Erica McIntyre

Plant-Based Medicines for Anxiety Disorders, Part 2: A Review of Clinical Studies with Supporting Preclinical Evidence

Research in the area of herbal psychopharmacology has revealed a variety of promising medicines that may provide benefit in the treatment of general anxiety and specific anxiety disorders. However, a comprehensive review of plant-based anxiolytics has been absent to date. Thus, our aim was to provide a comprehensive narrative review of plant-based medicines that have clinical and/or preclinical evidence of anxiolytic activity. We present the article in two parts. In part one, we reviewed herbal medicines for which only preclinical investigations for anxiolytic activity have been performed. In this current article (part two), we review herbal medicines for which there have been both preclinical and clinical investigations of anxiolytic activity. A search of MEDLINE (PubMed), CINAHL, Scopus and the Cochrane Library databases was conducted (up to 28 October 2012) for English language papers using the search terms ‘anxiety’ OR ‘anxiety disorder’ OR ‘generalized anxiety disorder’ OR ‘social phobia’ OR ‘post-traumatic stress disorder’ OR ‘panic disorder’ OR ‘agoraphobia’ OR ‘obsessive compulsive disorder’ in combination with the search terms ‘Herb*’ OR ‘Medicinal Plants’ OR ‘Botanical Medicine’ OR ‘Chinese herb*’, in addition to individual herbal medicines. This search of the literature revealed 1,525 papers, of which 53 plants were included in the review (having at least one study using the whole plant extract). Of these plants, 21 had human clinical trial evidence (reviewed here in part two), with the other 32 having solely preclinical evidence (reviewed in part one). Support for efficacy was found for chronic use (i.e. greater than one day) of the following herbs in treating a range of anxiety disorders in human clinical trials: Piper methysticum, Matricaria recutita, Ginkgo biloba, Scutellaria lateriflora, Silybum marianum, Passiflora incarnata, Withania somniferum, Galphimia glauca, Centella asiatica, Rhodiola rosea, Echinacea spp., Melissa officinalis and Echium amoenum. For several of the plants studied, conclusions need to be tempered due to methodological issues such as small sample sizes, brief intervention durations and non-replication. Current evidence does not support Hypericum perforatum or Valeriana spp. for any anxiety disorder. Acute anxiolytic activity was found for Centella asiatica, Salvia spp., Melissa officinalis, Passiflora incarnata and Citrus aurantium.Bacopa monnieri has shown anxiolytic effects in people with cognitive decline. The therapeutic application of psychotropic plant-based treatments for anxiety disorders is also discussed, specifically Psychotria viridis and Banisteriopsis caarti (ayahuasca), Psilocybe spp. and cannabidiol-enriched (low tetrahydrocannabinol (Δ9-THC)) Cannabis spp.

Plant-based medicines for anxiety disorders, Part 1: a review of preclinical studies.

Research in the area of herbal psychopharmacology has revealed a variety of promising medicines that may provide benefit in the treatment of general anxiety and specific anxiety disorders. However, a comprehensive review of plant-based anxiolytics has been absent to date. This article (part 1) reviews herbal medicines for which only preclinical investigations for anxiolytic activity have been performed. In part 2, we review herbal medicines for which there have been clinical investigations for anxiolytic activity. An open-ended, language-restricted (English) search of MEDLINE (PubMed), CINAHL, Scopus and the Cochrane Library databases was conducted (up to 28 October 2012) using specific search criteria to identify herbal medicines that have been investigated for anxiolytic activity. This search of the literature revealed 1,525 papers, from which 53 herbal medicines were included in the full review (having at least one study using the whole plant extract). Of these plants, 21 had human clinical trial evidence (reviewed in part 2), with another 32 having solely preclinical studies (reviewed here in part 1). Preclinical evidence of anxiolytic activity (without human clinical trials) was found for Albizia julibrissin, Sonchus oleraceus, Uncaria rhynchophylla, Stachys lavandulifolia, Cecropia glazioui, Magnolia spp., Eschscholzia californica, Erythrina spp., Annona spp., Rubus brasiliensis, Apocynum venetum, Nauclea latifolia, Equisetum arvense, Tilia spp., Securidaca longepedunculata, Achillea millefolium, Leea indica, Juncus effusus, Coriandrum sativum, Eurycoma longifolia, Turnera diffusa, Euphorbia hirta, Justicia spp., Crocus sativus, Aloysia polystachya, Albies pindrow, Casimiroa edulis, Davilla rugosa, Gastrodia elata, Sphaerathus indicus, Zizyphus jujuba and Panax ginseng. Common mechanisms of action for the majority of botanicals reviewed primarily involve GABA, either via direct receptor binding or ionic channel or cell membrane modulation; GABA transaminase or glutamic acid decarboxylase inhibition; a range of monoaminergic effects; and potential cannabinoid receptor modulation. Future research should focus on conducting human clinical trials on the plants reviewed with promising anxiolytic activity.

Compulsive Internet use and relations between social connectedness, and introversion

People with poor social connectedness have a greater risk of developing compulsive Internet use.More introverted people appear to be more vulnerable to compulsive Internet use.Using the Internet can become problematic and lead to poor social connectedness.Compulsive Internet Use Scale is a reliable and valid scale in a sample of students. This study aims to further understand factors involved in compulsive Internet use, with specific focus on the relation between social connectedness, the trait introversion, and compulsive Internet use. While Internet use can enhance social connectedness, compulsive Internet use has been associated with poor social connectedness. The factors that make a person vulnerable to compulsive Internet use and its negative effects remain unclear. The personality trait introversion has been associated with poor social connectedness, and there is disagreement on whether or not social interaction on the Internet is beneficial for people high in this trait. Australian university students (N=168) participated in an online survey. Standardised scales were used to measure social connectedness, introversion, and compulsive Internet use. Results show that introverted adults report more compulsive Internet use symptoms than extroverts. In addition, introversion partially mediated the relation between compulsive Internet use and social connectedness. The results raise questions for future research into factors involved in the development of compulsive Internet use and its effect on social connectedness, especially in those who are introverted.

Herbal medicine use in adults who experience anxiety: A qualitative exploration

Herbal medicine use is widespread and has been reported to be as high as 21% in people with anxiety disorders. Critical thematic analysis was used to explore beliefs and attitudes towards herbal medicines in adults experiencing anxiety. In-depth interviews were conducted with eight adults who experienced anxiety and used herbal medicines. Three major themes were found: Herbal medicines being different from pharmaceuticals, evidence and effectiveness, and barriers to herbal medicine use. Within these themes people held beliefs about the safety of natural treatments, valued anecdotes from friends and family as a form of evidence for self-prescribing, and described confusion about herbal medicines and their cost as barriers to using them as a treatment option. The findings will inform future research and provide guidance for health practitioners.Herbal medicine use is widespread and has been reported to be as high as 21% in people with anxiety disorders. Critical thematic analysis was used to explore beliefs and attitudes towards herbal medicines in adults experiencing anxiety. In-depth interviews were conducted with eight adults who experienced anxiety and used herbal medicines. Three major themes were found: Herbal medicines being different from pharmaceuticals, evidence and effectiveness, and barriers to herbal medicine use. Within these themes people held beliefs about the safety of natural treatments, valued anecdotes from friends and family as a form of evidence for self-prescribing, and described confusion about herbal medicines and their cost as barriers to using them as a treatment option. The findings will inform future research and provide guidance for health practitioners.

Potential herbal anxiolytics

The following substances also have a long traditional history of use, however not necessarily in the treatment of anxiety. These herbs have been included as they have demonstrated some clinical evidence and may be considered as potential treatments for anxiety. It is recommended that future studies further investigate these substances in order to determine their efficacy in the treatment of anxiety. Milk thistle (Silybum marianum) Iranian borage (Echium amoenum) Bitter orange (Citrus aurantium) Echinacea (Echinacea spp.)

The associations between medical, allied and complementary medicine practitioner visits and childhood vaccine uptake

BACKGROUND Vaccination rates have remained steady for a number of years in Australia, however geographical areas of lower vaccine coverage remains a day-to-day challenge. The study explores parental attitudes, beliefs and intentions in relation to vaccination and examines the early effects of recent No Jab No Pay legislation. METHODS A national survey of was conducted, using an online questionnaire. Parents from all states in Australia with at least one child aged <6 years were invited to participate. RESULTS A total of 429 parents participated in the study. The substantial majority of participants reported having their youngest childs vaccination status up to date (n = 401, 93.5%). A childs vaccinations were more likely to be up to date if they had consulted a paediatrician in the previous 12-months (OR 5.01; 95%CI 1.05, 23.92; p = .043). Conversely they were less likely to be vaccinated if they were influenced by information from a complementary medicine (CM) practitioner (OR 0.03; 95%CI 0.01, 0.15; p < .001) or had visited a CM-practitioner (OR 0.09; 95%CI 0.02, 0.33; p < .001) in the previous 12-months. A total of 2.6% of parents had immunised their child as a result of the No Jab No Pay legislation, while 3.9% stated the legislation had no effect, and 1.2% said it had made them less likely to vaccinate. A further 1.2% of parents stated they are considering vaccination as a result of the legislative changes. CONCLUSION Parents who have not vaccinated their children appear to trust non-mainstream sources of information such as CM-practitioners. Further research is required to determine how to manage the challenges and opportunities of CM-practitioners as a source of vaccine information.

Consultations with Naturopaths and Western Herbalists: Prevalence of Use and Characteristics of Users in Australia

OBJECTIVES To report the prevalence of naturopathic and Western herbal medicine service utilization in Australia, and describe the characteristics of individuals who use these services. DESIGN This is a national cross-sectional study. SETTINGS Online survey platform. SUBJECTS Purposive convenience sampling was used to recruit 2025 adults who were matched to Australian population demographics by gender, age, and state of residence. INTERVENTIONS A survey instrument consisting of 50 items covering demographics, health service utilization, health status, health literacy, and medicine disclosure to complementary health care providers. OUTCOME MEASURES The prevalence, frequency, and cost of naturopathy and Western herbal medicine consultations and sociodemographic characteristics of users of naturopathic and Western herbalist services and associations between these factors. RESULTS The final data set included 2019 participants: 6.2% (n = 126) consulted a naturopath and 3.8% (n = 76) a Western herbalist. These health services were most commonly used to improve well-being. An average of AUD

Associations Between Cancer Screening Behavior and Complementary Medicine Use: Results of a National Cross-Sectional Survey of 9151 Australian Women.

102.67 and AUD

Herbal Anxiolytics with Sedative Actions

49.64 was spent per user on consultations with naturopaths and Western herbalists, respectively, in the previous year. The most prevalent users were those between 18 and 29 years of age (39.3%), in a relationship (51%), employed (70%), and held a bachelor degree or higher (40.5%). Some degree of financial difficulty was reported by 65.4% of users. Having a chronic illness (p < 0.01) and using both conventional and complementary medicines (p = 0.05) were both associated with using naturopathic or Western herbal medicine services. Less than 40% of participants disclosed their use of conventional medicines to Western herbalists. CONCLUSIONS Naturopathy and Western herbal medicine services are used by a substantial number of Australian adults who also use conventional health services. Accordingly, research is needed to determine how these health professions can be better integrated into mainstream health care settings to improve patient-practitioner communication and safety related to the use of these health services.

The Need for Evidence-Based Herbal and Nutritional Anxiety Treatments in Psychiatry

Introduction: Complementary medicine (CM) use has been found to influence the uptake of conventional cancer treatment. This study examines associations between CM use and cancer screening rates. Methods: Women aged 62 to 67 years from the Australian Longitudinal Study on Women’s Health were surveyed regarding their use of cancer screening initiatives. Associations between cancer screening behavior and visits to CM practitioners were analyzed. Results: Of the 9151 women, 9049 (98.9%) completed questions about cancer screening. A total of 65.1% of women had received a clinical skin examination, 54.3% colorectal cancer screening, 56.2% Pap test (within past 2 years), 83.3% mammogram (within past 2 years), 55.8% clinical breast examination, and 55.8% had conducted breast self-examination. Women who had consulted a massage therapist were more likely to undergo clinical skin examination (P = .002), clinical breast examination (P = .018), and mammogram (P = .001). Women who had consulted a chiropractor were more likely to undergo a clinical skin examination (P = .001), colorectal cancer screening (P = .020), and mammogram (P = .011). Women who had consulted an acupuncturist were more likely to undergo colorectal cancer screening (P = .019), and those who consulted with an osteopath were more liable to have a Pap test (P = .049). Conclusion: Women who visit CM practitioners are more likely to participate in cancer screening initiatives. Research is required to understand the current and potential role that CM practitioners (can) have as public health advocates, recommending preventative health measures such as cancer screening. Such an examination will help ensure optimal screening utilization and effective, timely care for all cancer patients.