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Health Condition

Anxiety

  • Chamomile

    Chamomile is an old folk remedy for anxiety, particularly anxiety that causes insomnia. Animal studies support this idea, due possibly to the herb’s calming compounds.

    Dose:

    Refer to label instructions
    Chamomile
    ×
     

    An old folk remedy for anxiety, particularly when it causes insomnia, is chamomile tea. There is evidence from test tube studies that chamomile contains compounds with a calming action.1 There are also animal studies that suggest a benefit from chamomile for anxiety,2 but no human studies support this belief. In an eight-week double-blind trial, treatment with a chamomile extract improved anxiety by an average of 50% in people suffering from chronic anxiety. This improvement was significantly greater than the improvement in the placebo group. The amount of chamomile extract used was 220 mg per day of a product standardized to contain 1.2% apigenin. After one week this was increased to 440 mg per day. For people whose anxiety did not improve sufficiently, the amount of extract was increased progressively, to a maximum of 1,100 mg per day by the fifth week of the study.3 Traditionally, one cup of tea is taken three or more times per day to treat anxiety.

  • Fish Oil

    In a double-blind trial, fish oil was significantly more effective than a placebo in improving anxiety levels for substance abusers.

    Dose:

    3 grams per day
    Fish Oil
    ×
    In a double-blind trial, fish oil was significantly more effective than a placebo in improving anxiety levels in a group of substance abusers (alcohol, cocaine, and/or heroin).4 The fish oil used in this study provided 3 grams per day of omega-3 fatty acids and was given for three months.
  • Inositol

    Inositol has been used to help people with anxiety who have panic attacks.

    Dose:

    4 to 6 grams three times per day
    Inositol
    ×
     

    Inositol has been used to help people with anxiety who have panic attacks. Up to 4 grams three times per day was reported to control such attacks in a double-blind trial.5 Inositol (18 grams per day) has also been shown in a double-blind trial to be effective at relieving the symptoms of obsessive-compulsive disorder.6

  • Lavender

    In a double-blind trial, a proprietary lavender oil preparation (silexan) provided significant symptom relief to people with generalized anxiety disorder.

    Dose:

    Refer to label instructions
    Lavender
    ×
    In a double-blind trial, individuals with anxiety (generalized anxiety disorder) received 80 mg per day of a proprietary lavender oil preparation (silexan, 80 mg once a day) or a low dose of an anti-anxiety drug (lorazepam, 0.5 mg once a day) for 6 weeks. Significant improvement was seen in both groups, and the degree of improvement was similar in both treatment groups.7 In another double-blind trial, Silexan also improved anxiety in people who were suffering from a combination of anxiety and depression.8
  • Multivitamin

    A double-blind trial found that supplementing with a multivitamin-mineral supplement significantly reduced anxiety and perceived stress.

    Dose:

    Follow label instructions
    Multivitamin
    ×
     

    A double-blind trial found that supplementation with a multivitamin-mineral supplement for four weeks led to significant reductions in anxiety and perceived stress compared to placebo.9

  • Passion Flower and Valerian

    A combination of passion flower and valerian has been shown to reduce symptoms in people suffering from anxiety.

    Dose:

    100 to 200 mg valerian and 45 to 90 mg passion flower three times a day
    Passion Flower and Valerian
    ×
     

    Several plants, known as “nervines” (nerve tonics), are used in traditional herbal medicine for people with anxiety, with few reports of toxicity. Most nervines have not been rigorously investigated by scientific means to confirm their efficacy. However, one study found that a combination of the nervines valerian and passion flower reduced symptoms in people suffering from anxiety.10 In a double-blind study, 45 drops per day of an extract of passion flower taken for four weeks was as effective as 30 mg per day of oxazepam (Serax), a medication used for anxiety.11

  • Rhodiola

    Taking rhodiola has been shown to significantly improve anxiety symptoms.

    Dose:

    170 mg of a standardized extract twice per day
    Rhodiola
    ×

    In a preliminary study, supplementation with rhodiola (Rhodiola rosea) significantly improved measures of anxiety in people suffering from generalized anxiety disorder. The amount used was 170 mg of a standardized extract taken twice a day for ten weeks.12

  • St. John’s Wort

    St. John’s wort has been reported in one double-blind study to reduce anxiety.

    Dose:

    Refer to label instructions
    St. John’s Wort
    ×

    Caution: It is likely that there are many drug interactions with St. John's wort that have not yet been identified. St. John's wort stimulates a drug-metabolizing enzyme (cytochrome P450 3A4) that metabolizes at least 50% of the drugs on the market.13 Therefore, it could potentially cause a number of drug interactions that have not yet been reported. People taking any medication should consult with a doctor or pharmacist before taking St. John's wort.

    St. John’s wort has been reported in one double-blind study to reduce anxiety.14

  • American Scullcap

    American scullcap is one of a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

    Dose:

    Refer to label instructions
    American Scullcap
    ×

    Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.15

  • Bacopa

    Bacopa, a traditional herb used in Ayurvedic medicine, has been shown to have anti-anxiety effects.

    Dose:

    Refer to label instructions
    Bacopa
    ×
     

    Bacopa, a traditional herb used in Ayurvedic medicine, has been shown to have anti-anxiety effects in animals.16 A preliminary study reported that a syrup containing an extract of dried bacopa herb reduced anxiety in people with anxiety neurosis.17 A double-blind trial in healthy adults found that 300 mg per day of a standardized bacopa extract reduced general feelings of anxiety, as assessed by a questionnaire.18

  • Hops

    Hops is one of a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

    Dose:

    Refer to label instructions
    Hops
    ×

    Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.19

  • Linden

    Linden is one of a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

    Dose:

    Refer to label instructions
    Linden
    ×
     

    Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.

  • L-Tryptophan

    Research suggests a connection between anxiety and serotonin deficiency and that its precursur L-tryptophan may help reduce anxiety in people with social anxiety disorder and neurosis.

    Dose:

    Refer to label instructions
    L-Tryptophan
    ×
    Animal research suggests that the brain chemical serotonin is involved in the mechanisms underlying anxiety,20 and double-blind studies have reported that creating deficiencies of L-tryptophan, a precursor of serotonin, worsens symptoms in people with anxiety disorders.21,22 A small double-blind trial tested a food bar containing 250 mg of L-tryptophan plus carbohydrate compared with a placebo bar containing only carbohydrate in a people diagnosed with social anxiety disorder.23 The bars were consumed one hour before doing a task designed to provoke anxiety, and anxiety was measured with two tests of heart rate changes and by ratings of anxiety by the participants. Only one of the two heart rate measures showed the L-tryptophan bar was more effective, and only slightly lower anxiety was reported when L-tryptophan was consumed.23 A double blind study in China reported that 3 grams per day of L-tryptophan improved symptoms, including anxiety, in a group of people diagnosed with “neurosis.”25 More research is needed to evaluate L-tryptophan as a treatment for anxiety disorders.
  • Magnesium

    Many years ago, magnesium was reported to be relaxing for people with mild anxiety. Some doctors recommend soaking in a hot bathtub containing magnesium sulfate crystals (Epsom salts).

    Dose:

    Refer to label instructions
    Magnesium
    ×
     

    Many years ago, magnesium was reported to be relaxing for people with mild anxiety.25 Typically, 200 to 300 mg of magnesium are taken two to three times per day. Some doctors recommend soaking in a hot tub containing 1–2 cups of magnesium sulfate crystals (Epsom salts) for 15 to 20 minutes, though support for this approach remains anecdotal.

  • Motherwort

    Motherwort is one of a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

    Dose:

    Refer to label instructions
    Motherwort
    ×
     

    Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.

  • Oats

    Oats are part a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

    Dose:

    Refer to label instructions
    Oats
    ×
     

    Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.

  • Pennyroyal

    Pennyroyal is one of a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

    Dose:

    Refer to label instructions
    Pennyroyal
    ×
     

    Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.

  • Vitamin B3 (Niacin)

    Niacinamide (a form of vitamin B3) has been shown in animals to work in the brain in ways similar to anxiety medications. One study found that niacinamide helped people get through withdrawal from benzodiazepines—a common problem.

    Dose:

    Refer to label instructions
    Vitamin B3 (Niacin)
    ×
     

    Niacinamide (a form of vitamin B3) has been shown in animals to work in the brain in ways similar to drugs such as benzodiazepines (Valium-type drugs), which are used to treat anxiety.26 One study found that niacinamide (not niacin) helped people get through withdrawal from benzodiazepines—a common problem.27 A reasonable amount of niacinamide to take for anxiety, according to some doctors, is up to 500 mg four times per day.

  • Vitamin B-Complex

    Double-blind research suggests that supplementing with vitamin B-complex multivitamin may reduce feelings of anxiety, perceived stress, and tiredness.

    Dose:

    Refer to label instructions
    Vitamin B-Complex
    ×
    In one double-blind study, 80 healthy male volunteers (aged 18 to 42 years) were randomly assigned to receive a daily multivitamin-mineral formula or placebo for 28 days.28 The multi contained the following: thiamine (15 mg), riboflavin (15 mg), niacin (50 mg), pantothenic acid (23 mg), vitamin B6 (10 mg), biotin (150 mcg), folic acid (400 mcg), vitamin B12 (10 mcg), vitamin C (500 mg), calcium (100 mg), magnesium (100 mg), and zinc (10 mg). Compared with the placebo group, the multivitamin group experienced consistent and statistically significant reductions in anxiety and perceived stress, as determined by questionnaires measuring psychological state. This group also tended to rate themselves as less tired and better able to concentrate.
  • Wood Betony

    Wood betony is one of a group of “nerve tonic” (nervine) herbs used in traditional herbal medicine for people with anxiety, with few reports of toxicity.

    Dose:

    Refer to label instructions
    Wood Betony
    ×
     

    Other nervines include oats (oat straw), hops, passion flower, American scullcap, wood betony, motherwort, pennyroyal, and linden.

What Are Star Ratings
×
Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Holistic Options

Reducing exposure to stressful situations can help decrease anxiety. In some cases, meditation, counseling, or group therapy can greatly facilitate this process.29

Acupuncture has been the subject of limited research as a therapy for anxiety. In an uncontrolled study, eight patients suffering from anxiety were treated with acupuncture three times per week for eight sessions. Six of the eight patients achieved good to moderate improvement.30 However, a trial of acupuncture treatment for anxiety associated with quitting smoking did not provide any evidence of benefit.31 A double-blind study of acupuncture for the treatment of anxiety associated with dental procedures reported that acupuncture and placebo were equally effective.32 Acupuncture remains unproven in the treatment of people with anxiety.

A form of counseling known as Cognitive-Behavioral Therapy (CBT) has been shown to be superior to placebo for managing the symptoms of panic disorder.33 In a controlled trial, six months of CBT produced a response rate of 39.5%, compared to only 13% in the placebo group. When combined with the tricyclic antidepressant drug imipramine (Tofranil®), response rates were even higher (57.1%). For long-term management of panic disorder, imipramine produced a superior quality of response, but CBT had more durability and was better tolerated.

References

1. Viola H, de Stein ML, et al. Apigenin, a component of Matricaria recutita flowers, is a central benzodiazepine receptors-ligand with anxiolytic effects. Planta Med 1995;61:213-6.

2. Yamada K, Miura T, Mimaki Y, Sashida Y. Effect of inhalation of chamomile oil vapour on plasma ACTH level in ovariectomized rats under restriction stress. Biol Pharm Bull 1996;19:1244-6.

3. JD, Li Y, Soeller I, et al. A randomized, double-blind, placebo-controlled trial of oral Matricaria recutita (chamomile) extract therapy for generalized anxiety disorder. J Clin Psychopharmacol 2009;29:378-82.

4. Buydens-Branchey L, Branchey M. n-3 polyunsaturated fatty acids decrease anxiety feelings in a population of substance abusers. J Clin Psychopharmacol 2006;26:661-5.

5. Benjamin J, Levine J, Fux M, et al. Double-blind, placebo-controlled, crossover trial of inositol treatment for panic disorder. Am J Psychiatry 1995;152:1084-6.

6. Fux M, Levine J, Aviv A, Belmaker RH. Inositol treatment of obsessive-compulsive disorder. Am J Psychiatry 1996;153:1219-21.

7. Woelk H, Schlafke S. A multi-center, double-blind, randomized study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. Phytomedicine 2010;17:94–9.

8. Kasper S, Volz HP, Dienel A, Schlafke S. Efficacy of Silexan in mixed anxiety-depression - A randomized, placebo-controlled trial. Eur Neuropsychopharmacol 2016;26:331–40.

9. Carroll D, Ring C, Suter M, Willemsen G. The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: a double-blind placebo-controlled trial. Psychopharmacology (Berl) 2000;150:220-5.

10. Brown D. Valerian root: Non-addictive alternative for insomnia and anxiety. Quart Rev Nat Med 1994;Fall:221-4 [review].

11. Akhondzadeh S, Naghavi HR, Vazirian M, et al. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther 2001;26:363-7.

12. Bystritsky A, Kerwin L, Feusner JD. A pilot study of Rhodiola rosea (Rhodax) for generalized anxiety disorder (GAD). J Altern Complement Med 2008; 14:175-80.

13. Markowitz JS, Donovan JL, DeVane CL, et al. Effect of St John's wort on drug metabolism by induction of cytochrome P450 3A4 enzyme. JAMA 2003;290:1500-4.

14. Witte B, Harrer G, Kaptan T, et al. Treatment of depressive symptoms with a high concentration Hypericum preparation. A multicenter placebo-controlled double-blind study. Fortschr Med 1995;113:404-8 [in German].

15. Murray MT. The Healing Power of Herbs. Rocklin, CA: Prima Publishing, 1995.

16. Bhattacharya SK, Ghosal S. Anxiolytic activity of a standardized extract of Bacopa monniera—an experimental study. Phytomedicine 1998;5:77-82.

17. Singh RH, Singh L. Studies on the anti-anxiety effect of the medyha rasayana drug, Brahmi (Bacopa monniera Wettst.) Part 1. J Res Ayur Siddha 1980;1:133-48.

18. Stough C, Lloyd J, Clarke J, et al. The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects. Psychopharmacology 2001;156:481-4.

19. Murray MT. The Healing Power of Herbs. Rocklin, CA: Prima Publishing, 1995.

20. Iversen SD. 5-HT and anxiety. Neuropharmacology 1984;23:1553-60 [review].

21. Schruers K, Klaassen T, Pols H, et al. Effects of tryptophan depletion on carbon dioxide provoked panic in panic disorder patients. Psychiatry Res 2000;93:179-87.

22. Argyropoulos SV, Hood SD, Adrover M, et al. Tryptophan depletion reverses the therapeutic effect of selective serotonin reuptake inhibitors in social anxiety disorder. Biol Psychiatry 2004;56:503-9.

23. Hudson C, Hudson S, MacKenzie J. Protein-source tryptophan as an efficacious treatment for social anxiety disorder: a pilot study. Can J Physiol Pharmacol 2007;85:928-32.

24. Zang DX. A self body double blind clinical study of L-tryptophan and placebo in treated neurosis. Zhonghua Shen Jing Jing Shen Ke Za Zhi 1991;24:77-80,123-4 [in Chinese].

25. Weston PG et al. Magnesium sulfate as a sedative. Am J Med Sci 1923;165:431-3.

26. Mohler H, Polc P, Cumin R, et al. Niacinamide is a brain constituent with benzodiazepine-like actions. Nature 1979;278:563-5.

27. Vescovi PP, et al. Nicotinic acid effectiveness in the treatment of benzodiazepine withdrawal. Curr Ther Res 1987;41:1017.

28. Carroll D, Ring C, Suter M, Willemsen G. The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: a double-blind placebo-controlled trial. Psychopharmacology (Berl) 2000;150:220-5.

29. Miller JJ, Fletcher K, Kabat-Zinn J, et al. Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. Gen Hosp Psychiatry 1995;17:192-200.

30. Lo CW, Chung QY. The sedative effect of acupuncture. Am J Chin Med 1979;7:253-8.

31. Lamontagne Y, Annable L. Acupuncture and anxiety. Can J Psych 1979;24:584-5.

32. Taub HA, Mitchell JN, Stuber FE, et al. Analgesia for operative dentistry: a comparison of acupuncture and placebo. Oral Surg Oral Med Oral Pathol 1979;48:205-10.

33. Barlow DH, Gorman JM, Shear MK, Woods SW. Cognitive-behavioral therapy, imipramine, or their combination for panic disorder. A randomized controlled trial. JAMA 2000;283:2529-36.

34. Bruce M et al. Anxiogenic effects of caffeine in patients with anxiety disorders. Arch Gen Psychiatry 1992;49:867-9.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2019.