Natural supplements for anxiety

[Student4Life0]

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Hi all,

I had been doing some reading about natural supplements for anxiety (things such as Kava kava and St. John's Wort). Does anybody have any information/ideas regarding the effectiveness of these supplements (in conjunction with treatment, of course), or can anybody point me in the right direction?

Thanks!

 

[stigmata]

There is no solid research as supplements cannot be branded in the USA like drugs. Kava Kava is potentially dangerous as is St. Johns Wort for various reasons, but there is general support for 5HTP and CoQ-10. There is also a new beast being created in psychiatry to be called "medical foods". The first one is L-methyl-folate, which is a metabolite of folate (folic acid) and plays a major role in the cellular metabolism necessary to create monoamines such as serotonin, NE and dopamine. You should check out Dr. Stephen Stahl's group called NEI.

 

[JockNerd]

There is no solid research as supplements cannot be branded in the USA like drugs. Kava Kava is potentially dangerous as is St. Johns Wort for various reasons, but there is general support for 5HTP and CoQ-10. There is also a new beast being created in psychiatry to be called "medical foods". The first one is L-methyl-folate, which is a metabolite of folate (folic acid) and plays a major role in the cellular metabolism necessary to create monoamines such as serotonin, NE and dopamine. You should check out Dr. Stephen Stahl's group called NEI.

How does not being branded as a drug affect whether solid research can be done on it? There are hundreds of studies on St. John's Wort and several meta-analyses, that indicate effectiveness over placebo for mild to moderate depression. As far as danger, I'd say you're in for a pretty long road if you want to contend that St. John's Wort is more dangerous than prettymuch any existing antidepressant or antianxiety med.

 

[Ollie123]

Won't speak for him, but I suspect the issue is more one of "won't" than "can't".
There is no money to be made from discovering uses for supplements since they can't be patented, therefore people aren't willing to pump money into them the way the pharmaceutical pumps money into drug research. This was one of the reasons NIH created the complementary and alternative medicine institute...prior to that the funding for these things was even less.

Of course, that doesn't mean that a solid research base can't grow for some supplements (can't testify to whether it is there or not for St. John's Wort since I haven't looked). It also doesn't speak to the quality of the science, since the financial incentives that accompany pharma-funding may certainly result in some...less than scrupulous behavior on the part of the researchers.

 

[DynamicDidactic]

How does not being branded as a drug affect whether solid research can be done on it? There are hundreds of studies on St. John's Wort and several meta-analyses, that indicate effectiveness over placebo for mild to moderate depression.

my take on the literature, not my area of concentration though, is that the effectiveness of St. John's wort for depression compared to placebo is still inconclusive.

as far as it being anxiolytic, not familiar with that at all. A quick search comes up with this recent meta-analysis

Lakhan & Vieira (2010). Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review.

 

[Therapist4Chnge]

How does not being branded as a drug affect whether solid research can be done on it? There are hundreds of studies on St. John's Wort and several meta-analyses, that indicate effectiveness over placebo for mild to moderate depression. As far as danger, I'd say you're in for a pretty long road if you want to contend that St. John's Wort is more dangerous than prettymuch any existing antidepressant or antianxiety med.

In controlled studies SJW has shown some statistically significant findings, though how they translate to real world populations is a bit fuzzier. The issue with SJW has always been the quality and consistancy of the dosing. Neutracueticals are dicey at best, and for this reason alone I'd have a hard time seeing SJW as anything more than a complicating factor for most people. For mild depression someone may find relief, but I wouldn't trust the variability within and between brands. I've seen a number of seratonin syndrome cases that involved SJW, as the person took too much and/or it interacted with other prescribed meds.

 

[CharmedDiamond]

How does not being branded as a drug affect whether solid research can be done on it? There are hundreds of studies on St. John's Wort and several meta-analyses, that indicate effectiveness over placebo for mild to moderate depression. As far as danger, I'd say you're in for a pretty long road if you want to contend that St. John's Wort is more dangerous than prettymuch any existing antidepressant or antianxiety med.

The problem is that these drugs aren't necessarily consistent due to the lack of industry oversight. Unlike the lab made medications, the herbals can be of varying potency, and dosage of "active" ingredient can vary immensely between brands. Even different batches made by the same company can affect the same person differently.

If you're looking for some anxiety relief, try the classics like non-caffinated tea, a hot bath, breathing exercises, or even half a glass of red wine. Activities that can keep your hands busy help sometimes too.

 

[stigmata]

Thank-you everyone for your answers, I didn't have the energy to point out the obvious. I really wish people would learn to have a clue about what they are responding to before they adamantly respond.

For JockNerd: "As far as danger, I'd say you're in for a pretty long road if you want to contend that St. John's Wort is more dangerous than prettymuch any existing antidepressant or antianxiety med. "

Why don't you explain to me why this is true? I can assure you it is not.

 

[Knights24]

In my (very limited) understanding, I believe a good bit of research as been done on 5-HTP showing that it is more effective than placebo at helping anxiety, and especially depression.

However, the quality of these studies as been called into question (not as bad, but as not rigorous enough)

 

[JockNerd]

For JockNerd: "As far as danger, I'd say you're in for a pretty long road if you want to contend that St. John's Wort is more dangerous than prettymuch any existing antidepressant or antianxiety med. "

Why don't you explain to me why this is true? I can assure you it is not.

Really? I could post links to studies on SJW side effects being low (other than bad results from mixing with antidepressants, as T4C mentioned, but that would be bad treatment anyhow, for several reasons too obvious to bother listing), but a pubmed search with that string will pop up a few dozen studies, so it doesn't seem very useful to post them selectively. As far as the other side, again, really? I could post studies on the sides of standard antidepressants and antianxieties but the lit on that is beyond massive...

As Knights said, the research base isn't as large as for most of the basic medications, but Ollie points out exactly why that is. And, really, it's not as though the pharma-funded clinical trials of meds are really all that solid through and through.

 

[Daftrage]

Really? I could post links to studies on SJW side effects being low (other than bad results from mixing with antidepressants, as T4C mentioned, but that would be bad treatment anyhow, for several reasons too obvious to bother listing), but a pubmed search with that string will pop up a few dozen studies, so it doesn't seem very useful to post them selectively. As far as the other side, again, really? I could post studies on the sides of standard antidepressants and antianxieties but the lit on that is beyond massive...

As Knights said, the research base isn't as large as for most of the basic medications, but Ollie points out exactly why that is. And, really, it's not as though the pharma-funded clinical trials of meds are really all that solid through and through.

I am currently taking a CAM (complimentary/alternative med) course and one of my lecturers who has researched St. Johns Wort extensively spoke for a while on that topic.

SJW can be fairly effective for mild/moderate depression but the real problem lies in drug interactions as stated before. It is one of the most powerful inducers of Cyp 3a4 known to man. This means that you have to be really careful if someone is taking it because Cyp 3a4 is the major metabolizer of over half of all drugs. They figured this out because people who had transplants were having them fail (sometimes leading to death) for what remained a mystery until they learned they were taking SJW.

 

[JockNerd]

SJW can be fairly effective for mild/moderate depression but the real problem lies in drug interactions as stated before. It is one of the most powerful inducers of Cyp 3a4 known to man. This means that you have to be really careful if someone is taking it because Cyp 3a4 is the major metabolizer of over half of all drugs. They figured this out because people who had transplants were having them fail (sometimes leading to death) for what remained a mystery until they learned they were taking SJW.

Ah, yup, good point. I'd read that somewhere and then forgotten it (not applicable to populations I've ever worked with).

 

[stigmata]

I am not really interested in seeing studies you have found, or listings of drug side-effects.... been there, done that as I am a medical psychologist and psychopharmacologist. I am wondering what information you have that would result in you posting incorrect information so adamantly?

 

[Ollie123]

The issue with SJW has always been the quality and consistancy of the dosing.

Absolutely true, the lack of oversight is what kills its utility in the real-world. Doesn't necessarily prevent the research from being done though (not sure if you were saying that it did). Wouldn't the first time researchers had to have something specially prepared for them because it wasn't available on the market. We're still trying to convince NIDA to start making cigarettes😉

I am not really interested in seeing studies you have found, or listings of drug side-effects.... been there, done that as I am a medical psychologist and psychopharmacologist. I am wondering what information you have that would result in you posting incorrect information so adamantly?

Umm...regardless of who is right/wrong on this particular topic, you seem to be jumping on JN awfully hard for something you aren't entirely innocent of yourself. Glass houses and all that...

 

[stigmata]

Oh really? like what? I reply to very few posts and only those I know about.

 

[Ollie123]

Don't want to derail things too much, but here's one I remembered offhand:

RE: my assertion that APA is practitioner-heavy.

You are wrong on every point. They lose practitioner membership points every year, but have always been academically overloaded.

I then posted APA's membership data (http://www.apa.org/workforce/publications/09-member/index.aspx). Showing that clinical/counseling psychology is by far the dominant "primary field" (51k combined vs. IO (the next highest) at 4k), mental health services is the dominant "primary activity" identified (11k vs. education (the next highest) at 3k), the 5 largest divisions are (in order): Clinical Neuropsychology, Psychologists in Independent Practice, Clinical Psychology, Psychoanalysis, Psychotherapy).

While I can't provide outright data on another one, I also remember you stating pretty plainly that it is the trend for academics to be licensed regardless of whether or not they have a clinical background. That's something I strongly question because, frankly, I've met more than a few non-clinical academics given my research area and have yet to meet a licensed one, and in fact half the clinical folks I know don't even bother getting licensed unless they will be supervising students. Obviously not something I can prove definitely either way, but something I'm pretty sure you can't either despite the conviction with which it was stated.

Anyways, not trying to make this personal since I suspect we both lack the time, energy, and desire for petty internet feuding. I'm also entirely certain there are things I've said on here that are incorrect as well that wouldn't be too hard to find so I'm certainly not claiming I'm innocent either. However, I remembered these two offhand (though could not for the life of me remember what thread the first one came from and had to dig it up), and some of your comments seemed a little snide and uncalled for (despite the fact that I generally agree with your view in this thread - at least RE: non-research uses)

 

[stigmata]

Two minor things...and I still contend that APA is losing practitioner members. However, if I remember correctly you rode my butt pretty hard on both issues so it may be appropriate to dismount the high horse 😉

 

[Roadguru]

i recommend the following:

Hordeum vulgare subsp. spontaneum
Humulus lupulus
S. cerevisiae.
Dihydrogen Monoxide

mix, wait a couple weeks, and then ingest in moderation.