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Valerian for anxiety disorders

  • Review
  • Intervention

Authors


Abstract

Background

Anxiety disorders are very common mental health problems in the general population and in primary care settings. Herbal medicines are popular and used worldwide and might be considered as a treatment option for anxiety if shown to be effective and safe.

Objectives

To investigate the effectiveness and safety of valerian for treating anxiety disorders.

Search methods

Electronic searches: The Cochrane Collaboration Depression, Anxiety and Neurosis Cochrane Controlled Trials Register (CCDANCTR-Studies and CCDANCTR-References) searched on 04/08/2006, MEDLINE, Lilacs. References of all identified studies were inspected for additional studies. First authors of each included study, manufacturers of valerian products, and experts in the field were contacted for information regarding unpublished trials.

Selection criteria

Randomised controlled trials (RCTs) and quasi-randomised trials of valerian extract of any dose, regime, or method of administration, for people with any primary diagnosis of general anxiety disorder, anxiety neurosis, chronic anxiety status, or any other disorder in which anxiety is the primary symptom (panic disorder, obsessive compulsive disorder, social phobia, agoraphobia, other types of phobia, postraumatic stress disorder). Effectiveness was measured using clinical outcome measures and other scales for anxiety symptoms.

Data collection and analysis

Two review authors independently applied inclusion criteria, extracted and entered data, and performed the trial quality assessments. Where disagreements occurred, the third review author was consulted. Methodological quality of included trials was assessed using Cochrane Handbook criteria. For dichotomous outcomes, relative risk (RR) was calculated, and for continuous outcomes, the weighted mean difference (WMD) was calculated, with their respective 95% confidence intervals.

Main results

One RCT involving 36 patients with generalised anxiety disorder was eligible for inclusion. This was a 4 week pilot study of valerian, diazepam and placebo. There were no significant differences between the valerian and placebo groups in HAM-A total scores, or in somatic and psychic factor scores. Similarly, there were no significant differences in HAM-A scores between the valerian and diazepam groups, although based on STAI-Trait scores, significantly greater symptom improvement was indicated in the diazepam group. There were no significant differences between the three groups in the number of patients reporting side effects or in dropout rates.

Authors' conclusions

Since only one small study is currently available, there is insufficient evidence to draw any conclusions about the efficacy or safety of valerian compared with placebo or diazepam for anxiety disorders. RCTs involving larger samples and comparing valerian with placebo or other interventions used to treat of anxiety disorders, such as antidepressants, are needed.

摘要

背景

使用Valerian在焦慮性疾患

焦慮性疾患在一般大眾及基層照顧環境中是非常常見的精神健康問題。草藥治療很常見且在世界各地使用,如果有效而且安全,草藥可能被視為焦慮的治療選項。

目標

調查Valerian使用在焦慮性疾患的療效及安全性。

搜尋策略

電子搜尋:The Cochrane Collaboration Depression, Anxiety and Neurosis Cochrane Controlled Trials Register (CCDANCTRStudies and CCDANCTRReferences)以 MEDLINE, Lilacs搜尋於04/08/2006。審視所有可辨認研究的引用文獻來找尋更多的研究。聯絡納入研究的第一作者、valerian製品的製造商、及這領域中的專家以求得未發表的試驗資料。

選擇標準

隨機控制試驗或類似隨機控制試驗,研究valerian抽取物的劑量、食用、及給予方式,對象是任何主要診斷為廣泛性焦慮病、神經性焦慮、慢性焦慮狀態、或任何疾病其焦慮為主要症狀(panic disorder, obsessive compulsive disorder, social phobia, agoraphobia, other types of phobia, postraumatic stress disorder)。療效評估使用臨床結果的評估及其他焦慮症狀的量表。

資料收集與分析

兩位文獻回顧作者獨立使用納入條件來抽取及鍵入數據,及評估試驗品質。當意見不合時,第三位文獻回顧作者會被諮詢。納入試驗的方法學品質以Cochrane Handbook criteria來評估。對於二分法變項以相對風險來計算,而連續性變項則以加權平均差來計算,兩者均使用95%的信賴區間。

主要結論

一個符合受入條件的隨機控制試驗有36個廣泛性焦慮症的患者。這是針對valerian、diazepam及安慰劑,共4週的先驅研究。在HAMA總分或身體及精神方面的分數,valerian組及安慰劑組的比較沒有明顯的差異。同樣在HAMA分數上,valerian組及diazepam組的比較也沒有顯著的差異,雖然diazepam組由STAITrait 分數上可見明顯症狀的改善。在副作用報告數及退出率的比較上,三組沒有顯著的差異。

作者結論

因為目前僅有一個小型的研究,對於valerian與安慰劑及diazepam在焦慮性疾患的治療效果及安全性的比較,仍沒有足夠的證據得到任何結論。仍需要更大型的隨機控制試驗來比較valerian與安慰劑及其他介入方式,譬如抗憂鬱劑在焦慮性疾患上的治療。

翻譯人

本摘要由彰化基督教醫院李柏賢翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

焦慮性疾患在社區是非常常見的精神健康問題。大部分治療焦慮的藥物都有副作用。Valerian是一種常用在失眠的草藥。這篇研究的目的在調查Valerian使用在焦慮性疾患的療效及安全性。只有找到一個比較valerian、diazepam及安慰劑,共36個人的研究。這研究發現valerian與安慰劑,或valerian與diazepam的比較,從醫師評估的焦慮症狀上沒有明顯的療效差異;而valerian及diazepam都同樣能被病患接受。然而要確定valerian的療效及安全性,及作為焦慮性疾患的治療選擇,仍需要更多大型的研究。

Plain language summary

Valerian for anxiety disorders

Anxiety disorders are a very common mental health problem in the community. Most of the medications used to treat anxiety have side effects. Valerian is a phytotherapeutic medication frequently used for insomnia. The aim of this study was to investigate the efficacy and safety of valerian for anxiety disorders. Only one study was identified, involving 36 patients and comparing valerian with placebo and diazepam. This study found no significant differences in effectiveness between valerian and placebo, or between valerian and diazepam, for clinician-rated anxiety symptoms, and that both valerian and diazepam were equally well tolerated by patients. However, additional studies with larger numbers of patients are necessary before drawing conclusions about the effectiveness and safety of valerian as a treatment option for anxiety disorders.

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