Anxiety Info - The Natural Way? - New options for herbal treatment
A clinical trial was recently conducted in France to assess the benefits of a combination of extracts of hawthorn (Crataegus oxyacantha) and Californian poppy (Eschscholtzia californica) together with magnesium versus placebo in the treatment of mild to moderate anxiety disorders. (1) A total of 264 patients (81% female) presenting with generalized anxiety (DSM-III-R) with a Hamilton anxiety score of between 16 and 28 were included in a double-blind, randomized, placebo-controlled trial. Patients were randomly assigned to two groups: 130 received the herbal treatment and 134 a placebo.
Efficacy and safety data were recorded before first administration and at 7, 14, 30, 60 and 90 days after the start of treatment. Efficacy was assessed by a change in the Hamilton anxiety scale, a change in patient self-assessment as well as the number of responsive patients.
Total and somatic (physical) Hamilton anxiety scale scores and subjective patient-rated anxiety fell during treatment, indicating clinical improvement. The decrease was greater for the herbal treatment than in the placebo group. End results, although mild, were statistically significant. In all, 15 patients (11.5%) in the study group and 13 patients (9.7%) in the placebo group experienced 22 and 15 adverse events, respectively. Undesirable events were mainly mild or moderate digestive or psychological responses.
 Commentary
The doses used in the trial were relatively modest: the total daily dose was 300 mg of a dry aqueous alcoholic extract of the flowering tops of hawthorn (probably equivalent to around 1.5 g of herb) and 80 mg of dry aqueous extract of Californian poppy (probably equivalent to around 500 mg of herb). The dose of magnesium was 300 mg per day of elemental magnesium. The relatively low doses of herbs would explain the mild therapeutic effect observed, although it was significant. Californian poppy is well-known as an herbal sedative and has been used successfully for such effects in combination with a European species of Corydalis. While hawthorn is generally regarded as the herbal treatment for heart conditions and high blood pressure, it also has significant traditional use as a mild sedative, especially for symptoms marked by excessive sympathetic nerve tone. Hence the positive results of the trial should not be surprising to any herbal clinician. The results also showed that benefits from the herbal treatment were maintained and even slightly increased with long-term use, indicating that tolerance to the treatment did not develop. Indeed, this is a common finding with herbal treatments: that the benefits actually increase, rather than decrease, with consistent long-term use.
Reference
1. Hanus M, Lafon J, Mathieu M. Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of a fixed combination containing two plant extracts (Crataegus oxyacantha and Eschscholtzia californica) and magnesium in mild-to-moderate anxiety disorders. Curr Med Res Opin 2004; 20(1): 63-71
Townsend Letter for Doctors and Patients, April, 2005 by Kerry Bone
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