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 .
Randomized placebo-controlled adjunctive study of an extract of withania somnifera for cognitive dysfunction in bipolar disorder.
OBJECTIVE Cognitive impairments contribute significantly to inadequate functional recovery following illness episodes in bipolar disorder , yet data on treatment interventions are sparse . We assessed the cognitive effects of a st and ardized extract of the medicinal herb Withania somnifera ( WSE ) in bipolar disorder . METHOD Sixty euthymic subjects with DSM-IV bipolar disorder were enrolled in an 8-week , double-blind , placebo-controlled , r and omized study of WSE ( 500 mg/d ) as a procognitive agent added adjunctively to the medications being used as maintenance treatment for bipolar disorder . Study enrollment and data analyses were completed between December 2008 and September 2012 .  Cognitive testing  at baseline and 8 weeks assessed primary efficacy outcomes . Psychopathology and adverse events were monitored at scheduled visits . RESULTS Fifty-three patients completed the study ( WSE , n = 24 ; placebo , n = 29 ) , and the 2 groups were matched in terms of demographic , illness , and treatment characteristics . Compared to placebo , WSE provided significant benefits for 3 cognitive tasks : digit span backward ( P = .035 ) , Flanker neutral response time ( P = .033 ) , and the social cognition response rating of the Penn Emotional Acuity Test ( P = .045 ) . The size of the WSE  treatment effect for digit span backward was in the medium range ( Cohen d = 0.51 ; 95 % CI , 0.25 - 0.77 ) . None of the other cognitive tasks showed significant between-group differences . Mood and anxiety scale scores remained stable , and adverse events were minor . CONCLUSIONS Although results are preliminary , WSE appears to improve auditory-verbal working memory ( digit span backward ) , a measure of reaction time , and a measure of social cognition in bipolar disorder . Given the paucity of data for improving cognitive capacity in bipolar disorder , WSE offers promise , appears to have a benign side-effects profile , and merits further study . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT00761761
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 .