Herbal remedies for depression and anxiety

An epidemiological study on herbal product self-medication practice among psychotic outpatients from Serbia: A cross-sectional study

Utilization of herbal products (HPs) is a common practice in the traditional medicine of people from southeastern Serbia. In this study, we focused on the usage of HPs as a self-medication practice among patients diagnosed with a mental illness, by aiming to ascertain the usage prevalence, the identity of the main plant taxa utilized, their formulations and target symptoms. This was accomplished through a cross-sectional study of psychiatric outpatients, conducted in the Clinic for Mental Health Protection in Niš, and which included a questionnaire on HP utilization and a non-structured psychiatric interview. Typically, single, middle-aged males, with a secondary education degree, utilized Matricaria chamomilla and/or Melissa officinalis in a form of an infusion (tea) for relieving anxiety and psychotic symptoms. In some cases, adverse effects were noted when HPs were used in combination with prescribed psychotropic medications. Our and previous results urge a thorough evaluation of possible benefits and/or harmful interactions of HP with standard medication in the treatment of psychiatric patients.

The ‘Natural Health Service’: natural does not mean safe

Plants have been used for medicinal purposes for centuries, treating everything from non-specific ailments such as backache and colds to serious conditions, including depression and cancer. In this review, a few commonly known plants with psychotropic effects (St John's wort, Ginkgo biloba, kava, ginseng and valerian) are discussed by way of illustration. The readers' attention is brought to important interactions between herbal remedies and conventional drugs. A background to the constituents of herbs, possible mechanisms of action and an explanation of their antioxidant properties is given.

Adverse psychiatric effects of non-psychotropic medications

Patients presenting to psychiatrists frequently have comorbid medical conditions for which they are receiving treatment. A range of medications used for treatment of these conditions can have adverse effects resembling psychiatric symptoms. This article presents the results of our review of the literature on psychiatric adverse effects of various non-psychotropic medications, and discusses the mechanisms of such effects, their assessment and management. Among the commonly prescribed drugs found to have psychiatric adverse effects are corticosteroids, anti-Parkinsonian drugs, anti-epileptics, antiretrovirals, antibiotics, anticancer drugs, analgesics, drugs targeting endocrine and cardiovascular disorders, immunosuppressants, skeletal muscle relaxants and bronchodilators. Some adverse effects are predictable and dose dependent, whereas others are rare and idiosyncratic, and psychiatrists need to be aware of them for accurate diagnosis and appropriate treatment.

Prevalence of self-medication practice with herbal products among non-psychotic psychiatric patients from southeastern Serbia: A cross-sectional study

The aim of this study was to evaluate the usage prevalence of herbal products (HP) and to ascertain the identity, mode and adverse effects of plant taxa used in self-medication practice for anxiety, depression and insomnia in patients with non-psychotic disorders originating from southeastern Serbia. Also, we compared HP users and non-users on the variables of socio-demographic characteristics, information source and origin of HP. The study was done by a face-to-face interview with a trained psychiatrist using a structured questionnaire administered to 136 adult patients suffering from non-psychotic mental disorders. A typical herbal-product user among non-psychotic psychiatric patients from southeastern Serbia is a middle-aged married woman, with a secondary level of education, unemployed and living in an urban area. Non-psychotic psychiatric patients, although not living predominantly in rural areas, were familiar with a variety of ethno-medicines and were often using HP primarily without the consultation of their psychiatrists/physicians. HP stated to be most frequently used for psychiatry-related symptoms included: Melissa officinalis, Mentha × piperita, Hypericum perforatum and Valeriana officinalis. The interviewees rarely stated adverse reactions related to the HP usage; however, this should not be generalized, since HP are known to vary in the content of their adverse reaction-causing constituents.

Effects in dogs with behavioural disorders of a commercial nutraceutical diet on stress and neuroendocrine parameters

The well-being of dogs can be affected by changes in human lifestyle, eating habits and increased stressors that lead to behavioural disorders including fear, hyperactivity and anxiety, followed by negative affective moods and poor welfare. This randomised, controlled clinical evaluation involved 69 dogs, 38 males and 31 females, of different breeds, with behavioural disorders related to anxiety and chronic stress. They were fed a control diet or a nutraceutical diet (ND group) for 45 days. Neuroendocrine (serotonin, dopamine, β-endorphins, noradrenaline and cortisol) and stress (derivatives of reactive oxygen metabolites (dROMs) and biological antioxidant potential (BAP)) parameters related to behavioural disorders were evaluated at the beginning and end of the study period. Results showed a significant increase in serotonin, dopamine and β-endorphins plasma concentrations (*P<0.05, *P<0.05 and **P<0.01, respectively) and a significant decrease in noradrenaline and cortisol plasma concentrations in the ND group (*P<0.05). dROMs significantly decreased in the ND group (*P<0.05) while BAP was not affected. This study demonstrated for the first time that a specific diet significantly and positively affected neuroendocrine parameters and dROMs. These results open significant perspectives concerning the use of diet and nutraceuticals in the treatment of behavioural disorders.

Effectiveness of Cuscuta planiflora Ten. and Nepeta menthoides Boiss. & Buhse in Major Depression

Background.

Depression is one the most common mental disorders that can be seen all over the world. In traditional Persian medicine, some medicinal herbs are recommended for depression treatment. This study aimed to evaluate the effects of Cuscuta planiflora Ten. and Nepeta menthoides Boiss. & Buhse in patients with major depression.

Methodology.

This study is a randomized triple-blind controlled clinical trial conducted in the year 2010 in Shiraz University of Medical Sciences on patients with major depression. Pharmaceutical capsules of Cuscuta planiflora (500 mg) and Nepeta menthoides (400 mg) were prepared by a pharmacist. Patients were randomly assigned to 3 groups: group A (treated with Nepeta menthoides capsules and conventional drugs), group B (treated with Cuscuta planiflora capsules and conventional drugs), and group C (treated only with conventional drugs). The study period was 8 weeks and depression was measured before and after the study by Beck Depression Inventory and Hamilton Depression Inventory. The data were analyzed by SPSS version 20 and the P < .05 was considered statistically significant.

Results.

A total of 43 subjects participated in this study, of whom 81.4% were females (n = 35) and 18.6% were males (n = 8). The mean ± standard deviation of age of the participants was 38 ± 10.9 years. The majority of patients (65.1%, n = 28) were married. There were 15 patients (34.9%) in group A, 13 (30.29%) in group B, and 15 (34.9%) in group C. There was a significant decrease in mean scores of Beck and Hamilton depression inventories in the 3 groups after treatment ( P < .01); moreover, there was more decrease in scores of the Beck and Hamilton depression inventories in groups A and B compared with group C after treatment ( P < .01).

Conclusion.

Despite the paucity of the population under study, the findings showed that Cuscuta planiflora and Nepeta menthoides capsules could be effective, affordable herbal medicines with improved cost–benefit in treatment of major depression and it is worth designing further and more extensive studies to get to a more accurate conclusion.

The Effects of Lavandula Angustifolia Mill Infusion on Depression in Patients Using Citalopram: A comparison Study

BACKGROUND

Many herbs have been used to treat psychiatric disorders including anxiety and depression in traditional medicine.

OBJECTIVES

This study was carried out to determine the effect of using Lavandula angustifilia infusion on depression in patients taking Citalopram.

PATIENTS AND METHODS

Among all patients referred to the Hajar Hospital psychiatric clinic, Shahrekord, Iran, 80 patients who met the criteria of major depression according to the structured interviews and the Hamilton questionnaire for Depression were included in the study. They were randomly assigned into two groups of experimental treatment group and standard treatment group at this study. In standard treatment group, the patients were given Citalopram 20 mg. In experimental treatment group, the patients took 2 cups of the infusion of 5 g dried Lavandula angustifilia in addition to tablet Citalopram 20 mg twice a day. The patients were followed up for four and eight weeks of the study onset using Hamilton Scale questionnaire and treatment side effects form. Data were analyzed using student t-test, pair t-test and chi square.

RESULTS

After four weeks of the trial onset, the mean depression score according to the Hamilton Scale for Depression was 17.5 ± 3.5 in the standard treatment group and 15.2 ± 3.6 in the experimental treatment group (P < 0.05). After eight weeks, it was 16.8±4.6 and 14.8±4 respectively (P < 0.01). In addition, the most commonly observed adverse effects were nausea (12.8 %) and confusion (10%). In terms of side effects, there were no significant differences between two groups.

CONCLUSIONS

Considering the results of this study, Lavandula angustifilia infusion has some positive therapeutic effects on depressed patients most importantly decreases mean depression score and might be used alone or as an adjunct to other anti-depressant drugs.

Economic evaluation of St. John's wort (Hypericum perforatum) for the treatment of mild to moderate depression

BACKGROUND

The burden of rising health care expenditures has created a demand for information regarding the clinical and economic outcomes associated with Complementary and Alternative Medicines. Clinical controlled trials have found St. John's wort to be as effective as antidepressants in the treatment of mild to moderate depression. The objective of this study was to develop a model to assess the cost-effectiveness of St. John's wort based on this evidence.

METHODS

A Markov model was constructed to estimate health and economic impacts of St. John's wort versus antidepressants. Outcomes were treatment costs, quality-adjusted life years (QALYs) and Net Monetary Benefits (NMB). Probabilistic analyses were conducted on key model parameters.

RESULTS

The average NMB across 5000 simulations identified St. John's wort as the strategy with the highest net benefit. The total cost savings for SJW were $359.66 and $202.56 per individual for venlafaxine and sertraline respectively, with a gain of 0.08 to 0.12 QALYs over the 72 weeks of the model.

LIMITATIONS

A lack of direct comparative clinical trial data comparing SJW to venlafaxine and limited data with sertraline as a comparator was a major limitation.

CONCLUSIONS

In this model, St. John's wort was shown to be a cost-effective alternative to generic antidepressants. Patients are more likely to receive treatment for a duration consistent with professional guidelines for treatment of major depression due to reduced incidence of adverse effects, improving outcomes. This represents an important option in the treatment of Major Depressive Disorder.

Complementary and alternative medicine in the treatment of anxiety and depression

PURPOSE OF REVIEW

There is well documented evidence for the increasing widespread use of complementary and alternative medicine in the treatment of physical and psychiatric symptoms and disorders within Western populations. Here we provide a review of the recent literature on evidence for using such interventions in the treatment of anxiety and depression.

RECENT FINDINGS

With regard to herbal treatments, kava is effective in reducing anxiety symptoms and St John's wort in treating mild to moderate depression. The association of kava with hepatotoxicity, however, is a significant concern. Promising data continue to emerge for the use of omega-3 fatty acids in managing depression. Evidence for the use of acupuncture in treating anxiety disorders is becoming stronger, although there is currently minimal empirical evidence for the use of aromatherapy or mindfulness-based meditation.

SUMMARY

The evidence base for the efficacy of the majority of complementary and alternative interventions used to treat anxiety and depression remains poor. Recent systematic reviews all point to a significant lack of methodologically rigorous studies within the field. This lack of evidence does not diminish the popularity of such interventions within the general Western population.