PLANT PIGMENTS IN PSYCHIATRY AND NEUROLOGY: HISTORICAL AND MODERN USES. PART II. A LITERATURE REVIEW WITH A CLINICAL CASE PRESENTATION
Authors: Bekker Roman A. , Bykov Yuriy V. 
Published: March 2024

Purpose. To continue the narrative that we have started in the first part of this article, telling the reader about the history of the use of certain plant pigments in the treatment of several mental and neurological diseases, as well as in histological studies of brain tissue. To present to the reader the modern research data regarding the potential effectiveness and safety of some plant pigments in the treatment of various mental and psychosomatic pathologies, as well as some neurodegenerative diseases. Then, to present the reader a detailed description of a clinical case from the authors’ own practice. In the aforementioned case, the combined use of a low-calorie diet, exercise, metformin, chromium picolinate, thermogenic fat burners (caffeine and synephrine) and several different plant pigments and antioxidants — made it possible to achieve remission, both in terms of the mental state and in terms of endocrine and metabolic status in a young woman with obesity, polycystic ovary syndrome, depression, hyperuricemia, and an initial stage of urate-based urolithiasis, without the use of traditional psychopharmacotherapy.
Methodology. For the purpose of second part of this review, we have selected primarily those plant pigments that are widely distributed in a variety of plants, and therefore cannot be attributed to any one plant (for example, the carotenoids lycopene, lutein and zeaxanthin, or anthocyanins, which are present in many berries and in the brightly colored flowers of some plants, such as hibiscus).
Secondly, we were interested in the pigments from dyeing plants that some traditional medical systems (for example, traditional Chinese medicine, or Indian Ayurvedic medicine, or traditional medicine of the American Indians) have historically used and/or still continue using for the treatment of mental and neurological diseases. Many of those plants, for example, madder, are relatively little known as medicinal plants to modern European doctors and patients.
We then searched for information about the medical use of such plant pigments with the help of search engines and databases such as PubMed, Google Scholar, Science Direct, Web of Science. Then we have summarized the data we had found and collected, and presented the summarized data in this second part of the review. Then we described in detail a clinical case from our own clinical practice.
Results. The data we have obtained in the process of compiling this review, in our opinion, indicate a significant therapeutic potential for the use of some plant pigments that we have reviewed there — in the treatment of several mental and neurological disorders. The evidence base for the use of such plant pigments in psychiatry and neurology — varies widely in quality. For some plant pigments (eg, for lycopene from tomatoes, for lutein and zeaxanthin, for anthocyanins from various berries or from hibiscus flowers, for resveratrol from red wine and from dark grape varieties) — there are positive data from small randomized clinical trials, in combination with data from population studies (for example, on the association between the consumption of tomatoes, of lycopene and of carotenoids in general, of resveratrol and of plant antioxidants in general — and the frequency of depressive and anxiety disorders).
For some other plant pigments that were historically used and are still used in some traditional medical systems, among other their uses, specifically for the treatment of mental and neurological disorders — for example, madder extract — we so far were able to find only experimental data on animals and on neuronal cell cultures, combined with the empirical experience of such traditional medical systems.
Practical implications. The results that we have presented in this review, in our opinion, can provide theoretical and practical grounds for the use of some of the plant pigments that we have reviewed there (for example, lycopene, lutein and zeaxanthin, resveratrol, etc.) in the combination treatment of chronic fatigue syndrome, of mild forms of anxiety and depressive disorders, mild cognitive impairment — especially in patients who refuse standard psychopharmacotherapy, or who do not tolerate it well.
Some other plant pigments that were historically used in the treatment of mental and neurological disorders in some traditional medical systems (for example, madder extract) — in our opinion, deserve to be studied in humans in this role, preferably in the format of randomized controlled trials.