In Germany, 70% of German MDs prescribe herbal medicine alongside conventional drugs. Herbal medicine is mainstream in Germany rather than fringe.
In 1978, the German Commission E issued scientific profiles on nearly 400 herbs, and this is still used as important scientific data to this day.
In 1991, the World Health Organisation (WHO) issued general guidelines for the use of herbs, and in 1997, ESCOP (European Scientific Co-operative on Phytotherapy) published monographs on 50 herbs.
These included, St. John's Wort, ginger, feverfew etc.
Whilst herbal preparations can be helpful in combating psychological symptoms, please remember that they are not harmless and they may interact with other medication you are taking.
Always check with your doctor.
As a general rule, try to use single herb preparations rather than the complex ?synergistic' combinations available that are marketed pretty aggressively.
In addition to the herbs that work directly on the nervous system, the anti-spasmodic herbs - which work on the peripheral nerves and the muscle tissue - can have an indirect relaxing effect on the whole system.
By calming the nervous system, the whole physical system is beneficially affected, and in turn, the emotional status.
Below is a brief list and description of some of the more common herbs that are used in conditions such as anxiety, depression, lack of energy, insomnia etc.
You will notice that there is some overlap: herbs that are helpful in anxiety may also help with sleep or may reduce nerve-type pains as they have a generally calmative effect on the whole nervous system.
Ashwagandha: a shrub cultivated in India and North America whose roots have been used for thousands of years by Ayurvedic practitioners as a rasayana (health promoter).
Ashwagandha contains flavonoids and several active ingredients of the withanolide class.
Several studies over the past few years have indicated that Ashwagandha has antioxidant properties and influences brain chemistry.
Rat studies have shown that activity of the neurotransmitter acetylcholine receptors is increased and this may account for its properties in improving cognitive ability.
A study done in 1991 at the Department of Pharmacology, University of Texas Health Science Center indicated that extracts of Ashwagandha had GABA-like activity.
This may account for this herb's antianxiety effects.
Black Cohosh: this native American remedy, an ingredient in Lydia Pinkham's famous medicinal compound, is widely known for its benefits during menopause.
It is also said to be sedative and to combat anxiety. However, it is not recommended for use for over 6 months.
Black Haw/ Guelder Rose: The bark, known as Cramp Bark, is used as a nerve sedative and anti-spasmodic in asthma and hysteria.
California Poppy: contains alkaloids and is a natural hypnotic (helps to bring sleep on, and reduces night-time waking) also an anxiolytic and a sedative.
The plant is also an antispasmodic so may be helpful for the treatment of colitis, relieving intestinal spasms and pains. It is present in many over the counter sleep aids.
Celery seed: has sedative properties. Note that it can increase photosensitivity of the skin.
Chamomile: there are 2 types: Roman and German, both being helpful in anxiety and used as nerve sedatives. Chamomile tea is a favourite for helping to promote a restful night's sleep. Commission E approved the German type (Matricaria chamomilla) for medicinal use.
Chamomile flowers contain antispasmodics and anti-inflammatory agents; the active chemicals (bioabolol which is anti-inflammatory and apigenin which settles the stomach and has a calmative effect) are concentrated in the essential oil, (which is a lovely blue colour).
Studies in animals have shown that inhalation of chamomile vapour partly blocks the hormonal response to stress.
Cola nut (Kola nut): the nut of the cola tree is familiar to us in cola soft drinks. Its energizing properties come directly from caffeine. It is thus of use in banishing mental and physical fatigue because it stimulates the central nervous system.
The downside is, of course, that it can cause or worsen symptoms of anxiety, restlessness and difficulty sleeping. It can increase the effects of prescribed antidepressants.
However, people with stomach ulcers should not use it.
Flax seed oil: (linseed) a highly valuable source of omega-3 oils (see below)
Frankincense: believed to have a ?centering' effect on the emotions; traditionally used for spiritual growth, frankincense is often incorporated into creams or oil or perfume. It blends well with neroli and orange aromatherapy oils.
Gingko biloba: this is a much touted plant for improving memory, although recent studies have refuted that this can be demonstrated. It is also thought to help improve circulation.
However, it interacts with anti-inflammatory drugs (NSAIDs) and can increase the risk of bleeding from an ulcer; it should not be taken if you have bleeding problems or are on anticoagulants.
One area in which it has been shown helpful is in combating antidepressant-induced sexual dysfunction, which is a common and distressing problem.
An American study found that 240 mg of gingko a day reduced this problem in both men and women.
Gotu Kola: It is regarded as one of the most spiritual and rejuvenating herbs in Ayurveda and is used to improve meditation. It is said to develop the crown chakra, the energy center at the top of the head, and to balance the right and left hemispheres of the brain, which the leaf is said to resemble.
In recent years, Gotu kola has become popular in the West as a nerve tonic to promote relaxation and to enhance memory.
Hops (Humulus lupulus): a 1996 German study found that hops were as effective as the drug Rohypnol (the ?date rape' drug) with regard to inducing sleep. Hops are known for their properties in curbing restlessness and anxiety and for promoting restless sleep (hop pillows are popular for the latter).
Hop tea can be made by pouring boiling water over a heaped teaspoonful of the ground herb and steeping for 10-15 minutes. Hops were approved by Commission E.
Jamaican Dogwood: In some people it cures violent toothache, neuralgia, and migraine and promotes sleep, also acting as an antispasmodic in asthma.
It is also useful in nervous debility and in the relief of ovarian and uterine pain.
In other people it only causes gastric distress and nausea; overdoses produce toxic effects. Jamaican Dogwood is a powerful sedative, used in its West Indian homeland as a fish poison.
While not being poisonous to humans, the given dosage level should not be exceeded. Its main use is for insomnia (when this is due to nervous tension or pain) being best combined with Hops & Valerian.
Lavender: contains at least 1.5% essential oil, which includes camphor and tannins unique to the lavender family. It has been found to work well against insomnia and is calmative.
It also helps to reduce muscle spasms. Apart from occasional skin rash from the essential oil, there are no known side effects or contraindications. Commission E approved lavender.
Lemon Balm (Melissa): contains terpenes, which are tranquillising agents. The essential oil smells pleasantly lemony. It can also be taken as a tea. It is one of the herbs approved by Commission E
Lime Blossom: also known as linden blossom; the Vikings used to spread the flowers on the floor of the bridal bedchambers to ensure that the children conceived would be tall and beautiful. It is a strong nervine that can be used for relief of anxiety, stress and headaches.
Mistletoe: has nervine properties and is helpful in relieving tension, insomnia and mild depression.
Motherwort: known as the ?herb of life', this has a reputation as the finest of all nervines.
Traditional writers tell us that there is no better herb for strengthening and gladdening the heart; allaying nervous irritability and inducing calming of the whole nervous system.
It also acts as a tonic, without producing over-excitement.
Pasque flower: also known as pulsatilla (and used in homeopathic preparations) so called because it flowers at Easter. Being sedative and analgesic, it is helpful for tension headaches, insomnia, neuralgia and nervous exhaustion.
Passionflower: Passiflora: so called not because it invokes passion, but because part of the flower resembles the crown of thorns worn by Jesus on the day of His crucifixion.
It is sedative and reduces muscle tension, being helpful in neuralgia, headaches and insomnia. Its active ingredient is chrysin, which appears to be a partial agonist of benzodiazepine receptors.
It can be taken for anxiety as a tincture in warm water or as capsules of the freeze-dried plant, one to four times a day as needed.
As a nighttime sleep aid (hypnotic), doses range from 200-300 mg of the extract, (standardized as 3.5% to 4% isovitexin: flavonoids), taken an hour before bedtime.
It is combined with valerian for relief of insomnia, anxiety and irritability. There are no clinical studies of passiflora alone, but one undertaken with passionflower and valerian found that it showed some benefit in anxiety.
Relora: this new supplement contains extracts from magnolia and Phellodendron. It is designed to help relieve mild anxiety.
It is also reported to help control stress-related eating and drinking. Trials suggest that Relora affects levels of the stress hormone cortisol, reducing raised levels due to stress, whilst increasing levels of DHEA that are depleted by chronic stress.
It does not affect benzodiazepine receptors so is not sedating. In open trials, 8 out of 10 people taking 200mg 3 times a day felt more relaxed, 7 out of 10 reported more restful sleep and 9 out of 10 said it was gentle on the stomach.
The recommended dose now is 250mg 3 times a day. Animal tests suggest that Relora is safe and the company that markets the product claims, "No side effects are expected at the recommended human dosage." This product recently featured in the Sunday Times "What's the Alternative" column.
Rhodiola: Rhodiola rosea, found in the polar arctic regions of eastern Siberia, has been shown on healthy men and women to have positive effects on the nervous system and to support normal moods.
The extract is widely used in Russia, where it is known for its adaptogenic activity, which increases the body's resistance to stress. Rhodiola rosea increases b-endorphin (which inhibits hormonal changes due to stress) in the blood.
Rosemary: this herb that has been used for centuries, has a reputation for enhancing memory. There is, however, so direct scientific evidence of this.
In French hospitals it used to be customary to burn rosemary along with juniper berries to purify the air and prevent infection. Banckes' Herbal has the following quotations relating to rosemary:
'Take the flowers thereof and make powder thereof and binde it to thy right arme in a linnen cloath and it shale make thee light and merrie.
'Also put the leaves under thy bedde and thou shalt be delivered of all evill dreames.
Grete Herbal:
'ROSEMARY. - For weyknesse of ye brayne. Against weyknesse of the brayne and coldenesse thereof, sethe rosemaria in wyne and lete the pacyent receye the smoke at his nose and keep his heed warme.'
Rosemary is a stimulant herb; essential oil in a warm bath can clear the head of fatigue and help to banish headaches. It also makes a pleasant tea, which is reputed to help relieve ?nervous ailments', and may have some mild antidepressant properties.
St.John's Wort: Hypericum: this herb was used by Hippocrates. More recently, it has enjoyed considerable popularity as a non-prescription treatment of depression.
"St. John's Wort is a promising treatment for depression . . . Hypericum extracts were significantly superior to placebo and similarly effective as standard antidepressants . . . The herb may offer an advantage, however, in terms of relative safety and tolerability, which might improve patient compliance."
British Medical Journal August 3, 1996
The German Commission E monograph lists mild to moderate depressive states, fear, and nervous disturbances, and somatoform disturbances as clinical indications for hypericum.
As most of the scientific literature on SJW relates to mild to moderate depressions, treatment of more severe depression (with suicidal, psychotic or severe melancholic features) with SJW is not recommended.
SJW seems to work in a similar fashion to Prozac and other SSRIs (see above). Indeed, in Germany SJW substantially outsells Prozac (one source suggests sixty-six million daily doses in 1994); more than fifty percent of depression, anxiety, and sleep disorders are treated in that country with SJW.
The active ingredient is hypericin. (Look for labels specifying 0.3% hypericin; products may vary considerably in their strength). Commission E recommended a daily dose of 2-4 g; with onset of action within 6 weeks of commencing treatment.
25 controlled double-blind studies (involving over 2,000 patients with mild to moderate depressive disorders) have been conducted. 16 compared SJW with placebo (sugar-pills) and 9 with standard drug treatments (Imipramine, Amitriptyline, Maprotiline, Desipramine, Diazepam, and Light-therapy.
In the majority of the studies various parameters (depressed mood, anxiety, loss of interest, feelings of worthlessness, decreased activity, sleep disturbance, lack of concentration, somatic complaints) improved significantly after 4 weeks of treatment.
The response rate to SJW is around 50-80%, which compares favourably with standard drug therapy.
SJW increases deep sleep but does not impair cognitive (thinking) functions or the ability to work or drive a car. It has also been shown to have a long-term effect on anxiety comparable to Diazepam.
The optimum dosage of SJW, based on the majority of medical studies, is 300 mg of extract three times a day. As with prescription antidepressants, the effect takes place gradually.
Studies tend to indicate that SJW takes longer to reach full effect than do prescription antidepressants. This means that assessment of the benefits should not be done before 6 weeks of treatment.
Side effects: In a study of 3,250 patients taking SJW, only 2.4 percent experienced any side effects at all.
These included: Gastrointestinal irritation (0.6%), allergic reactions (0.5%), tiredness (0.4%), and restlessness (0.3%).
The British Medical Journal, in a review of 6 studies, suggested a higher figure of 10.8% (compared with 35.9% reported due to prescription antidepressants); but concluded that side effects were "rare and mild."
SJW is considered a dangerous weed in Australia and is listed in Common Poisonous Plants and Mushrooms of North America, by Nancy J. Turner and Adam F. Szczawinski.
This is because it increases animals' susceptibility to sunlight, so that they may become sick and sometimes die from extreme sunburn.
This is a phenomenon known as phototoxicity -- overexposure to light (photo) being harmful (toxic). This phenomenon, while theoretically possible in humans, has not been documented in the recommended doses for depression.
The possibility of phototoxicity should be borne in mind, if you already have hypersensitivity to sunlight, or if you are taking other photosensitising drugs such as Chlorpromazine and Tetracyclines. (and some anticonvulsants)
SJW and prescription antidepressants:
Note: never discontinue taking prescribed antidepressants without proper medical supervision, because you run the risk of a ?rebound effect'.
Also note that SJW is not suitable for severe depression or bipolar disorder (manic-depressive illness).
SJW should not be taken alongside MAOIs, as this can produce the same sort of severe adverse effects as interactions between SSRIs and MAOIs (see above).
A wait of 4 weeks between stopping MAOI and starting SJW is recommended.
Generally speaking, the best method of transition to SJW from SSRIs such as Prozac and Zoloft is a gradual introduction of the herb whilst tapering off the antidepressant medication.
The longer latent period before onset of benefit of SJW means that this gradual transition should be undertaken over a period of 4-6 weeks before a significant reduction in prescription antidepressants.
This helps to avoid re-emergence of depressive symptoms. However, it is important to serotonin syndrome (see above).
Symptoms of this include sweating, agitation, confusion, lethargy, tremor and muscle jerks. Should these occur it is vital to seek immediate medical attention.
Interaction with other medication has not been found. For instance, a study in 2000 found that SJW did not affect the way in which the anticonvulsant carbamazepine worked on the body or the speed of the drug's metabolism.
This means that SJW is unlikely to interact with anticonvulsant medication that is commonly used to combat nerve-related pain.
Skullcap: relaxes nervous tension whilst also renewing and revitalising the nervous system. It can be used in exhausted or depressed conditions and in anxiety.
Valerian: a sedative herb known as ?God's valium' in the popular press, valerian acts as a minor tranquilliser to relieve restlessness, anxiety and sleep disturbance. It can also work as a muscle relaxant.
It achieves its effects by acting on the neurotransmitter GABA, which is the same chemical that benzodiazepines like Valium work on. Stimulating GABA dampens the level of arousal of the central nervous system.
Studies have demonstrated a mild sedative effect, but does not cause a hangover effect in the morning or impair attention. Unlike other sedatives, it does not seem to interact with prescription medication.
Commission E recommended use of valerian root as treatment of restlessness and sleep disorders.
It is found in products such as Kalms, in combination with other herbs such as gentian.
Side effects are uncommon but include gastrointestinal upset and rarely, contact allergy. Occasionally, with long-term use, restlessness, sleep disorder, headaches etc. can occur, which is why prolonged use is not recommended. Overdose can cause dystonic reactions (muscle tone disorder) and liver toxicity.
It is sold as a tea, tincture or extract. For insomnia, dosage is 1 teaspoon (2 g to 3 g) of tincture in a little warm water or 300- 500 mg capsules at bedtime.
As a daytime dose to relieve anxiety, small doses of 10 drops or one to one and one-half teaspoonfuls of tincture, in warm water, can be used or 150- 300 mg capsules.
It takes effect within 30-45 minutes. Note that although Valerian has a distinctive unpleasant smell, redolent of dirty socks, this won't make your breath smell like the inside of old shoes!
Recipe for calming nerves:
Fragrant valerian
Hops
Lavender flowers
Balm
Chamomile
Anise
Mix in equal parts. Steep 1 tbsp. in 1/2 cup boiling water. Take 1 cup per day.
Note: Kava Kava has been withdrawn from shops because of a few isolated cases of toxicity in Europe, which were related to prolonged use of high doses.
It had been used for its tranquillising properties and its ability to increase sociability.
For centuries, its relaxing influence on the mind and body has been used at weddings and other special occasions.
In fact, dignitaries such as the Queen and the Pope have drunk Kava-Kava during South Pacific welcoming ceremonies (Reader's Digest, 1999).
A leafy member of the pepper family, kava is known to reduce anxiety and tension, promote restful sleep and decrease muscle tension (can ease muscle spasms), without major side effects or loss of alertness.
It has also been found to have pain-relieving qualities that can be used to treat muscle aches and chronic pain.
Adverse effects include dermatitis, shortness of breath and visual disturbances (sensitivity to light and hallucinations).
Excessive use (over 400 mg) for as little as three months can cause temporary yellowing of the skin, hair and nails.
In rare cases, an allergic skin reaction called icthyosiform kava dermopathy can occur (a dry scaly rash first appears on the face and then on the rest of the body).
Overdose can lead to intoxication, disorientation, loss of voluntary muscle control and somnolence.
Other effects of high doses include loss of appetite, difficulty breathing, blurred vision, bloodshot eyes and gait difficulties (Wong et al., 1998).
It should not be used with alcohol, sedative/hypnotics, barbiturates, antidepressants, tranquillizers (including buspirone [Buspar]) or other substances that act on the central nervous system.
There has been a reported case in which kava potentiated the effects of the benzodiazepine Alprazolam; it may cause excessive drowsiness with sedating antihistamine drugs, muscle relaxants such as carisoprodol (Soma) or cyclobenzaprine (Flexeril) and narcotic analgesics such as codeine and hydrocodone.
Cautions:
If you have heart disease you should avoid: ginseng
If you have ulcers you should avoid: gingko, cola nut.
Note: this covers only the herbs mentioned in this article; if you have any medical condition you should consult your doctor and/or a qualified herbalist before embarking on use of ANY herb.
Herbs that interact with drugs:
Belladonna and antidepressants
Cola nut and antidepressants
Gingko and anticoagulants, aspirin, NSAIDs
Kava kava and alcohol, barbiturates
Sarsaparilla and hypnotics
St. John's Wort and alcohol/antidepressants/tranquillisers/HIV medication
Valerian and tranquillisers/antidepressants
Flaxseed may affect drug absorption/increase sensitivities to drugs
Herbs not to be taken over prolonged periods:
Black cohosh
Gingko
Ginseng
Kava kava
Valerian
How To Make Sedative Herbal Medicinal Tea
The general recipe for making medicinal teas is:
4 parts therapeutic herb
1 part aromatic herb
1 part demulcent herb
Use a total of one teaspoon of herbs to one cup of water. If you use more than one herb, they must add up to no more than one teaspoon.
Aromatic herbs are used to spice teas and give them flavour. E.g.
Allspice/Anise/Caraway/Cardamom/Cinnamon/Clove/Coriander/Ginger/Lemon or orange peel/Vanilla bean
Demulcent herbs have soothing qualities that prevent any internal irritation, such as stomach upset.
Examples: Arrowroot/Borage/Coltsfoot/Comfrey root/Liquorice root/Marshmallow leaves and root/Oatmeal/Slippery elm bark/Solomon's-seal root
Effective nerviness/ herbal tranquillisers
Chamomile/Feverfew/Hops/Mullein/Passion
Flower/Peppermint/Skullcap/Valerian/Verbena
Dosage:
Drink one to three cups of tea each day in half-cup doses. To keep freshness, make only just one or two cups at a time.
