Chamomile for anxiety disorder.
Article Type: Report
Subject: Medicine, Botanic (Research)
Medicine, Herbal (Research)
Anxiety (Care and treatment)
Anxiety (Diagnosis)
Chamomile (Health aspects)
Author: Finney-Brown, Tessa
Pub Date: 03/22/2011
Publication: Name: Australian Journal of Medical Herbalism Publisher: National Herbalists Association of Australia Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 National Herbalists Association of Australia ISSN: 1033-8330
Issue: Date: Spring, 2011 Source Volume: 23 Source Issue: 1
Topic: Event Code: 310 Science & research
Geographic: Geographic Scope: Australia Geographic Code: 8AUST Australia
Accession Number: 254971778
Full Text: Amsterdam J, Li Y, Soeller I et al. 2011. A randomized, double-blind, placebo-controlled trial of oral Matricaria recutita (chamomile) extract therapy for generalized anxiety disorder. J Clin Psychopharmacol 29:4;378-82.

Generalised anxiety disorder (GAD) is characterised by a wide array of psychological and physical symptoms, it usually manifests as a chronic disorder and only 30% of patients experience spontaneous remission. Benzodiazepine anxiolytics, selective serotonin reuptake inhibitors and other antidepressants have been used to treat GAD. These are often associated with unwanted adverse effects. Matricaria recutita (chamomile) is a widely used herbal remedy often employed for its relaxation and calming effect.

This eight week trial examined the role of oral chamomile extract in the treatment of mild to moderate GAD. Sixty-one patients were enrolled in the trial, 57 patients had a baseline visit and at least 1 post baseline measurement. The patients were divided into two groups: chamomile (n = 28) and placebo (n = 29). Patients were over 18 years and had a DSM-IV Axis I diagnosis of GAD. They had a minimum baseline total Hamilton Anxiety Rating (HAMA) score of 9 or more. Patients were excluded from the trial if they had a current diagnosis of major depressive disorder, bipolar disorder, panic disorder, phobic disorder, obsessive compulsive disorder, post traumatic stress disorder, acute stress disorder, substance induced anxiety disorder, psychosis, dementia or substance abuse or dependence within the preceding 3 months.

Identical looking capsules were prepared containing either pharmaceutical grade German chamomile extract, standardised to a content of 1.2% apigenin or placebo. Chamomile was prepared at 220 mg per capsule. Blinding of the characteristic chamomile aroma was achieved by inserting a disk impregnated with 1 drop of chamomile oil (for placebo) or 1 drop of neutral oil (for chamomile) into the lid of each airtight medication container.

Chamomile or placebo therapy was initiated at 1 capsule daily for the first week and increased to 2 capsules daily during the second week of therapy. Patients with a 50% reduction or less in total HAM-A score (vs baseline) were increased to 3 and then 4 capsules daily. Patients who continued to have a 50% reduction or less in baseline HAM-A score were increased to 5 capsules daily during study weeks 5 through 8 of therapy. Dose reductions could occur at any time based upon drug tolerability.

Two patients discontinued treatment because of adverse events: 1 for allergic reaction (placebo) and 1 for abdominal discomfort (chamomile).

There was a significantly greater reduction over time in the mean total HAM-A score for patients receiving chamomile versus placebo (60p3 = -3.17; 95% CI, -6.29 to -0.45; P = 0.047). Researchers found a lower incidence rate of adverse events at higher chamomile doses (0.003; 2/717) versus lower chamomile doses (0.015; 11/734; P = 0.015), suggesting that there is no increase in adverse events at higher chamomile doses.

There are a number of limitations to the study including its small sample size and reasonably short duration. Nonetheless the present findings support the role of chamomile as an anxiolytic in patients with mild GAD.

Tessa Finney-Brown mnhaa
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