Herbal Treatment of Anxiety: Clinical Studies in Western, Chinese and Ayurvedic Traditions

323 Pages·2022·4.771 MB·English

by  Scott D. Mendelson

Herbal Treatment
of Anxiety
Herbal Treatment of Anxiety: Clinical Studies in Western, Chinese and Ayurvedic Traditions
explains the nature and types of anxiety, its neurobiology, the pathophysiology that exacerbates
and perpetuates it, and the psychopharmacology of the chemical agents that relieve its
manifestations. Throughout the text are discussions of Western, Chinese and Ayurvedic herbal
treatments that have been clinically shown to be effective in relieving anxiety. The book also
features a scientific discussion of the use of herbs and essential oils in aromatherapy and the
mechanisms by which they may work. The book concludes by providing bases upon which
herbs can be chosen to treat the anxiety of patients according to their individual needs.
Additional features include:
• Examines the increasingly popular subject of the use of herbs as a natural alternative
treatment and provides a much-needed scientific basis for treatments often considered
as merely “folk medicine.”
• Discusses the psychoactive phytochemicals contained in herbs.
• Includes a chapter discussing the nature and mechanisms of action of adaptogens.
• Adds to the armamentarium of anxiolytics for providers who have become reluctant
to prescribe benzodiazepines as treatment of anxiety, particularly in the context of the
opiate crisis.
• Gives an introduction to herbal treatments of traditional Chinese and Ayurvedic
medicine.
• Offers practical advice on initiating and managing herbal treatments.
Herbal Treatment of Anxiety is a valuable reference for psychiatrists, psychiatric nurse prac-
titioners, primary care providers, naturopathic doctors and therapists interested in the most
current scientific information on the effects of herbal treatments of anxiety disorders.
Scott D. Mendelson is a practicing psychiatrist in Roseburg, Oregon. He earned a Ph.D. in
biopsychology at the University of British Columbia in Vancouver, Canada. He then worked
for three years as a postdoctoral fellow at The Rockefeller University in the Laboratory of
Neuroendocrinology under Bruce McEwen, Ph.D. During his doctoral work and as a p ostdoctoral
fellow, he published 24 papers on the subjects of serotonergic and hormonal regulation of
sexual behavior and the effects of stress on serotonin receptor subtypes in the brain. He then
attended medical school at the University of Illinois and, after graduating in 1996, he did his
residency in psychiatry at the University of Virginia. In 2007, Elsevier published his first book,
Metabolic Syndrome and Psychiatric Illness: Interactions, P athophysiology, Assessment and
Treatment. In 2009, M. Evans published his second book, Beyond Alzheimer’s: How to Avoid
the Modern Epidemic of Dementia.
Clinical Pharmacognosy Series
Series Editors
Navindra P. Seeram and Luigi Antonio Morrone
Botanical medicines are rapidly increasing in global recognition with significant
public health and economic implications. For instance, in developing countries, a
vast majority of the indigenous populations use medicinal plants as a major form
of healthcare. Also, in industrialized nations, including Europe and North America,
consumers are increasingly using herbs and botanical dietary supplements as part
of integrative health and complementary and alternative therapies. Moreover, the
paradigm shifts occurring in modern medicine, from mono-drug to multi-drug and
poly-pharmaceutical therapies, has led to renewed interest in botanical medicines and
botanical drugs.
Natural Products and Cardiovascular Health
Catherina C. Caballero George
Aromatherapy: Basic Mechanisms and Evidence-Based Clinical Use
Giacinto Bagetta, Marco Cosentino, and Tsukasa Sakurada
Herbal Medicines: Development and Validation of Plant-Derived Medicines for Human
Health
Giacinto Bagetta, Marco Cosentino, Marie Tiziana Corasaniti, and Shinobu Sakurada
Natural Products Interactions on Genomes
Siva G. Somasundaram
Principles and Practice of Botanicals as an Integrative Therapy
Anne Hume and Katherine Kelly Orr
Herbal Treatment of Major Depression: Scientific Basis and Practical Use
Scott Mendelson
Herbal Treatment of Anxiety: Clinical Studies in Western, Chinese and
Ayurvedic Traditions
Scott D. Mendelson
Herbal Treatment
of Anxiety
Clinical Studies in Western,
Chinese and Ayurvedic Traditions
Scott D. Mendelson
Cover image: Shutterstock
First edition published 2023
by CRC Press
6000 Broken Sound Parkway NW, Suite 300, Boca Raton, FL 33487–2742
and by CRC Press
4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
CRC Press is an imprint of Taylor & Francis Group, LLC
© 2023 Scott D. Mendelson
Reasonable efforts have been made to publish reliable data and information, but the
author and publisher cannot assume responsibility for the validity of all materials or
the consequences of their use. The authors and publishers have attempted to trace
the copyright holders of all material reproduced in this publication and apologize to
copyright holders if permission to publish in this form has not been obtained. If any
copyright material has not been acknowledged please write and let us know so we
may rectify in any future reprint.
Except as permitted under U.S. Copyright Law, no part of this book may be reprinted,
reproduced, transmitted, or utilized in any form by any electronic, mechanical, or
other means, now known or hereafter invented, including photocopying, microfilming,
and recording, or in any information storage or retrieval system, without written
permission from the publishers.
For permission to photocopy or use material electronically from this work, access
www.copyright.com or contact the Copyright Clearance Center, Inc. (CCC), 222
Rosewood Drive, Danvers, MA 01923, 978–750–8400. For works that are not avail-
able on CCC please contact [email protected]
Trademark notice: Product or corporate names may be trademarks or registered
trademarks and are used only for identification and explanation without intent to
infringe.
Library of Congress Cataloging‑in‑Publication Data
Names: Mendelson, Scott D., author.
Title: Herbal treatment of anxiety : clinical studies in Western, Chinese and ayurvedic
traditions / Scott D. Mendelson, M.D. Ph.D.
Description: First edition. | Boca Raton : CRC Press, 2022. | Includes bibliographical
references and index.
Subjects: LCSH: Anxiety disorders—Alternative treatment. | Herbs—Therapeutic
use.
Classification: LCC RC531 .M46 2022 | DDC 616.85/22—dc23/eng/20220322
LC record available at https://lccn.loc.gov/2022003084
ISBN: 978-1-032-29159-8 (hbk)
ISBN: 978-1-032-29160-4 (pbk)
ISBN: 978-1-003-30028-1 (ebk)
DOI: 10.1201/9781003300281
Typeset in Times New Roman
by Apex CoVantage, LLC
Contents
Preface.....................................................................................................................xix
Chapter 1 What Is Anxiety? .................................................................................1
References ............................................................................................4
Chapter 2 Non-Pharmacological Treatments of Anxiety .....................................7
References ............................................................................................9
Chapter 3 The Neurobiology of Anxiety .............................................................11
3.1 Brain Circuitry of Anxiety .......................................................11
3.2 Neurochemistry ........................................................................12
3.2.1 Gamma Amino Butyric Acid ......................................12
3.2.2 Glutamate ....................................................................13
3.2.3 Monoamines ................................................................13
3.2.4 Acetylcholine ...............................................................14
3.2.5 Endocannabinoids .......................................................14
3.2.6 Endorphins ..................................................................14
3.2.7 Histamine ....................................................................15
3.2.8 Glycine ........................................................................15
3.3 Stress .........................................................................................15
3.4 Inflammation ............................................................................16
3.5 Metabolic Syndrome ................................................................16
3.6 Summary ..................................................................................17
References ..........................................................................................18
Chapter 4 Medications Commonly Used to Treat Anxiety ................................23
4.1 Benzodiazepines ......................................................................23
4.2 Buspirone .................................................................................25
4.3 Antidepressants .......................................................................25
4.4 Gabapentin ...............................................................................26
4.5 Pregabalin ................................................................................27
4.6 Hydroxyzine ............................................................................27
4.7 Propranolol ..............................................................................27
4.8 Clonidine .................................................................................28
4.9 Neurosteroids ...........................................................................28
4.10 Mechanisms of Anxiolytic Drug Action .................................28
References ..........................................................................................29
v
vi Contents
Chapter 5 Anxiolytic Phytochemicals .................................................................33
5.1 Flavonoids .................................................................................33
5.2 Terpenes ...................................................................................34
5.3 Alkaloids ..................................................................................35
5.4 Phytochemicals That Relieve Anxiety ....................................36
5.4.1 Amentoflavone.............................................................37
5.4.2 Apigenin ......................................................................37
5.4.3 Baicalein .....................................................................38
5.4.4 β-Caryophyllene .........................................................38
5.4.5 Bisabolol .....................................................................38
5.4.6 Caffeic Acid................................................................38
5.4.7 3-Carene ......................................................................39
5.4.8 Carvacrol .....................................................................39
5.4.9 Chrysin ........................................................................39
5.4.10 7,8,Dihydroxyflavone .................................................40
5.4.11 Ellagic Acid ................................................................40
5.4.12 Epigallocatechin Gallate ............................................40
5.4.13 Eugenol ........................................................................41
5.4.14 Ferulic Acid .................................................................41
5.4.15 Hispidulin ....................................................................42
5.4.16 Hyperoside ...................................................................42
5.4.17 Icariin ..........................................................................42
5.4.18 Isopulegol ....................................................................43
5.4.19 Kaempferol ..................................................................43
5.4.20 Limonene .....................................................................43
5.4.21 Linalool .......................................................................43
5.4.22 Luteolin ......................................................................44
5.4.23 Menthol ......................................................................44
5.4.24 Mangiferin ..................................................................44
5.4.25 Myricetin .....................................................................45
5.4.26 Naringin ......................................................................45
5.4.27 Nerolidol ......................................................................45
5.4.28 Nobiletin ......................................................................45
5.4.29 Pinene .........................................................................46
5.4.30 Resveratrol ..................................................................46
5.4.31 Quercetin ....................................................................46
5.4.32 Rosmarinic Acid ..........................................................47
5.4.33 Ursolic Acid .................................................................47
5.4.34 Wogonin ......................................................................47
References ..........................................................................................48
Chapter 6 Herbal Treatment of Anxiety ..............................................................55
6.1 Acorus calamus ........................................................................55
6.1.1 Anxiolytic Effects .......................................................55
Contents vii
6.1.2 Mechanism of Action .................................................56
6.1.3 Dosage ........................................................................56
6.1.4 Toxicity .......................................................................56
6.1.5 Safety in Pregnancy....................................................56
6.1.6 Drug Interaction .........................................................56
6.2 Avena sativa..............................................................................57
6.2.1 Anxiolytic Effects .......................................................57
6.2.2 Mechanism of Action ..................................................57
6.2.3 Dosage .........................................................................57
6.2.4 Toxicity ........................................................................57
6.2.5 Safety in Pregnancy.....................................................58
6.2.6 Drug Interactions .........................................................58
6.3 Bacopa monnieri ......................................................................58
6.3.1 Anxiolytic Effects .......................................................58
6.3.2 Mechanism of Action ..................................................58
6.3.3 Dosage .........................................................................59
6.3.4 Toxicity ........................................................................59
6.3.5 Safety in Pregnancy.....................................................59
6.3.6 Drug Interactions .........................................................59
6.4 Camellia sinensis .....................................................................59
6.4.1 Anxiolytic Effects .......................................................59
6.4.2 Mechanism of Action .................................................60
6.4.3 Dosage ........................................................................60
6.4.4 Toxicity ........................................................................61
6.4.5 Safety in Pregnancy.....................................................61
6.4.6 Drug Interactions .........................................................61
6.5 Cannabis sativa ........................................................................61
6.5.1 Anxiolytic Effects .......................................................62
6.5.2 Mechanism of Action ..................................................62
6.5.3 Dosage ........................................................................63
6.5.4 Toxicity .......................................................................63
6.5.5 Safety in Pregnancy....................................................63
6.5.6 Drug Interactions ........................................................64
6.6 Centella asiatica ......................................................................64
6.6.1 Anxiolytic Effects ......................................................64
6.6.2 Mechanism of Action .................................................65
6.6.3 Dosage ........................................................................65
6.6.4 Toxicity .......................................................................65
6.6.5 Safety in Pregnancy....................................................65
6.6.6 Drug Interactions ........................................................65
6.7 Cinnamomum spp ....................................................................66
6.7.1 Anxiolytic Effects ......................................................66
6.7.2 Mechanism of Action .................................................66
6.7.3 Dosage .........................................................................67
6.7.4 Toxicity ........................................................................67
viii Contents
6.7.5 Safety in Pregnancy.....................................................67
6.7.6 Drug Interactions .........................................................67
6.8 Citrus aurantium ......................................................................67
6.8.1 Anxiolytic Effects ......................................................68
6.8.2 Mechanism of Action .................................................68
6.8.3 Dosage ........................................................................68
6.8.4 Toxicity .......................................................................68
6.8.5 Safety in Pregnancy....................................................68
6.8.6 Drug Interaction .........................................................68
6.9 Convolvulus pluricaulis ..........................................................69
6.9.1 Anxiolytic Effects ......................................................69
6.9.2 Mechanism of Action .................................................69
6.9.3 Dosage ........................................................................69
6.9.4 Toxicity .......................................................................69
6.9.5 Safety in Pregnancy.....................................................70
6.9.6 Drug Interaction ..........................................................70
6.10 Crocus sativus ..........................................................................70
6.10.1 Anxiolytic Effects .......................................................70
6.10.2 Mechanism of Action ..................................................70
6.10.3 Dosage .........................................................................71
6.10.4 Toxicity ........................................................................71
6.10.5 Safety in Pregnancy.....................................................71
6.10.6 Drug Interactions .........................................................71
6.11 Curcuma longa .........................................................................71
6.11.1 Anxiolytic Effects .......................................................72
6.11.2 Mechanism of Action ..................................................72
6.11.3 Dosage .........................................................................72
6.11.4 Toxicity ........................................................................72
6.11.5 Safety in Pregnancy.....................................................73
6.11.6 Drug Interactions .........................................................73
6.12 Echinacea angustifolia .............................................................73
6.12.1 Anxiolytic Effects .......................................................73
6.12.2 Mechanism of Action ..................................................73
6.12.3 Dosage .........................................................................74
6.12.4 Toxicity ........................................................................74
6.12.5 Safety in Pregnancy.....................................................74
6.12.6 Drug Interaction ..........................................................74
6.13 Echium amoenum .....................................................................74
6.13.1 Anxiolytic Effects .......................................................74
6.13.2 Mechanism of Action ..................................................75
6.13.3 Dosage .........................................................................76
6.13.4 Toxicity ........................................................................76
6.13.5 Safety in Pregnancy.....................................................76
6.13.6 Drug Interactions .........................................................76
Contents ix
6.14 Eleutherococcus senticosus ......................................................76
6.14.1 Anxiolytic Effects .......................................................76
6.14.2 Mechanism of Action .................................................77
6.14.3 Dosage ........................................................................77
6.14.4 Toxicity ........................................................................78
6.14.5 Safety in Pregnancy.....................................................78
6.14.6 Drug Interactions .........................................................78
6.15 Eschscholzia californica ..........................................................78
6.15.1 Anxiolytic Effects .......................................................78
6.15.2 Mechanism of Action ..................................................78
6.15.3 Dosage .........................................................................79
6.15.4 Toxicity ........................................................................79
6.15.5 Safety in Pregnancy.....................................................79
6.15.6 Drug Interaction ..........................................................79
6.16 Euphytose .................................................................................79
6.16.1 Anxiolytic Effects ......................................................80
6.16.2 Mechanism of Action .................................................80
6.16.3 Dosage ........................................................................80
6.16.4 Toxicity .......................................................................80
6.16.5 Safety in Pregnancy....................................................80
6.16.6 Drug Interactions .........................................................81
6.17 Evolvulus alsinoides .................................................................81
6.17.1 Anxiolytic Effects .......................................................81
6.17.2 Mechanism of Action ..................................................81
6.17.3 Dosage ........................................................................82
6.17.4 Toxicity .......................................................................82
6.17.5 Safety in Pregnancy....................................................82
6.17.6 Drug Interaction .........................................................82
6.18 Foeniculum vulgare .................................................................82
6.18.1 Anxiolytic Effects ......................................................82
6.18.2 Mechanism of Action .................................................83
6.18.3 Dosage ........................................................................83
6.18.4 Toxicity .......................................................................83
6.18.5 Safety in Pregnancy....................................................83
6.18.6 Drug Interactions ........................................................84
6.19 Galphimia glauca ....................................................................84
6.19.1 Anxiolytic Effects ......................................................84
6.19.2 Mechanism of Action .................................................84
6.19.3 Dosage ........................................................................85
6.19.4 Toxicity .......................................................................85
6.19.5 Safety in Pregnancy....................................................85
6.19.6 Drug Interaction .........................................................85
6.20 Ganoderma lucidum................................................................85
6.20.1 Anxiolytic Effects ......................................................85