Update Phytotherapie – Aktueller wissenschaftlicher Stand bei Angst, Depression, innerer Unruhe und Schlafstörungen

Zusammenfassung

Psychische Erkrankungen und Belastungen sind weltweit auf dem Vormarsch. Aktuell beherrschen Ängste und deren Folgen ganze Bevölkerungsgruppen. Im Rahmen einer multimodalen Therapie können Phytopharmaka, für die es in den letzten Jahren zunehmend wissenschaftliche Belege gibt, neben Gesprächs- und Verhaltenstherapien eine wertvolle Hilfe sein. Der Beitrag geht auf die bekannten Phytotherapeutika ein und zeigt jedoch auch weniger bekannte Heilpflanzen mit anxiolytischer Wirkung auf.

Abstract

Mental illnesses and stress are on the rise worldwide. Currently, fears and their consequences dominate entire population groups. Phytopharmaceuticals, for which there has been increasing scientific evidence in recent years, can be a valuable aid in the context of a multimodal therapy, along with talk and behavioral therapies. The article discusses well-known phytotherapeutics, but also highlights lesser-known medicinal plants with anxiolytic effects.

Schlüsselwörter

Phytotherapeutika - Angststörung - Cave-Syndrom - Passionsblume - Lavendel

Key words

Phytotherapeutics - anxiety disorder - cave syndrome - passionflower - lavender

Publication History

Article published online:
23 August 2021

• Literatur

• 1 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: 363-367
• 2 Amsterdam 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 (04) 378-382
• 3 Amsterdam JD, Li QS, Xie SX. et al. Putative antidepressant effect of chamomile (Matricaria chamomilla L.) oral extract in subjects with comorbid generalized anxiety disorder and depression. J Altern Compl Med 2020; 26 (09) 813-819
• 4 Andreatini R, Sartori VA, Seabra MLV. et al. Effect of valepotriates (valerian extract) in generalized anxiety disorder: A randomized placebo-controlled pilot study. Phytother Res 2002; 16 (07) 650-654
• 5 Araj-Khodaei M, Noorbala AA, Yarani R. et al. A double-blind, randomized pilot study for comparison of Melissa officinalis L. and Lavandula angustifolia Mill. with Fluoxetine for the treatment of depression. BMC Compl Med Ther 2020; 20 (01) 207
• 6 Azimaraghi O, Yousefshahi F, Khatavi F. et al. Both oral Passiflora incarnate and Oxazepam can reduce pre-operative anxiety in ambulatory surgery patients: A double-blind placebo-controlled study. Asian J Pharm Clin Res 2017; 10 (08) 331-334
• 7 Berger M. Hrsg. Psychische Erkrankungen – Klinik und Therapie. 6. Aufl.. München: Elsevier; 2018
• 8 Carter RM, Wittchen H-U, Kessler RC. One-ear prevalence of subthreshold and threshold DSM-IV generalized anxiety disorder in a nationally representative sample. Depress Anx 2001; 13: 78-88
• 9 Cases J, Ibarra A, Feuillère N. et al. Pilot trial of Melissa officinalis L. leaf extract in the treatment of volunteers suffering from mild-to-moderate anxiety disorders and sleep disturbances. Med J Nutr Metab 2011; 4 (03) 211-218
• 10 Corneo Gazola A, Modesti Costa G, Zucolottoe SM. et al. The sedative activity of flavonoids from Passiflora quadrangularis is mediated through the GABAergic pathway. Biomed Pharmacother 2018; 100: 388-393
• 11 Dantas L-P, de Oliveira-Ribeiro A, de Almeida-Souza L-M. et al. Effects of Passiflora incarnata and Midazolam for control of anxiety in patients undergoing dental extraction. Med Oral Patol Oral Cir Bucal 2017; 22 (01) e95-e101
• 12 Dillenburger B, Kolb C, Häberlein H. Aktueller Forschungsstand zum pflanzlichen Antidepressivum Johanniskrautextrakt. Review der Wirkmechanismen. Nervenheilkunde 2020; 39: 565-571
• 13 Donath F, Quispe S, Diefenbach K. et al. Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry 2000; 33 (02) 47-53
• 14 Donelli D, Antonelli M, Bellinazzi C. et al. Effects of lavender on anxiety: A systematic review and meta-analysis. Phytomedicine 2019; 65: 153099
• 15 EMEA. Community Herbal Monograph on Hypericum Perforatum L., Herba. HMPC; 2009: 0-8
• 16 Fiebich BL, Knörle R, Appel K. et al. Pharmacological studies in an herbal drug combination of St. John’s wort (Hypericum perforatum) and passion flower (Passiflora incarnata): In vitro and in vivo evidence of synergy between Hypericum and Passiflora in antidepressant pharmacological models. Fitoterapia 2011; 82: 474-480
• 17 Firoozeei TS, Feizi A, Rezaeizadeh H. et al. The antidepressant effects of lavender (Lavandula angustifolia Mill.): A systematic review and meta-analysis of randomized controlled clinical trials. Compl Ther Med 2021; 59: 102679
• 18 Gastpar M, Zeller K. Hypericum-Extrakt STW3 und Sertralin zur Behandlung der mittelschweren Depression. Psychopharmakotherapie 2005; 12: 146-153
• 19 Gastpar M, Singer A, Zeller K. Comparative efficacy and safety of a once-daily dosage of Hypericum extract STW3-VI and Citalopram in patients with moderate depression: A double-blind, randomised, multicentre, placebo-controlled study. Pharmacopsychiatry 2006; 39: 66-75
• 20 Ghazizadeh J, Hamedeyazdan S, Torbati M. et al. Melissa officinalis L. hydro-alcoholic extract inhibits anxiety and depression through prevention of central oxidative stress and apoptosis. Exp Physiol 2020; 105 (04) 707-720
• 21 Gibbert J, Kreimendahl F, Lebert J. et al. Improvement of stress resistance and quality of life of adults with nervous restlessness after treatment with a passion flower dry extract. Compl Med Res 2017; 24: 83-89
• 22 Haybar H, Javid AZ, Haghighizadeh MH. et al. The effects of Melissa officinalis supplementation on depression, anxiety, stress, and sleep disorder in patients with chronic stable angina. Clin Nutr ESPEN 2018; 26: 47-52
• 23 Herrera-Arellano A, Jiménez-Ferrer E, Zamilpa A. et al. Efficacy and tolerability of a standardized herbal product from Galphimia glauca on generalized anxiety disorder. A randomized, double-blind clinical trial controlled with lorazepam. Planta Med 2007; 73 (08) 713-717
• 24 Herrera-Arellano A, Jiménez-Ferrer JE, Zamilpa A. et al. Therapeutic effectiveness of Galphimia glauca vs. lorazepam in generalized anxiety disorder. A controlled 15-week clinical trial. Planta Med 2012; 78 (14) 1529-1535
• 25 Janda K, Wojtkowska K, Jakubczyk K. et al. Passiflora incarnata in neuropsychiatric disorders – A systematic review. Nutrients 2020; 12 (12) 3894
• 26 Kang H-J, Nam ES, Lee Y. et al. How strong is the evidence for the anxiolytic efficacy of lavender? Systematic review and meta-analysis of randomized controlled trials. Asian Nurs Res 2019; 13: 295e305
• 27 Kasper S, Anghelescu IG, Szegedi A. et al. Superior efficacy of St. John’s wort extract WS 5570 compared to placebo in patients with major depression: A randomized, double-blind, placebo-controlled, multi-center trial. BMC Med 2006; 4: 14
• 28 Kasper S, Gastpar M, Müller WE. et al. Silexan, an orally administered Lavandula oil preparation, is effective in the treatment of anxiety disorder – a randomised, double-blind, placebo controlled trial. Int Clin Psychopharmacol 2010; 25 (05) 277-287
• 29 Kasper S, Gastpar M, Müller WE. et al. Lavender oil preparation Silexan is effective in generalized anxiety disorder – a randomized, double-blind comparison to placebo and paroxetine. Int J Neuropsychopharmacol 2014; 17 (06) 859-869
• 30 Kessler RC, Andrade LH, Bijl RV. et al. The effects of co-morbidity on the onset and persistence of generalized anxiety disorder in the ICPE surveys. International Consortium in Psychiatric Epidemiology. Psychol Med 2002; 32: 1213-1225
• 31 Kraft K. Mit Melisse und Lavendel gegen Angst und Depression?. MMW Fortschr Med 2011; 153 (15) 35-37
• 32 Kyrou I, Christou A, Panagiotakos D. et al. Effects of a hops (Humulus lupulus L.) dry extract supplement on self-reported depression, anxiety and stress levels in apparently healthy young adults: A randomized, placebo-controlled, double-blind, crossover pilot study. Hormones 2017; 16 (02) 171-180
• 33 Lecrubier Y, Clerc G, Didi R. et al. Efficacy of St. John’s wort extract WS 5570 in major depression: A double-blind, placebo-controlled trial. Am J Psy 2002; 159: 1361-1366
• 34 Linde K, Berner MM, Kriston L. St. John’s wort for depression: Meta-analysis of randomised controlled trials. Br J Psy 2005; 186: 99-107
• 35 Linde K, Berner MM, Kriston L. St. John’s wort for treating depression. The Cochrane Collaboration 2008. http://www.cochrane.org/reviews/en/ab000448.html Stand: 16.07.2021
• 36 Mao JJ, Xie SX, Keefe JR. et al. Long-term chamomile (Matricaria chamomilla L.) treatment for generalized anxiety disorder: A randomized clinical trial. Phytomedicine 2016; 23 (14) 1735-1742
• 37 Miyasaka LS, Atallah AN, Soares BGO. Valerian for anxiety disorders. Coch Data Syst Rev 2006; 18 (04) CD004515
• 38 Möller H-J, Volz H-P, Dienel A. et al. Efficacy of Silexan in subthreshold anxiety: Meta-analysis of randomised, placebo-controlled trials. Eur Arch Psy Clin Neurosci 2019; 269: 183-193
• 39 Müller WE. Current St. John’s wort research from mode of action to clinical efficacy. Pharmacol Res 2003; 47: 101-109
• 40 Ng QX, Venkatanarayanan N, Ho CYX. Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis. J Affect Disord 2017; 210: 211-221
• 41 Orme-Johnson DW, Barnes VA. Effects of TM practice on trait anxiety: A meta-analysis of randomized controlled trials. J Alt Compl Med 2013; 19 (10) 1-12
• 42 Philipp M, Kohen R, Hiller KO. Hypericum extract versus imipramine or placebo in patients with moderate depression: Randomised multicentre study of treatment for eight weeks. BMJ 1999; 319: 1534-1538
• 43 Ranjbar M, Firoozabadi A, Salehi A. et al. Effects of herbal combination (Melissa officinalis L. and Nepeta menthoides Boiss. & Buhse) on insomnia severity, anxiety and depression in insomniacs: Randomized placebo controlled trial. Integr Med Res 2018; 7 (04) 328-332
• 44 Röder C, Schaefer M, Leucht S. Meta-Analyse zu Wirksamkeit und Verträglichkeit der Behandlung der leichten und mittelschweren Depression mit Johanniskraut. Fortschr Neurol Psychiatr 2004; 72: 330-343
• 45 Ruoff K. SWR. American Psychological Association Stress in America. One year later, a new wave of pandemic health concerns. https://www.apa.org/news/press/releases/stress/2021/one-year-pandemic-stress Stand: 04.07.2021
• 46 Schrader E. Equivalence of St. John’s wort extract (Ze117) and fluoxetine: A randomized, controlled study in mild-moderate depression. Int Clin Psychopharmacol 2000; 15: 61-68
• 47 Schulz H-U, Schürer M, Bässler D. et al. Investigation of pharmacokinetic data of Hypericin, Pseudohypericin, Hyperforin and the flavonoids Quercetin and Isorhamnetin revealed from single and multiple oral dose studies with a Hypericum extract containing tablet in healthy male volunteers. Arzneimittelforschung 2012; 55: 561-568
• 48 Schulz V. Safety of St. John’s wort extract compared to synthetic antidepressants. Phytomedicine 2006; 13: 199-204
• 49 Schuwald AM. Lavender oil (silexan) – anxiolytic properties by inhibition of voltage-operated calcium channels. Society of Neuroscience, annual meeting; San Diego: 2010
• 50 Shakeri A, Sahebkar A, Javadi B. Melissa officinalis L. – A review of its traditional uses, phytochemistry and pharmacology. J Ethnopharmacol 2016; 188: 204-228
• 51 Shinjyo N, Waddell G, Green J. Valerian root in treating sleep problems and associated disorders – A systematic review and meta-analysis. J Evid Based Integr Med 2020; 25: 2515690X20967323
• 52 Szegedi A, Kohnen R, Dienel A. et al. Acute treatment of moderate to severe depression with Hypericum extract WS 5570 (St. John’s wort): Randomised controlled, double-blind non-inferiority trial versus paroxetine. BMJ 2005; 330: 503-506
• 53 Tippmann ME. Wirkprinzip für Johanniskraut entschlüsselt!. PharmaFokus ZNS 2007; 4: 70-72
• 54 Trompetter I, Krick B, Weiss G. Herbal triplet in treatment of nervous agitation in children. Wien Med Wochenschr 2013; 163: 52-57
• 55 Volz HP, Gastpar M, Kasper S. et al. Subsyndromale Angststörungen. Definition, Messparameter, Epidemiologie. Neurol Neurochir Psychiatr 2009; 10: 1-6
• 56 Vorbach EU, Hübner WD, Arnoldt KH. Wirksamkeit und Verträglichkeit des Hypericum-Extraktes LI 160 im Vergleich mit Imipramin. Nervenheilkunde 1993; 12: 290-296
• 57 Vorbach EU, Arnoldt KH, Hübner WD. Efficacy and tolerability of St. John’s wort extract LI 160 versus imipramine in patients with severe depressive episodes according to ICD-10. Pharmacopsychiatry 1997; 30 (02) 81-85
• 58 Woelk H, Arnoldt KH, Kieser M. et al. Ginkgo biloba special extract EGb 761 in generalized anxiety disorder and adjustment disorder with anxious mood: A randomized, double-blind, placebo-controlled trial. J Psychiatr Res 2007; 41 (06) 472-480
• 59 Woelk H, Schläfke S. A multi-center, double-blind, randomised study of the lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. Phytomedicine 2010; 17 (02) 94-99