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Passiflora for anxiety disorder

  • Review
  • Intervention

Authors


Abstract

Background

Anxiety is a very common mental health problem in the general population and in the primary care setting. Herbal medicines are popularly used worldwide and could be an option for treating anxiety if shown to be effective and safe. Passiflora (passionflower extract) is one of these compounds.

Objectives

To investigate the effectiveness and safety of passiflora for treating any anxiety disorder.

Search methods

The following sources were used: electronic databases: Cochrane Collaboration Depression, Anxiety and Neurosis Cochrane Controlled Trials Register (CCDANCTR-Studies), Medline and Lilacs; Cross-checking references; contact with authors of included studies and manufacturers of passiflora.

Selection criteria

Relevant randomised and quasi-randomised controlled trials of passiflora using 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 mental health disorder in which anxiety is a core symptom (panic disorder, obsessive compulsive disorder, social phobia, agoraphobia, other types of phobia, postraumatic stress disorder). Effectiveness was measured using clinical outcome measures such as Hamilton Anxiety Scale (HAM-A) and other scales for anxiety symptoms.

Data collection and analysis

Two reviewers independently selected the trials found through the search strategy, extracted data, performed the trial quality analyses and entered data. Where any disagreements occured, the third reviewer was consulted. Methodological quality of the trials included in this review was assessed using the criteria described in the Cochrane Handbook. For dichotomous outcomes, relative risk with 95% confidence intervals (CI) were calculated, and for continuous outcomes, weighted mean difference with 95%CI was used.

Main results

Two studies, with a total of 198 participants, were eligible for inclusion in this review. Based on one study, a lack of difference in the efficacy of benzodiazepines and passiflora was indicated. Dropout rates were similar between the two interventions. Although the findings from one study suggested an improvement in job performance in favour of passiflora (post-hoc outcome) and one study showed a lower rate of drowsiness as a side effect with passiflora as compared with mexazolam, neither of these findings reached statistical significance.

Authors' conclusions

RCTs examining the effectiveness of passiflora for anxiety are too few in number to permit any conclusions to be drawn. RCTs with larger samples that compare the effectiveness of passiflora with placebo and other types of medication, including antidepressants, are needed.

摘要

背景

使用西蕃蓮萃取物治療焦慮性病患

焦慮是一般人和一般醫療機構常見的精神健康問題.全球很多人使用草藥治療焦慮,若證明有效且安全則可作為治療焦慮症的治療選擇.西蕃蓮萃取物來自西蕃蓮花就屬於常用的一種化合物

目標

探討西蕃蓮萃取物治療任何焦慮性病患的安全性和療效

搜尋策略

我們使用以下的電子資料庫文獻資源:Cochrane Collaboration Depression, Anxiety and Neurosis Cochrane Controlled Trials Register (CCDANCTR研究), Medline and Lilacs;交叉檢查確認引用文獻和與納入研究的作者聯繫,並與西蕃蓮萃取物的生產工廠聯繫.

選擇標準

相關的隨機和半隨機的對照試驗,使用任何的劑量,型式或服用方式的西蕃蓮萃取物,治療診斷為廣泛性焦慮症,焦慮性神經症,慢性焦慮狀態或任何其他的焦慮為核心症狀的精神疾病(恐慌症,強迫症,社交恐懼症,懼曠症,其他種類的畏懼症,創傷後壓力病患)的病人.療效評估使用評估臨床結果的量表如漢密爾頓焦慮量表(HAMA)和其他焦慮症狀的量表

資料收集與分析

兩位審閱者經由搜尋策略找出的資料進行試驗品質分析,並進入資料庫獨立挑選找到的試驗.當不同的看法發生時,則詢問第三審閱者意見.本回顧納入試驗的方法學品質由Cochrane 手冊中描述的方式作評估.異質的試驗結果則計算其相對危險RR和其95%信賴區間.連續試驗的結果則計算加權平均差和其95%信賴區間.

主要結論

兩個研究共189位受試者納入回顧.其中一個試驗結果發現,苯二氮平類和西蕃蓮萃取物兩組的療效沒有差異.中途退出率也似.但是另一個研究顯示西蕃蓮萃取物組的受試者的工作表現進步(治療後一次性評估).另一個研究顯示西蕃蓮萃取物組與mexazolam相比較,較少有昏昏欲睡的副作用.但是這些結果都沒有達到統計上的顯著差異

作者結論

評估西蕃蓮萃取物對焦慮療效的隨機對照試驗太少,無法得到結論.需要較大樣本的隨機對照試驗,以比較西蕃蓮萃取物和安慰劑和其他藥物(包括抗憂鬱劑是需要的)

翻譯人

本摘要由成功大學附設醫院尹子真翻譯。

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

總結

評估西蕃蓮萃取物治療成人的焦慮性病患.焦慮是一種一般人十分常有的精神健康問題.西蕃蓮萃取物是一種草藥,若證明有效且安全,則西蕃蓮萃取物可作為治療焦慮症的一種選擇.本回顧整理現有的西蕃蓮萃取物的文獻. 只有兩個試驗,共198位受試者.其中一個研究的試驗結果發現,西蕃蓮萃取物療效與苯二氮平類藥物相當.中途退出率也相似.但是因為欠缺研究,無法對西蕃蓮萃取物治療焦慮性病患的療效和安全做出結論

Plain language summary

Passiflora for the treatment of anxiety disorders in adults

Anxiety is a very common mental health problem in the general population. Passiflora, a herbal medicine, could be an option for treating anxiety if shown to be effective and safe. This review summarised the evidence from currently available studies on passiflora. Only two studies were eligible for inclusion, involving a total of 198 participants. One study showed that passiflora was as effective as benzodiazepines, with similar dropout rates between the two treatments. Given the lack of studies, it is not possible to draw any conclusions on the effectiveness or safety of passiflora in the treatment of anxiety disorders.

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