Collectively , the literature reveals pre clinical and clinical evidence for various phytomedicines modulating GABA-pathways , with comparative anxiolytic effect to the current array of pharmaceuticals , along with good safety and tolerability profiles
Anxiety disorders are chronic and functionally disabling conditions with high psychological stress , characterised by cognitive symptoms of excessive worry and focus difficulties and physiological symptoms such as muscle tension and insomnia .
Gamma-aminobutyric acid ( GABA ) is an inhibitory neurotransmitter within the central nervous system and is a key target of pharmacotherapies in the treatment of anxiety .
Although current pharmaceutical treatments are often efficacious , they may cause undesirable side effects including cognitive decrements and withdrawal symptoms .
Plant-based " phytomedicines " may provide novel treatment options , to act as an adjunctive or alternative to existing anxiolytic medications .
As such , we conducted a systematic review to assess the current body of literature on anxiolytic phytomedicines and /or phytoconstituents .
Long-term chamomile (Matricaria chamomilla L.) treatment for generalized anxiety disorder: A randomized clinical trial.
BACKGROUND Generalized Anxiety Disorder ( GAD ) is one of the most common anxiety disorders treated in primary care , yet current therapies have limited efficacy and substantial side effects . PURPOSE To evaluate long-term chamomile ( Matricaria chamomilla L. ) use for prevention of GAD symptom relapse . METHODS Out patients from primary care practice s and local communities with a primary diagnosis of moderate-to-severe GAD were enrolled for this two-phase study at a large US academic medical center . During Phase 1 , eligible participants received 12 weeks of open-label therapy with chamomile pharmaceutical grade extract 1500 mg ( 500 mg capsule 3 times daily ) . During Phase 2 , treatment responders were r and omized to either 26 weeks of continuation chamomile therapy or placebo in a double-blinded , placebo-substitution design . The primary outcome was time to relapse during continuation therapy , analyzed using Cox proportional hazards . Secondary outcomes included the proportion who relapsed , treatment-emergent adverse events , and vital sign changes . This study is registered at Clinical Trials.gov , identifier NCT01072344 . RESULTS Between March 1 , 2010 , and June 30 , 2015 , we enrolled 179 participants . Of those , 93 ( 51.9 % ) were responders and agreed to continue in the double-blind r and omized controlled trial . A numerically greater number of placebo-switched ( n=12/47 ; 25.5 % ) versus chamomile-continuation ( n = 7/46 ; 15.2 % ) participants relapsed during follow-up . Mean time to relapse was 11.4 ± 8.4 weeks for chamomile and 6.3 ± 3.9 weeks for placebo  . Hazard of relapse was non-significantly lower for chamomile ( hazard ratio , 0.52 ; 95 % CI , 0.20 - 1.33 ; P = 0.16 ) . During follow-up , chamomile participants maintained significantly lower GAD symptoms than placebo ( P = 0.0032 ) , with significant reductions in body weight ( P = 0.046 ) and mean arterial blood pressure ( P = 0.0063 ) . Both treatments had similar low adverse event rates . CONCLUSIONS Long-term chamomile was safe and significantly reduced moderate-to-severe GAD symptoms , but did not significantly reduce rate of relapse . Our limited sample size and lower than expected rate of placebo group relapse likely contributed to the non-significant primary outcome finding . Possible chamomile superiority over placebo requires further examination in large-scale studies
Collectively , the literature reveals pre clinical and clinical evidence for various phytomedicines modulating GABA-pathways , with comparative anxiolytic effect to the current array of pharmaceuticals , along with good safety and tolerability profiles
Anxiety disorders are chronic and functionally disabling conditions with high psychological stress , characterised by cognitive symptoms of excessive worry and focus difficulties and physiological symptoms such as muscle tension and insomnia .
Gamma-aminobutyric acid ( GABA ) is an inhibitory neurotransmitter within the central nervous system and is a key target of pharmacotherapies in the treatment of anxiety .
Although current pharmaceutical treatments are often efficacious , they may cause undesirable side effects including cognitive decrements and withdrawal symptoms .
Plant-based " phytomedicines " may provide novel treatment options , to act as an adjunctive or alternative to existing anxiolytic medications .
As such , we conducted a systematic review to assess the current body of literature on anxiolytic phytomedicines and /or phytoconstituents .