS

E. amoenum extract shows protective effect against scopolamine-induced impairment and is suggested to be tested in clinical trials to evaluate the efficacy on AD.

Physiological and Biochemical Effects of Echium Amoenum Extract on Mn2+-Imposed Parkinson Like Disorder in Rats

Purpose: Manganism is a cognitive disorder take places in peoples are exposed to environmental manganese pollution. Overexposure to manganese ion (Mn2+) mainly influences central nervous system and causes symptoms that increase possibility of hippocampal damages. Methods: In this study rats were administrated by two different doses of MnCl2 and behavioral and physiological consequences were evaluated. We also investigated effects of E. Amoenum on Mn2+-imposed toxicity by behavioral, biochemical, immunoblotting and histological studies on hippocampus tissue. Results: Results showed metal overexposure increases oxidative stress mainly by lipid peroxidation and reactive oxygen species overproduction. Histological studies and caspase 3 analyses by immunoblotting revealed Mn2+ induced apoptosis from mitochondrial-dependent pathway in the presence of low metal dose. This study provides evidence that oral administration of E. amoenum extract inhibited manganese neurotoxicity by oxidative stress attenuation and apoptosis reduction that lead to improved depression like behavior. Plant extract also increased catecholamine content in Mn2+ treated hippocampus. Conclusion: As molecular and pathophysiological effects of E. amoenum, it could be considered as a pre-treatment for Parkinson and Parkinson like disorders in high-risk people.

The immunomodulatory tellurium compound ammonium trichloro (dioxoethylene-O,O') tellurate reduces anxiety-like behavior and corticosterone levels of submissive mice

Ammonium trichloro (dioxoethylene-O,O') tellurate (AS101) is a synthetic organotellurium compound with potent immunomodulatory and neuroprotective properties shown to inhibit the function of integrin αvβ3, a presynaptic cell-surface-adhesion receptor. As partial deletion of αvβ3 downregulated reuptake of serotonin by the serotonin transporter, we hypothesized that AS101 may influence pathways regulating anxiety. AS101 was tested in the modulation of anxiety-like behavior using the selectively bred Submissive (Sub) mouse strain that develop anxiety-like behavior in response to an i.p. injection. Mice were treated daily with AS101 (i.p., 125 or 200 μg/kg) or vehicle for 3 weeks, after which their anxiety-like behavior was measured in the elevated plus maze. Animals were then culled for the measurement of serum corticosterone levels by ELISA and hippocampal expression of brain-derived neurotrophic factor (BDNF) by RT-PCR. Chronic administration of AS101 significantly reduced anxiety-like behavior of Sub mice in the elevated plus maze, according to both time spent and entries to open arms, relative to vehicle-treated controls. AS101 also markedly reduced serum corticosterone levels of the treated mice and increased their hippocampal BDNF expression. Anxiolytic-like effects of AS101 may be attributed to the modulation of the regulatory influence integrin of αvβ3 upon the serotonin transporter, suggesting a multifaceted mechanism by which AS101 buffers the hypothalamic-pituitary-adrenal axis response to injection stress, enabling recovery of hippocampal BDNF expression and anxiety-like behavior in Sub mice. Further studies should advance the potential of AS101 in the context of anxiety-related disorders.

A Simple Isocratic High-perfomance Liquid Chromatography Method for the Simultaneous Determination of Shikonin Derivatives in Some Echium Species Growing Wild in Turkey

Objectives

Dried roots of Echium species are used in Turkey for the treatment of wounds, inflammation, and depression. In this study, an reversed-phase-liquid chromatographic method with isocratic elution was developed to determine shikonin derivatives in Echium species.

Materials and Methods

The chromatographic separation and quantification was performed on a C18 column (ACE, 150 mm × 4.6 mm, 5 μm), with a mobile phase of acetonitrile and 0.1 M acetic acid (70: 30, v/v) at a flow rate of 1 mL/min, and ultraviolet detection at 520 nm.

Results

Linear behavior was observed over the investigated concentration range (2-500 ppm) for all analytes, with a correlation coefficient of >0.998. The proposed method was found to be specific and precise for the quantification of shikonin derivatives in Echium species.

Conclusion

The highest content of shikonin derivatives was observed in E. italicum L. compared with the other species studied herein, advocating the use of E. italicum L. roots as an alternate source for shikonin derivatives.

Neuropharmacological activities of Taxus wallichiana bark in Swiss albino mice

Aims:

The bark of Taxus wallichiana is widely used for preparing a decoction and consumed as a tea by several tribal communities of the Indian subcontinent. The sedative, motor coordination, anxiolytic, and antidepressant effects of the hydroalcoholic extract of T. wallichiana bark and its ethylacetate fraction were evaluated in mice models of behavior analysis.

Materials and Methods:

The effects were evaluated on diazepam-induced sleeping time, elevated plus maze and light and dark box, and on the forced swimming test. General locomotor activity and motor coordination effects were evaluated in the actophotmeter and rota-rod tests respectively.

Statistical Analysis:

Results are expressed as mean ± standard error of the mean. Statistical analysis was performed using ANOVA, followed by post-hoc Dunnett's test. *P < 0.05, **P < 0.01, ***P < 0.001 were considered as significant.

Results:

Both the hydroalcoholic extract and ethylacetate fraction showed a marked decrease in latency of sleep onset, prolonged the diazepam-induced sleeping time, decreased spontaneous locomotor activity; whereas ethylacetate fraction produced anxiolytic and antidepressant activity.

Conclusions:

Both hydroalcoholic extract and its ethylacetate fraction of the bark of T. wallichiana have bioactive principles, which induce neuropharmacological changes.

Protective effects of Echium amoenum Fisch. and C.A. Mey. against cerebral ischemia in the rats

Background:

This study was designed to evaluate the protective effect of Echium amoenum total anthocyanin extract (ETAE) on partial/transient cerebral ischemia in the rats.

Materials and Methods:

Rats received ETAE (50, 100 and 200 mg/kg, i.p.) 30 min before the induction of cerebral ischemia. Cerebral ischemia was induced by bilateral common carotid arteries occlusion (BCCAO) for 30 min, followed by 72 h reperfusion. The neurological deficit, brain performance, and sensory motor function were assessed 48 h and 72 h after surgery. After sacrification, the brains were evaluated for myeloperoxidase (MPO) activity and histopathological changes.

Results:

Our results showed that motor function significantly decreased in ischemia/reperfusion (I/R) group as compared to the sham group. Histopathological analysis exhibited the shrinkage and atrophy of the neurons in I/R group. ETAE at the dose of 200 mg/kg improved spontaneous activity and memory induced by cerebral ischemia compared to the control group and also decreased brain MPO activity following cerebral ischemia. However, it could not affect the ability to climbing, body proprioception, vibrissae touch and brain water content. In addition, pretreatment with ETAE at higher doses significantly reduced ischemia-induced neuronal loss of the brain.

Conclusion:

The anthocyanin rich fraction from E. amoenum was found to have protective effects against some brain damages postischemic reperfusion. However, further researches are required for investigating the exact mechanisms of the effect of this plant in the prevention of cerebral ischemia in human.

Plant-based medicines for anxiety disorders, part 2: a review of clinical studies with supporting preclinical evidence

Research in the area of herbal psychopharmacology has revealed a variety of promising medicines that may provide benefit in the treatment of general anxiety and specific anxiety disorders. However, a comprehensive review of plant-based anxiolytics has been absent to date. Thus, our aim was to provide a comprehensive narrative review of plant-based medicines that have clinical and/or preclinical evidence of anxiolytic activity. We present the article in two parts. In part one, we reviewed herbal medicines for which only preclinical investigations for anxiolytic activity have been performed. In this current article (part two), we review herbal medicines for which there have been both preclinical and clinical investigations of anxiolytic activity. A search of MEDLINE (PubMed), CINAHL, Scopus and the Cochrane Library databases was conducted (up to 28 October 2012) for English language papers using the search terms 'anxiety' OR 'anxiety disorder' OR 'generalized anxiety disorder' OR 'social phobia' OR 'post-traumatic stress disorder' OR 'panic disorder' OR 'agoraphobia' OR 'obsessive compulsive disorder' in combination with the search terms 'Herb*' OR 'Medicinal Plants' OR 'Botanical Medicine' OR 'Chinese herb*', in addition to individual herbal medicines. This search of the literature revealed 1,525 papers, of which 53 plants were included in the review (having at least one study using the whole plant extract). Of these plants, 21 had human clinical trial evidence (reviewed here in part two), with the other 32 having solely preclinical evidence (reviewed in part one). Support for efficacy was found for chronic use (i.e. greater than one day) of the following herbs in treating a range of anxiety disorders in human clinical trials: Piper methysticum, Matricaria recutita, Ginkgo biloba, Scutellaria lateriflora, Silybum marianum, Passiflora incarnata, Withania somniferum, Galphimia glauca, Centella asiatica, Rhodiola rosea, Echinacea spp., Melissa officinalis and Echium amoenum. For several of the plants studied, conclusions need to be tempered due to methodological issues such as small sample sizes, brief intervention durations and non-replication. Current evidence does not support Hypericum perforatum or Valeriana spp. for any anxiety disorder. Acute anxiolytic activity was found for Centella asiatica, Salvia spp., Melissa officinalis, Passiflora incarnata and Citrus aurantium. Bacopa monnieri has shown anxiolytic effects in people with cognitive decline. The therapeutic application of psychotropic plant-based treatments for anxiety disorders is also discussed, specifically Psychotria viridis and Banisteriopsis caarti (ayahuasca), Psilocybe spp. and cannabidiol-enriched (low tetrahydrocannabinol (Δ(9)-THC)) Cannabis spp.

The use of endemic Iranian plant, Echium amoenum, against the ethyl methanesulfonate and the recovery of mutagenic effects

In this study, potential genotoxic effects of ethyl methanesulfonate (EMS) that caused mutagenicity in a variety of organisms were tried to resolve by the methanol and chloroform extract of Echium amoenum (EAmet and EAchl) Fisch. & C.A. Mey. from the family of Boraginaceae, which is an endemic plant, and is used as an alternative treatment among public in Iran. Somatic mutation and recombination test with Drosophila wing was used to determine the genotoxic and antigenotoxic effects in our investigations. For this purpose, 3-day-old transheterozygous larvae of mwh/flr3 genotype of Drosophila melanogaster were used in all our experiments. The larvae were fed chronically on the Drosophila instant medium (DIM) including 1 ppm EMS. However, in another application group, different concentrations (1, 2 and 4 ppm) of EAmet and EAchl were added to DIM including 1 ppm EMS (EMS + EAmet and EMS + EAchl). Then, for the matured individuals, wing preparates were prepared within the mediums that include control group that has only DIM, negative control group that contains dimethyl sulfoxide and application groups in different concentrations that contain EMS, EMS + EAmet and EMS + EAchl. Clone induction frequency for the normal wing phenotype of EMS application group was observed to be 2.00. In the EMS + EAmet application group, the value of 1 ppm EAmet is 1.49, value of 2 ppm EAmet is 1.08 and value of 4 ppm EAmet is 0.72; in the EMS + EAchl application group, the value of 1 ppm is EAchl 1.33, value of 2 ppm EAchl is 0.67 and value of 4 ppm EAchl is 0.56 were determined. This decrease observed between EMS and all application groups in terms of total induction frequency is statistically significant ( p < 0.05). These results concluded that chloroform extracts were more effective than the methanol extracts of E. amoenum.

Effect of Echium amoenum Fisch. et Mey a Traditional Iranian Herbal Remedy in an Experimental Model of Acute Pancreatitis

Acute pancreatitis is a morbid inflammatory condition of pancreas with limited specific therapy. Enhanced oxidative stress plays an important role in induction and progression of acute pancreatitis. So reducing oxidative stress may relieve this pathogenic process. Echium amoenum Fisch. and Mey has been implemented in Iranian folk medicine for several centuries. Antioxidant, analgesic, immunomodulatory, and anxiolytic properties of E. amoenum suggest that this plant may have beneficial effects in the management of acute pancreatitis. The aim of this study was to evaluate the protective effect of petals of E. amoenum extract (EAE) on a murine model of pancreatitis. Acute pancreatitis was induced by five intraperitoneal (i.p.) injection of cerulein (50 μg/kg) with 1h intervals which was characterized by pancreatic inflammation and increase in the serum level of digestive enzymes, in comparison to normal mice. EAE (100, 200, and 400 mg/kg) was administered i.p., 30 minutes before induction of pancreatitis. Pretreatment with EAE (400 mg/kg) reduced significantly the inflammatory response of cerulein-induced acute pancreatitis by ameliorating pancreatic edema, amylase and lipase serum levels, proinflammatory cytokines, myeloperoxidase activity, lipid peroxidation and pathological alteration. These results show that EAE attenuates the severity of cerulein-induced acute pancreatitis with an anti-inflammatory, immunomodulatory and antioxidant effects.

Evaluation of the anxiolytic effect of Nepeta persica Boiss. in mice

The aim of the present study was to evaluate the anxiolytic effects of hydroalcoholic extract (HE) of Nepeta persica Boiss. (Lamiaceae) on the elevated plus-maze (EPM) model of anxiety. The extract of arial parts of the plant was administered intraperitoneally to male NMRI mice, at various doses, 30 min before behavioural evaluation. The HE extract of N. persica at the dose of 50 mg kg⁻¹ significantly increased the percentage of time spent and percentage of arm entries in the open arms of the EPM. This dose of plant extract affected neither animal's locomotor activity nor ketamine-induced sleeping time. The 50 mg kg⁻¹ dose of the plant extract seemed to be the optimal dose in producing the anxiolytic effects, lower or higher doses of the plant produce either sedative or stimulant effects. At 100 mg kg⁻¹, the plant extract increased the locomotor activity. These results suggested that the extract of N. persica at dose of 50 mg kg⁻¹ possess anxiolytic effect with less sedative and hypnotic effects than that of diazepam and causes a non-specific stimulation at 100 mg kg⁻¹.

Complementary medicine, self-help, and lifestyle interventions for obsessive compulsive disorder (OCD) and the OCD spectrum: a systematic review

BACKGROUND

In Obsessive Compulsive Disorder (OCD) current standard pharmacotherapies may be of limited efficacy. Non-conventional interventions such as Complementary and Alternative Medicine (CAM), self-help techniques, and lifestyle interventions are commonly used by sufferers of OCD, however to date no systematic review of this specific area exists.

METHODS

We conducted a systematic review of studies using CAM, self-help, and lifestyle interventions for treatment of OCD and trichotillomania (TTM). PubMed, PsycINFO, China Academic Journals Full-text Database, The Cochrane Library and CINAHL were searched (up to Jan 11th 2011), for controlled clinical trials using non-conventional interventions for OCD. A quality analysis using a purpose-designed scale and an estimation of effect sizes (Cohen's d) where data was available, were also calculated.

RESULTS

The literature search revealed 14 studies that met inclusion criteria. Methodological quality of nutraceutical studies (nutrients and herbal medicines) were rated as high (mean 8.6/10), whereas mind-body or self-help studies were poorer (mean 6.1/10). In OCD, tentative evidentiary support from methodologically weak studies was found for mindfulness meditation (d=0.63), electroacupuncture (d=1.16), and kundalini yoga (d=1.61). Better designed studies using the nutrient glycine (d=1.10), and traditional herbal medicines milk thistle (insufficient data for calculating d) and borage (d=1.67) also revealed positive results. A rigorous study showed that N-acetylcysteine (d=1.31) was effective in TTM, while self-help technique "movement decoupling" also demonstrated efficacy (d=0.94). Mixed evidence was found for myo-inositol (mean d=0.98). Controlled studies suggest that St John's wort, EPA, and meridian-tapping are ineffective in treating OCD.

CONCLUSIONS

While several studies were positive, these were un-replicated and commonly used small samples. This precludes firm confidence in the strength of clinical effect. Preliminary evidence however is encouraging, and more rigorous research of some of the more hypothesis-based interventions in the treatment of OCD and TTM may be indicated.

Anxiolytic and Hypnotic Effects of Aqueous and Ethanolic Extracts of Aerial Parts of Echium italicum L. in Mice

BACKGROUND

Research in the area of herbal psychopharmacology has clearly improved in recent decades. Self-administration of herbal medicines has been the most popular therapeutic alternative to standard medicine.

OBJECTIVES

Since the extract of Echium amoenum exhibits an anxiolytic effect, the aim of this study is to evaluate the anxiolytic and hypnotic effects in mice of the aqueous and ethanolic extracts of aerial parts of E. italicum, a member of the Boraginaceae family.

MATERIALS AND METHODS

Mice were administered the agents intraperitoneally before the start of the experiments for evaluation of hypnotic activity (induced by sodium pentobarbital, 30 mg/kg, i.p.), anxiolytic activity (elevated plus-maze [EPM] test), locomotor activity (open field test), and motor coordination (rotarod test).

RESULT

The ethanolic and aqueous extracts of E. italicum, at doses of 1.2 and 2.1 g/kg, increased the percentage of time-spent and the percentage of arm entries in the open arms of the EPM and decreased the percentage of time-spent in the closed arms of the EPM. Moreover, both extracts decreased the pentobarbital-induced latency to sleep and significantly increased the total sleeping time induced by pentobarbital. In addition, locomotor activity was affected by aqueous extracts and ethanolic extract (at higher doses). Both extracts showed no effect in the rotarod test.

CONCLUSIONS

These results suggest that both ethanolic and aqueous extracts of E. italicum may have anxiolytic effects and sedative activity but no effect on muscle relaxation.

Herbal medicine for depression, anxiety and insomnia: a review of psychopharmacology and clinical evidence

Research in the area of herbal psychopharmacology has increased markedly over the past decades. To date however, a comprehensive review of herbal antidepressant, anxiolytic and hypnotic psychopharmacology and applications in depression, anxiety and insomnia has been absent. A search of MEDLINE (PubMed), CINAHL, PsycINFO, and the Cochrane Library databases was conducted (up to February 21st 2011) on commonly used psychotropic herbal medicines. A review of the literature was conducted to ascertain mechanisms of action of these botanicals, in addition to a systematic review of controlled clinical trials for treatment of mood, anxiety and sleep disorders, which are common comorbid psychiatric disorders. Specific emphasis was given to emerging phytomedicines. Analysis of evidence levels was conducted, as were effect sizes (Cohen's d) where data were available. Results provided evidence of a range of neurochemical, endocrinological, and epigenetic effects for 21 individual phytomedicines, which are detailed in this paper. Sixty six controlled studies were located involving eleven phytomedicines. Several of these provide a high level of evidence, such as Hypericum perforatum for major depression, and Piper methysticum for anxiety disorders. Several human clinical trials provide preliminary positive evidence of antidepressant effects (Echium amoenum, Crocus sativus, and Rhodiola rosea) and anxiolytic activity (Matricaria recutita, Ginkgo biloba, Passiflora incanata, E. amoenum, and Scutellaria lateriflora). Caution should however be taken when interpreting the results as many studies have not been replicated. Several herbal medicines with in vitro and in vivo evidence are currently unexplored in human studies, and along with use of emerging genetic technologies "herbomics", are areas of potential future research.

Immunomodulatory properties of borage (Echium amoenum) on BALB/c mice infected with Leishmania major

Leishmaniasis is caused by parasitic protozoa transmitted by the bite of a female sand fly and is currently endemic in 88 countries. BALB/c mice are highly susceptible to the infection with the parasite Leishmania major, and this susceptibility has been attributed, in part, to the expansion of Th2 cells, production of their cytokines, and downregulation of Th1 cytokine, interferon gamma (IFN-γ). In this report, we used both aqueous and alcoholic extracts of Iranian borage (Echium amoenum Fisch & C.A. Mey) for treatment of L. major infection in BALB/c mice. We found that both extracts had immunomodulatory properties and increased the level of IFN-γ and lowered the parasite burden in the proximal lymph nodes and prevented the necrosis of the footpad as compared with the untreated infected mice. These results may provide a basis for further studies directed toward the use of the Iranian borage against L. major infection.

Efficacy of aqueous extract of Echium amoenum in treatment of obsessive-compulsive disorder

Traditionally, the dried flower of Echium amoenum (Boraginaceae) has been used in Iran as an anxiolytic and mood enhancer. This study investigated the efficacy and safety of an aqueous extract of E. amoenum in treatment of obsessive-compulsive disorder. Forty-four patients were randomly assigned to receive either E. amoenum aqueous extract (500 mg/day) or placebo in a 6-week, double blind, parallel-group trial. Patients were assessed before the study and during weeks 1, 2, 4, and 6 by the Yale-Brown Obsessive Compulsive (Y-BOCS), the Hamilton Rating Scale for Anxiety (HAM-A), and a score sheet on adverse effects. In weeks 4 and 6, the extract showed a significant superiority over placebo in reducing obsessive and compulsive and anxiety symptoms. There was no significant difference between the two groups in terms of adverse effects. The results suggest that E. amoenum aqueous extract has some anti obsessive and compulsive effects. However, further studies are needed to confirm these findings.

Animal models of anxiety and anxiolytic drug action

Animal models of anxiety attempt to represent some aspect of the etiology, symptomatology, or treatment of human anxiety disorders, in order to facilitate their scientific study. Within this context, animal models of anxiolytic drug action can be viewed as treatment models relevant to the pharmacological control of human anxiety. A major purpose of these models is to identify novel anxiolytic compounds and to study the mechanisms whereby these compounds produce their anxiolytic effects. After a critical analysis of "face," "construct," and "predictive" validity, the biological context in which animal models of anxiety are to be evaluated is specified. We then review the models in terms of their general pharmacological profiles, with particular attention to their sensitivity to 5-HTIA agonists and antidepressant compounds. Although there are important exceptions, most of these models are sensitive to one or perhaps two classes of anxiolytic compounds, limiting their pharmacological generality somewhat, but allowing in depth analysis of individual mechanisms of anxiolytic drug action (e.g., GABAA agonism). We end with a discussion of possible sources of variability between models in response to 5-HTIA agonists and antidepressant drugs.

Evaluation of the analgesic effect of Echium amoenum Fisch & C.A. Mey. extract in mice: possible mechanism involved

Echium amoenum Fisch & C.A. Mey. has been used in Iranian traditional medicine as demulcent and analgesic in common cold from long ago. In this investigation, the analgesic effect of the methanolic extract of the petals of this plant on male albino mice was evaluated by formalin and hot-plate test. The methanolic percolated extract with different doses 5, 10, 20 and 30 mg/kg were injected intraperitoneally to mice. The results showed that the dose of 10 mg/kg of extract had the highest analgesia in formalin (P<0.05) and hot-plate test (P<0.01) compared to the control group. The analgesic effect of extract was lower than morphine 2.5 mg/kg and ASA 300 mg/kg in the chronic phase of pain in formalin test (P<0.05) and in hot-plate test too (P<0.05). Pretreatment of animal with naloxone 4 mg/kg, s.c. 5 min before extract, decreased the analgesia induced by extract in hot-plate and acute phase of formalin tests; therefore, the opioid receptor may be involved at least partly in the analgesic effect of Echium amoenum extract. The results suggested that Echium amoenum extract has a suitable analgesic effect and further studies are required to evaluate these effects and the potential of the plant.