Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho-oncologic relevance.

2018-02-21
Phytotherapy research : PTR 32(5)
- K Simon Yeung
- Marisol Hernandez
- Jun J Mao
- Ingrid Haviland
- Jyothirmai Gubili

PubMed: 29464801
DOI: 10.1002/ptr.6033

Study Design

Type: Systematic Review

Highly Cited

Anxiety and depression are prevalent among cancer patients, with significant negative impact. Many patients prefer herbs for symptom relief to conventional medications which have limited efficacy/side effects. We identified single-herb medicines that may warrant further study in cancer patients. Our search included PubMed, Allied and Complementary Medicine, Embase, and Cochrane databases, selecting only single-herb randomized controlled trials between 1996 and 2016 in any population for data extraction, excluding herbs with known potential for interactions with cancer treatments. One hundred articles involving 38 botanicals met our criteria. Among herbs most studied (≥6 randomized controlled trials each), lavender, passionflower, and saffron produced benefits comparable to standard anxiolytics and antidepressants. Black cohosh, chamomile, and chasteberry are also promising. Anxiety or depressive symptoms were measured in all studies, but not always as primary endpoints. Overall, 45% of studies reported positive findings with fewer adverse effects compared with conventional medications. Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments. These may benefit cancer patients by minimizing medication load and accompanying side effects. However, well-designed larger clinical trials are needed before these herbs can be recommended and to further assess their psycho-oncologic relevance.

Research Insights

Black Cohosh→Reduced Anxiety
Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments.
Effect
Beneficial
Effect size
Moderate
Black Cohosh→Reduced Depression Symptoms
Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments.
Effect
Beneficial
Effect size
Moderate
Chamomile→Reduced Anxiety
Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments.
Effect
Beneficial
Effect size
Moderate
Chamomile→Reduced Depression Symptoms
Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments.
Effect
Beneficial
Effect size
Moderate
Chasteberry→Reduced Anxiety
Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments.
Effect
Beneficial
Effect size
Moderate
Chasteberry→Reduced Depression Symptoms
Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments.
Effect
Beneficial
Effect size
Moderate
Lavender→Reduced Anxiety
Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments.
Effect
Beneficial
Effect size
Moderate
Lavender→Reduced Depression Symptoms
Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments.
Effect
Beneficial
Effect size
Moderate
Passionflower→Reduced Anxiety
Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments.
Effect
Beneficial
Effect size
Moderate
Passionflower→Reduced Depression Symptoms
Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments.
Effect
Beneficial
Effect size
Moderate
Saffron→Reduced Anxiety
Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments.
Effect
Beneficial
Effect size
Moderate
Saffron→Reduced Depression Symptoms
Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments.
Effect
Beneficial
Effect size
Moderate

Adverse Events Reported

Saffron→Overall tolerability
Overall, 45% of studies reported positive findings with fewer adverse effects compared with conventional medications.
Finding
Reported
Chamomile→Overall tolerability
These may benefit cancer patients by minimizing medication load and accompanying side effects.
Finding
Reported
Black Cohosh→Overall tolerability
These may benefit cancer patients by minimizing medication load and accompanying side effects.
Finding
Reported
Chasteberry→Overall tolerability
These may benefit cancer patients by minimizing medication load and accompanying side effects.
Finding
Reported
Passionflower→Overall tolerability
Overall, 45% of studies reported positive findings with fewer adverse effects compared with conventional medications.
Finding
Reported
Lavender→Overall tolerability
Overall, 45% of studies reported positive findings with fewer adverse effects compared with conventional medications.
Finding
Reported