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Alternative medicine

By Mayo Clinic staff

Several herbal remedies have been studied as a treatment for anxiety, such as kava, valerian and passionflower, but more research is needed to understand the risks and benefits. Here's what researchers know — and don't know:

  • Kava. Kava appeared to be a promising treatment for anxiety, but reports of serious liver damage — even with short-term use — caused several European countries to pull it off the market. The Food and Drug Administration has issued warnings but not banned sales in the United States. Avoid using kava until more rigorous safety studies are done, especially if you have liver problems or take medications that affect your liver.
  • Valerian. In some studies, people who used valerian reported less anxiety and stress. In other studies, people reported no benefit. Valerian is generally considered safe at recommended doses, but since long-term safety trials are lacking, don't take it for more than a few weeks at a time. It can cause some side effects such as headaches and drowsiness.
  • Passionflower. A few small clinical trials suggest that passionflower might help with anxiety. In many commercial products, passionflower is combined with other herbs, making it difficult to distinguish the unique qualities of each herb. Passionflower is generally considered safe when taken as directed, but some studies found it can cause drowsiness, dizziness and confusion.

Before taking herbal remedies or supplements, talk to your doctor to make sure they're safe for you and won't interact with any medications you take.

Coping and support Lifestyle and home remedies
References
  1. Anxiety disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed May 17, 2012.
  2. Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Washington, D.C.: American Psychiatric Publishing; 2008. http://www.psychiatryonline.com/resourceToc.aspx?resourceID=5. Accessed May 17, 2012.
  3. Rakel RE. Textbook of Family Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/191205553-4/0/1481/0.html#. Accessed May 18, 2012.
  4. Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0..X0001-1--TOP&isbn=978-0-323-05472-0&uniqId=230100505-57. Accessed May 18, 2012.
  5. Hicks D, et al. An approach to the patient with anxiety. Medical Clinics of North America. 2010;94:1127.
  6. Roy-Byrne PP, et al. Anxiety disorders and comorbid medical illness. General Hospital Psychiatry. 2008;30:208.
  7. Rakel D. Integrative Medicine. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-2/0/1494/0.html. Accessed May 21, 2012.
  8. Lakhan SE, et al. Nutritional and herbal supplements for anxiety and anxiety-related disorders: Systematic review. Nutrition Journal. 2010;9:42.
  9. Natural medicines in the clinical management of anxiety. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed May 24, 2012.
  10. Kava linked to liver damage. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/news/alerts/kava. Accessed May 24, 2012.
  11. Mayo Clinic statement: Recommendations regarding the safety concern with citalopram (Celexa) therapy. Mayo Clinic. http://mayoweb.mayo.edu/mfpfc-cmte/1202citalopramStatement.pdf. Accessed June 5, 2012.
  12. Jacka FN, et al. Association of Western and traditional diets with depression and anxiety in women. American Journal of Psychiatry. 2010;167:305.
  13. Teschke R, et al. Risk of kava hepatotoxicity and the FDA consumer advisory. Journal of the American Medical Association. 2010;304:2174.
  14. Valerian. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/valerian. Accessed June 5, 2012.
  15. Miyasaka LS, et al. Passiflora for anxiety disorder. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004518.pub2/abstract. Accessed June 5, 2012.
  16. Support & programs. National Alliance on Mental Illness. http://www.nami.org/Template.cfm?section=Find_Support. Accessed June 5, 2012.
  17. Getting support. Anxiety and Depression Association of America. http://www.adaa.org/finding-help/getting-support. Accessed June 5, 2012.
DS01187 June 30, 2012

© 1998-2013 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

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