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Rodríguez-Usaquén A, Sutachan JJ, Villarreal W, Costa GM, Acero Mondragon EJ, Ballesteros-Ramírez R, Albarracín SL. Sub-acute toxicity evaluation of aqueous leaf extract from Passiflora edulis Sims f. edulis (Gulupa) in Wistar rats. Toxicol Rep 2023; 11:396-404. [PMID: 37955035 PMCID: PMC10632121 DOI: 10.1016/j.toxrep.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 11/14/2023] Open
Abstract
The genus Passiflora (Passifloraceae) comprises about 500 species. The Passiflora edulis stands out because of its economic and medicinal importance. It is widely planted in tropical and subtropical regions worldwide, especially in South America, the Caribbean, South Africa, and Asia. The aqueous extract of Passiflora edulis Sims f. edulis (Gulupa) leaves is used in traditional medicine for its soothing and tranquilizing effects on the central nervous system. Therefore, evaluating its safety for human use is a fundamental requirement to continue the development of new therapies within the framework of regulatory, preclinical, and clinical guidelines. Here, the sub-acute toxicity study was conducted following the Organization for Economic Cooperation and Development (OECD) guideline 407 for 28 days in Wistar albino rats. The study showed that 1000 mg/kg/day of the aqueous extract in 10 adult Wistar rats (five males and five females) was well tolerated. The hematological results are at normal levels. However, monocytopenia and eosinopenia were observed with a significant difference (P < 0,05) for both male and female rats treated with the aqueous extract of Passiflora edulis. The results show that liver and kidney function profiles were conserved. However, an increase in ALT is observed with significant differences between male and female rats treated with the extract compared to the controls. Study findings were limited to non-adverse histopathological results of a slightly increased incidence of focal periportal lymphocytic infiltrate in the liver and focal corticomedullary nephrocalcinosis in the kidney compared to control. Therefore, the aqueous extract of Passiflora edulis has a good safety profile in oral administration, was well tolerated, and did not cause any lethality or adverse effects in the sub-acute toxicity study in male and female rats. The NOAEL (no observed adverse effect level) for the 28-day subacute toxicity study was considered to be 1000 mg/kg.
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Affiliation(s)
- Alex Rodríguez-Usaquén
- Grupo de Bioquímica Experimental y Computacional, Laboratorio de Neurobioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Jhon Jairo Sutachan
- Grupo de Bioquímica Experimental y Computacional, Laboratorio de Neurobioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Wilson Villarreal
- Grupo de Investigación Fitoquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Geison M Costa
- Grupo de Investigación Fitoquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Ricardo Ballesteros-Ramírez
- Grupo de Inmunobiología y Biología Celular, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Sonia Luz Albarracín
- Grupo de Bioquímica Experimental y Computacional, Laboratorio de Neurobioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
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Zhang J, Tao S, Hou G, Zhao F, Meng Q, Tan S. Phytochemistry, nutritional composition, health benefits and future prospects of Passiflora: A review. Food Chem 2023; 428:136825. [PMID: 37441935 DOI: 10.1016/j.foodchem.2023.136825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
Passiflora, also known as "passion fruit", is widely grown in tropical and subtropical regions. It is not only eaten raw but is also widely used in processed foods. Various extracts, juices and isolated compounds show a wide range of health effects and biological activities, such as antioxidant, anti-inflammatory, sedative, and neuroprotective effects. In this review, we not only review the phytochemical properties of Passiflora but also highlight the potential of Passiflora for food applications and the use of all parts as a source of ingredients for medicines and cosmetics that promote health and well-being. This will provide theoretical support for the integrated use of such natural products.
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Affiliation(s)
- Juan Zhang
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, China
| | - Siyu Tao
- Department of Basic and Applied Medical Sciences-Physiology Group, Ghent University, 9000 Ghent, Belgium
| | - Guige Hou
- School of Pharmacy, Binzhou Medical University, Yantai 264003, China
| | - Fenglan Zhao
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, China
| | - Qingguo Meng
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, China.
| | - Shenpeng Tan
- School of Pharmacy, Key Laboratory of Molecular Pharmacology and Drug Evaluation (Yantai University), Ministry of Education, Collaborative Innovation Center of Advanced Drug Delivery System and Biotech Drugs in Universities of Shandong, Yantai University, Yantai 264005, China.
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Sakalem ME, Tabach R, de Oliveira M, Carlini EA. Behavioral Pharmacology of Five Uncommon Passiflora Species Indicates Sedative and Anxiolytic-like Potential. Cent Nerv Syst Agents Med Chem 2022; 22:125-138. [PMID: 35473529 DOI: 10.2174/1871524922666220426102650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/06/2022] [Accepted: 02/16/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND There are over 500 species in the Passiflora genus, and while some of them are very well known in folk medicine for their anxiolytic effects, very little is known for the other genus representants, which could also present medicinal effects. OBJECTIVE In this study, we performed an interspecific pharmacological comparison of five little investigated Passiflora species, all native to Brazil: P. bahiensis, P. coccinea, P. quadrangularis, P. sidaefolia, and P. vitifolia. METHOD Extracts were administered to mice before behavioral testing, which included a general pharmacological screening and anxiolytic-like effect investigation. RESULTS Three of the species [P. coccinea, P. quadrangularis, and P. sidaefolia] induced a decrease in locomotor activity of mice; P. coccinea also reduced the latency to sleep. Importantly, none of the species interfered with motor coordination. Oral administration evoked no severe signs of toxicity even at higher doses. Regarding the anxiolytic-like profile, P. sidaefolia reduced the anxious-like behavior in the Holeboard test in a similar way to the positive control, Passiflora incarnata, while not affecting total motricity. CONCLUSION These results indicate that P. coccinea, P. quadrangularis, and P. sidaefolia reduced the general activity of mice and confer a calmative/sedative potential to these three species, which must be further elucidated by future investigations.
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Affiliation(s)
- Marna Eliana Sakalem
- Department of Psychobiology, Universidade Federal de Sao Paulo [UNIFESP], Sao Paulo, SP, Brazil
| | - Ricardo Tabach
- Department of Psychobiology, Universidade Federal de Sao Paulo [UNIFESP], Sao Paulo, SP, Brazil.,Universidade Santo Amaro, Sao Paulo, SP, Brazil
| | - Miriane de Oliveira
- Botucatu Medical School, Sao Paulo State University [UNESP], Botucatu, SP, Brazil
| | - Elisaldo Araújo Carlini
- Department of Psychobiology, Universidade Federal de Sao Paulo [UNIFESP], Sao Paulo, SP, Brazil
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Amaral RG, Gomes SVF, Andrade LN, dos Santos SA, Severino P, de Albuquerque Júnior RLC, Souto EB, Brandão GC, Santos SL, David JM, Carvalho AA. Cytotoxic, Antitumor and Toxicological Profile of Passiflora alata Leaf Extract. Molecules 2020; 25:molecules25204814. [PMID: 33092066 PMCID: PMC7587945 DOI: 10.3390/molecules25204814] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/08/2020] [Accepted: 10/15/2020] [Indexed: 12/14/2022] Open
Abstract
Passiflora alata or passion fruit is a native flowering plant from Amazon, geographically spread from Peru to Brazil. The plant has long been used in folks medicine for its pharmacological properties and is included in the Brazilian Pharmacopoeia since 1929. The aim of this study was to evaluate the potential cytotoxic and antitumor activities of Passiflora alata leaf extract (PaLE) in S180-tumor bearing mice. The percentage of cell proliferation inhibition (% CPI) and IC50 in relation to 4 tumor cell lines were determined in PC3, K-562, HepG2 and S180 cell lines using the MTT assay. PaLE showed a CPI > 75% and greater potency (IC50 < 30 µg/mL) against PC3 and S180 cell lines. PaLE showed antitumor activity in treatments intraperitoneally (36.75% and 44.99% at doses of 100 and 150 mg/kg/day, respectively). Toxicological changes were shown in the reduced body mass associated with reduced food consumption, increased spleen mass associated with histopathological increase in the white pulp of the spleen and increased number of total leukocytes with changes in the percentage relationship between lymphocytes and neutrophils. Our outcomes corroborate the conclusion that PaLE has antitumor activity in vitro and in vivo with low toxicity.
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Affiliation(s)
- Ricardo G. Amaral
- Department of Physiology, Federal University of Sergipe, São Cristóvão, Sergipe 49100-000, Brazil; (R.G.A.); (S.A.d.S.); (S.L.S.)
| | - Silvana V. F. Gomes
- Institute of Technology and Research, University of Tiradentes, Aracaju, Sergipe 49032-490, Brazil; (S.V.F.G.); (P.S.); (R.L.C.d.A.J.)
| | - Luciana N. Andrade
- Department of Medicine, Federal University of Sergipe (UFS), Avenida Governador Marcelo Déda, Lagarto-SE 49400-000, Brazil
- Correspondence: (L.N.A.); (E.B.S.); (A.A.C.)
| | - Sara A. dos Santos
- Department of Physiology, Federal University of Sergipe, São Cristóvão, Sergipe 49100-000, Brazil; (R.G.A.); (S.A.d.S.); (S.L.S.)
| | - Patrícia Severino
- Institute of Technology and Research, University of Tiradentes, Aracaju, Sergipe 49032-490, Brazil; (S.V.F.G.); (P.S.); (R.L.C.d.A.J.)
- Center for Biomedical Engineering, Department of Medicine, Brigham and Women′s Hospital, Harvard Medical School, 65 Landsdowne Street, Cambridge, MA 02139, USA
- Tiradentes Institute, 150 Mt Vernon St, Dorchester, MA 02125, USA
| | | | - Eliana B. Souto
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- CEB—Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
- Correspondence: (L.N.A.); (E.B.S.); (A.A.C.)
| | - Geraldo C. Brandão
- Department of Pharmacy, Federal University of Ouro Preto, Ouro Preto 78950-000, Brazil;
| | - Sandra L. Santos
- Department of Physiology, Federal University of Sergipe, São Cristóvão, Sergipe 49100-000, Brazil; (R.G.A.); (S.A.d.S.); (S.L.S.)
| | - Jorge M. David
- Institute of Chemistry, Federal University of Bahia, Salvador 40000-000, Brazil;
| | - Adriana A. Carvalho
- Department of Medicine, Federal University of Sergipe (UFS), Avenida Governador Marcelo Déda, Lagarto-SE 49400-000, Brazil
- Correspondence: (L.N.A.); (E.B.S.); (A.A.C.)
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Wasicky A, Hernandes LS, Vetore-Neto A, Moreno PR, Bacchi EM, Kato ETM, Yoshida M. Evaluation of gastroprotective activity of Passiflora alata. REVISTA BRASILEIRA DE FARMACOGNOSIA-BRAZILIAN JOURNAL OF PHARMACOGNOSY 2015. [DOI: 10.1016/j.bjp.2015.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Klein N, Gazola AC, de Lima TCM, Schenkel E, Nieber K, Butterweck V. Assessment of Sedative Effects of Passiflora edulis
f. flavicarpa
and Passiflora alata
Extracts in Mice, Measured by Telemetry. Phytother Res 2013; 28:706-13. [DOI: 10.1002/ptr.5043] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 06/13/2013] [Accepted: 06/28/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Nadine Klein
- College of Pharmacy; University of Florida; Gainesville USA
- Institut für Pharmazie; Universität Leipzig; Talstraße 33 04103 Leipzig Germany
| | - Andressa Córneo Gazola
- Programa de Pós-Graduação em Farmácia and Programa de Pós-Graduação em Farmacologia; Universidade Federal de Santa Catarina; Florianópolis SC 88040-970 Brazil
| | - Thereza Christina Monteiro de Lima
- Programa de Pós-Graduação em Farmácia and Programa de Pós-Graduação em Farmacologia; Universidade Federal de Santa Catarina; Florianópolis SC 88040-970 Brazil
| | - Eloir Schenkel
- Programa de Pós-Graduação em Farmácia and Programa de Pós-Graduação em Farmacologia; Universidade Federal de Santa Catarina; Florianópolis SC 88040-970 Brazil
| | - Karen Nieber
- Institut für Pharmazie; Universität Leipzig; Talstraße 33 04103 Leipzig Germany
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Almeida MR, Aissa AF, Ursula Hermogenes Gomes TD, Darin JDC, Chisté RC, Mercadante AZ, Antunes LMG, Bianchi MLP. In Vivo Genotoxicity and Oxidative Stress Evaluation of an Ethanolic Extract from Piquiá (Caryocar villosum) Pulp. J Med Food 2013; 16:268-71. [DOI: 10.1089/jmf.2012.0169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Mara Ribeiro Almeida
- Department of Clinical Analysis, Toxicology, and Food Science, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alexandre Ferro Aissa
- Department of Genetics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Tarsila Daysy Ursula Hermogenes Gomes
- Department of Clinical Analysis, Toxicology, and Food Science, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Joana D'Arc Castania Darin
- Department of Clinical Analysis, Toxicology, and Food Science, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renan Campos Chisté
- Department of Food Science, Faculty of Food Engineering, University of Campinas, Campinas, São Paulo, Brazil
| | - Adriana Zerlotti Mercadante
- Department of Food Science, Faculty of Food Engineering, University of Campinas, Campinas, São Paulo, Brazil
| | - Lusânia Maria Greggi Antunes
- Department of Clinical Analysis, Toxicology, and Food Science, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Maria Lourdes Pires Bianchi
- Department of Clinical Analysis, Toxicology, and Food Science, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Konta EM, Almeida MR, do Amaral CL, Darin JDC, de Rosso VV, Mercadante AZ, Antunes LMG, Bianchi MLP. Evaluation of the antihypertensive properties of yellow passion fruit pulp (Passiflora edulis Sims f. flavicarpa Deg.) in spontaneously hypertensive rats. Phytother Res 2013; 28:28-32. [PMID: 23436457 DOI: 10.1002/ptr.4949] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 01/14/2013] [Accepted: 01/14/2013] [Indexed: 12/26/2022]
Abstract
Various species of the genus Passiflora have been extensively used in traditional medicine as sedatives, anxiolytics, diuretics and analgesics. In the present study, after the identification and quantification of phytochemical compounds from yellow passion fruit pulp by liquid chromatography-photodiode array-mass spectrometry (HPLC-PDA-MS/MS), its antihypertensive effect was investigated on spontaneously hypertensive rats. Additionally, the renal function, evaluated by kidney/body weight, serum creatinine, proteinuria, urinary flow, reduced glutathione (GSH) levels and thiobarbituric acid-reactive substances (TBARS) and mutagenicity in bone marrow cells were assessed to evaluate the safety of passion fruit consumption. Yellow passion fruit pulp (5, 6 or 8 g/kg b.w.) was administered by gavage once a day for 5 consecutive days. HLPC-PDA-MS/MS analysis revealed that yellow passion fruit pulp contains phenolic compounds, ascorbic acid, carotenoids and flavonoids. The highest dose of passion fruit pulp significantly reduced the systolic blood pressure, increased the GSH levels and decreased TBARS. There were no changes in renal function parameters or the frequency of micronuclei in bone marrow cells. In conclusion, the antihypertensive effect of yellow passion fruit pulp, at least in part, might be due to the enhancement of the antioxidant status. The exact mechanisms responsible by this effect need further investigation.
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Affiliation(s)
- Eliziane Mieko Konta
- Departamento de Alimentos e Nutrição, Faculdade de Ciência Farmacêuticas de Araraquara, Universidade Estadual Paulista (UNESP), Araraquara, SP, Brazil
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Braga A, Stein AC, Dischkaln Stolz E, Dallegrave E, Buffon A, do Rego JC, Gosmann G, Fialho Viana A, Kuze Rates SM. Repeated administration of an aqueous spray-dried extract of the leaves of Passiflora alata Curtis (Passifloraceae) inhibits body weight gain without altering mice behavior. JOURNAL OF ETHNOPHARMACOLOGY 2013; 145:59-66. [PMID: 23107823 DOI: 10.1016/j.jep.2012.10.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 10/19/2012] [Accepted: 10/19/2012] [Indexed: 06/01/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Passiflora alata is a Southern American species that constitutes many traditional remedies as well as phytomedicines used for sedative and anxiolytic purposes in Brazil. However studies on repeated treatment effects are scarce. AIM OF THE STUDY To evaluate behavioral, physiological and biochemical effects of the repeated treatment with an aqueous spray-dried extract of Passiflora alata leaves containing 2.5% (w/v) of flavonoids (PA) in mice. MATERIAL AND METHODS Male adult CF1 mice were treated (p.o.) for 14 days with PA (2.5; 25 or 250 mg/kg). The feeding behavior was evaluated at the beginning (1h after the first administration) and at the end of the treatment (15th day). The body weight gain and food consumption were monitored along the days. On day 15 mice were evaluated on plus maze, spontaneous locomotor activity, catalepsy and barbiturate sleeping time tests. Serum glucose, lipids, ALT and AST enzymes were determined. Liver, kidney, perirenal fat, epididymal and peritoneal fat were analyzed. RESULTS The repeated treatment with the highest dose tested (250 mg/kg) did not alter the mice behavior on open field, elevated plus maze, catalepsy and barbiturate sleeping time tests. Repeated administration of PA 250 decreased mice feeding behavior and weight gain. PA 25 and PA 250 reduced mice relative liver weight and caused mild hepatic hydropic degeneration as well as a decrease in alanine aminotransferase (ALT) serum level. CONCLUSIONS These results indicate that Passiflora alata does not present central cumulative effects and point to the needs of further studies searching for its hepatotoxicity as well as potential anorexigenic.
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Affiliation(s)
- Andressa Braga
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Av. Ipiranga, 2752, Porto Alegre 90610-000, Brazil
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Lakhan SE, Vieira KF. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutr J 2010; 9:42. [PMID: 20929532 PMCID: PMC2959081 DOI: 10.1186/1475-2891-9-42] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Accepted: 10/07/2010] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Over the past several decades, complementary and alternative medications have increasingly become a part of everyday treatment. With the rising cost of prescription medications and their production of unwanted side effects, patients are exploring herbal and other natural remedies for the management and treatment of psychological conditions. Psychological disorders are one of the most frequent conditions seen by clinicians, and often require a long-term regimen of prescription medications. Approximately 6.8 million Americans suffer from generalized anxiety disorder. Many also suffer from the spectrum of behavioural and physical side effects that often accompany its treatment. It is not surprising that there is universal interest in finding effective natural anxiolytic (anti-anxiety) treatments with a lower risk of adverse effects or withdrawal. METHODS An electronic and manual search was performed through MEDLINE/PubMed and EBSCO. Articles were not discriminated by date of publication. Available clinical studies published in English that used human participants and examined the anxiolytic potential of dietary and herbal supplements were included. Data were extracted and compiled into tables that included the study design, sample population, intervention, control, length of treatment, outcomes, direction of evidence, and reported adverse events. RESULTS A total of 24 studies that investigated five different CAM monotherapies and eight different combination treatments and involved 2619 participants met the inclusion criteria and were analyzed. There were 21 randomized controlled trials and three open-label, uncontrolled observational studies. Most studies involved patients who had been diagnosed with either an anxiety disorder or depression (n = 1786). However, eight studies used healthy volunteers (n = 877) who had normal levels of anxiety, were undergoing surgery, tested at the upper limit of the normal range of a trait anxiety scale, had adverse premenstrual symptoms or were peri-menopausal, reported anxiety and insomnia, or had one month or more of elevated generalized anxiety. Heterogeneity and the small number of studies for each supplement or combination therapy prevented a formal meta-analysis. Of the randomized controlled trials reviewed, 71% (15 out of 21) showed a positive direction of evidence. Any reported side effects were mild to moderate. CONCLUSIONS Based on the available evidence, it appears that nutritional and herbal supplementation is an effective method for treating anxiety and anxiety-related conditions without the risk of serious side effects. There is the possibility that any positive effects seen could be due to a placebo effect, which may have a significant psychological impact on participants with mental disorders. However, based on this systematic review, strong evidence exists for the use of herbal supplements containing extracts of passionflower or kava and combinations of L-lysine and L-arginine as treatments for anxiety symptoms and disorders. Magnesium-containing supplements and other herbal combinations may hold promise, but more research is needed before these products can be recommended to patients. St. John's wort monotherapy has insufficient evidence for use as an effective anxiolytic treatment.
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Affiliation(s)
- Shaheen E Lakhan
- Global Neuroscience Initiative Foundation, Los Angeles, CA, USA.
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