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Inositol has been used to help people with anxiety
who have panic attacks. Up to 4 grams three times per day has been reported to control
such attacks in one double blind trial.4
Vitamin B3 as niacinamide may be
beneficial. It has been shown in animals to work in the brain in ways similar to drugs,
such as Valium®, which are used to treat anxiety.5 One study found that
niacinamide could help people get through withdrawal from Valium-type drugs—a common
problem.6 A reasonable amount of niacinamide (not niacin) to take for anxiety,
according to some doctors of natural medicine, is up to 500 mg four times per day.
Are there any side effects or
interactions? Refer to the individual
supplement for information about any side effects or interactions.
 |
- Herbs that may be helpful
|
- The preeminent botanical
remedy for anxiety is kava, an herb from the South Pacific. It has been
extensively studied for this purpose.7 One 100 mg capsule standardized to 70%
kava-lactone is given three times per day in many studies. Double blind studies have
validated the effectiveness of kava for people with anxiety,8 9
including menopausal
women.10 Although kava is safer and rarely causes side
effects at the given amount, it may cause problems if combined for more than a few days
with benzodiazepines in some people.11 A previous study found kava to be just
as effective as benzodiazepines over the course of six weeks.12 The latest
research shows that use of kava for up to six months is safe and effective compared
with placebo.13
St. John’s wort is very popular for the treatment of
mild depression. It has also been reported in at least one double blind study to reduce
anxiety.14 Like kava, a flavonoid compound from St. John’s wort known as amentoflavone has been found
to act in the central nervous system in a way similar to benzodiazepine drugs.15
An old folk remedy for anxiety, particularly when it
causes insomnia, is chamomile.
There is evidence from test tube studies that chamomile
contains compounds with a calming action.16 There are also animal studies that
suggest a benefit of chamomile for anxiety.17 Often one cup of tea
is taken three or more times per day.
| A number of other botanicals known as
“nerve tonics” are also used in traditional herbal medicine with anxious people.
These have not been rigorously investigated by scientific means to confirm their efficacy,
although they have a long track record of safety. These include hops, passion flower, scullcap, and valerian. A German study has found the combination of valerian and passion flower to be useful for anxiety.18 |
 - Ask the Expert about Mood and
Stress Supplements (click)
|
Are there any side effects
or interactions? Refer to the individual herb for information about any side
effects or interactions. |
 |
Product
Recommendations |
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1. Miler JJ, Fletcher K, Kabat-Zinn J, et al. Three-year follow-up and
clinical implications of a mindfulness meditation-based stress reduction intervention in
the treatment of anxiety disorders. Gen Hosp Psychiatry 1995;17:192–200.
2. Bruce M et al. Anxiogenic effects of caffeine in patients with anxiety disorders. Arch
Gen Psychiatry 1992;49:867–69.
3. Weston PG et al. Magnesium sulfate as a sedative. Am J Med Sci
1923;165:431–33.
4. Benjamin J, Levine J, Fux M, et al. Double-blind, placebo-controlled, crossover trial
of inositol treatment for panic disorder. Am J Psychiatry 1995;152:1084–86.
5. Mohler H, Polc P, Cumin R, et al. Niacinamide is a brain constituent with
benzodiazepine-like actions. Nature 1979;278:563–65.
6. Vescovi PP et al. Nicotinic acid effectiveness in the treatment of benzodiazepine
withdrawal. Curr Ther Res 1987;41:1017.
7. Piscopo G. Kava kava: Gift of the islands. Alt Med Rev 1997;2:355–81
[review].
8. Lehmann EE, Kinzler J, Friedmann J. Efficacy of a special kava extract (Piper
methysticum) in patients with states of anxiety, tension and excitedness of
non-mental origin. A double-blind placebo-controlled study of four weeks treatment. Phytomedicine
1996;3:113–19.
9. Volz HP, Kieser M. Kava-kava extract WS 1490 versus placebo in anxiety disorders. A
randomized placebo-controlled 25-week outpatient trial. Pharmacopsychiatry
1997;30:1–5.
10. Warnecke G. Psychosomatic dysfunctions in the female climacteric. Clinical
effectiveness and tolerance of kava extract WS 1490. Fortscher Med
1991;119–22 [in German].
11. Almeida JC, Grimsley EW. Coma from the health food store: Interaction between kava and
alprazolam. Arch Intern Med 1996;125:940–41.
12. Woelk H, Kapoula S, Lehrl S, et al. Treatment of patients suffering from
anxiety—double-blind study: Kava special extract versus benzodiazepines. Z
Allegemeinmed 1993;69:271–77 [in German].
13. Volz HP, Kieser M. Kava-kava extract WS 1490 vs. placebo in anxiety disorders—A
randomized placebo-controlled 25-week outpatient trial. Pharmacopsychiatry
1997;30:1–5.
14. Witte B, Harrer G, Kaptan T, et al. Treatment of depressive symptoms with a high
concentration Hypericum preparation. A multicenter placebo-controlled double-blind study. Fortschr
Med 1995;113:404–408 [in German].
15. Baureithel KH, Buter KB, Engesser A, et al. Inhibition of benzodiazepine binding in
vitro by amentoflavone, a constituent of various species of Hypericum. Pharm Acta Helv
1997;72:153–57.
16. Viola H, de Stein ML, et al. Apigenin, a component of Matricaria recutita flowers, is
a central benzodiazepine receptors-ligand with anxiolytic effects. Planta Med
1995;61:213–16.
17. Yamada K, Miura T, Mimaki Y, Sashida Y. Effect of inhalation of chamomile oil vapour
on plasma ACTH level in ovariectomized rats under restriction stress. Biol Pharm Bull
1996;19:1244–46.
18. Brown D. Valerian root: Non-addictive alternative for insomnia and anxiety. Quart
Rev Nat Med 1994;Fall:221–24 [review].
