From Proyar Laboratory we want to share with you the 2nd part of an exclusive article for Proyar Laboratory, written by Dr. Jorge Alonso. Physician, MN 67,640, Director of the Phytomedicine postgraduate program at U.B.A. and President of the Latin American Society of Phytomedicine.
Anxiety Disorders – Insomnia (Part 2)
Anxiety is defined as the emotional state in which a constant feeling of distress and despair is experienced, due to causes not consciously known. It can affect people of all ages, especially those under constant family or work-related stress… See first part.
Plant drugs with anxiolytic activity
Of all the plant drugs studied to date, most of them have shown to interact with GABA receptors in a similar way to benzodiazepines, although with lower pharmacological potency. This apparent "disadvantage" can be beneficial for the patient, since if the problem to be treated is occasional or the result of a circumstantial event, giving something mild is much better than initially giving a chemical substance capable of generating addiction or dependence. The good thing is that the dose of the natural product can be increased without problems (according to need), and it does not generate drowsiness, loss of reflexes, addiction, or withdrawal syndrome when wanting to stop it.
It is clear that the prescription of a medication always depends on the type of patient we have in front of us and the evolutionary degree of the pathological process. In the face of generalized panic attacks or situations of extreme nervous stress, we will undoubtedly have to prescribe a synthetic benzodiazepine since failing to do so could be dangerous for the patient by not having a control element. On the other hand, for simple nervousness, or as a preventive method for a panic attack, we can use sedatives of plant origin:
Valerian (Valeriana officinalis)
Probably the plant with the longest tradition as a sedative-hypnotic and the most pharmacologically potent compared to others. The part used is the root, where several active components are found: essential oil, iridoids, etc. Studies conducted in animals have shown a good anxiolytic effect, sleep-inducing properties, and even anticonvulsant activity. The latter could indicate the application of valerian in the management of patients with epilepsy, a practice widely used during Roman times, and which, in my personal experience, yielded very good results with several patients. It is noteworthy that doses for managing anxiety with valerian are around 200–400 mg/day, whereas for insomnia, exactly double is required. It is important to note that an oral dose of 400 mg/day produced an interesting pre-anesthetic effect, reducing anxiety in patients about to undergo surgical procedures.
The combination of valerian with other plant drugs such as hops or lemon balm has demonstrated synergistic effects with each other, improving both anxiety disorders and sleep quality. Valerian is part of a select group of herbs used in patients with a history of psychotropic drugs and alcohol abuse. It is also useful in stress management.
Passionflower (Passiflora coerulea / P. incarnata)
In our country, one of the most popularly used passionflowers is Passiflora coerulea, although the vast majority of studies conducted on this genus were done with the European species P. incarnata. An initial double-blind study on 166 patients with anxiety and/or insomnia demonstrated the usefulness of Passiflora incarnata extract in these cases. The flavonoid compounds present in it (especially chrysin) are believed to be responsible for its therapeutic action. Passionflower has the quality of inducing sleep similar to physiological sleep, accompanied by quick awakening, without grogginess or morning hangover. It is often synergized with valerian, hops, lemon balm, or linden in cases of insomnia.
Hops (Humulus lupulus)
Another European species with a long-standing sedative tradition, even used in beer production. It contains humulone and lupulone, which, when oxidized, generate the compound 2-methyl-3-buten-2-ol, believed to be largely responsible for its sedative effects. In Europe, there is a popular custom of placing hop strobiles in pillows and inhaling their aroma during nighttime rest. The combination of hops and valerian has been shown to improve sleep quality in patients with insomnia, indicating a synergistic effect between the two herbs.
Lemon Balm (Melissa officinalis)
A European plant cultivated since the Middle Ages, lemon balm not only has excellent sedative properties but also digestive and antimicrobial benefits. Animal studies have already demonstrated reduced anxiety following its administration. The calming activity of a chamomile and lemon balm infusion was evaluated in a clinical trial with 22 patients, showing a 68% improvement (considered between excellent and good) after a few weeks, while only 8% reported no effect. The efficacy of the combination of lemon balm and valerian in tablets was demonstrated in a clinical study of 98 people with insomnia over one month (120 mg of valerian and 80 mg of lemon balm), administered as 3 tablets daily, revealing a 33% improvement in sleep quality compared to 9% in the placebo group. It is important to note that lemon balm should not be administered to people with hypothyroidism.
Linden (Tilia platyphyllos / Tilia cordata)
Perhaps of all the species mentioned, linden is the one with the least anxiolytic and hypnotic power. However, it is an essential ingredient in sedative herbal teas, where it seems to synergize the activity of other plants with the same purpose. Linden, in fact, also has very good properties for the respiratory tract, acting as an antitussive and expectorant.
Tilo (Tilia platyphyllos / Tilia cordata)
Quizás de todas las especies mencionadas, el tilo sea la que posee menor poder ansiolítico e hipnótico. Sin embargo, es un ingrediente esencial en las tisanas sedativas, donde parece sinergizar la actividad de otras plantas con el mismo fin. El tilo, de hecho, también tiene muy buenas propiedades para el aparato respiratorio, actuando como antitusivo y expectorante.
5-HTP (5-Hydroxytryptophan)
It is an essential amino acid, the dietary sources of which can be found in red wine, peanuts, bananas, almonds, sesame, sunflower, and pumpkin seeds, among others. Tryptophan is a precursor to serotonin, a neurotransmitter related to relaxation, tranquility, and good sleep. It is also successfully used in cases of fibromyalgia.
L-Theanine
This amino acid, found in tea leaves (primarily green and black tea), promotes relaxation by increasing serotonin production and reducing glutamic acid (which is neurotoxic). It combines very well with 5-HTP (5-Hydroxytryptophan). Unlike other plants, it does not act on the GABA receptor but rather through different indirect pathways.
