Anxiety and Panic Attacks
Other Proposed Natural Treatments
- 5-HTP (5-Hydroxytryptophan)
- Arginine Plus Lysine
- Bach Flower Remedies
- Chinese Skullcap
- Fish Oil
- Flaxseed Oil
- Galphimia glauca
- Gamma Oryzanol
- Gotu Kola
- Inositol (for Panic Disorder)
- Lemon Balm
- Magnesium , Hawthorn , and Eschscholtzia californica (California poppy) Combination
- Multivitamin/Mineral Supplements
- Relaxation Therapies (Meditation and Guided Imagery)
- European Skullcap
Proposed Natural Treatments
Valerian: May Provide Calming Effects
Other Herbs and Supplements
- Acupuncture (for generalized anxiety as well as for situational anxiety) 10,29,240
- Yoga 71-76
- Aromatherapy (either alone or combined with massage) 11,43
- Biofeedback 36,68
- Music therapy 63,70
1 Meyer HJ, Kretzschmar R. Kawa Pyrones—a new kind of substance group of central muscle relaxants of the mephenesin type [translated from German]. Klin Wochenschr. 1966;44:902-903.
2 Klohs MW, Keller F, Williams RE, et al. A chemical and pharmacological investigation of Piper methysticum Forst. J Med Pharm Chem. 1959;1:95-103.
3 Bruggemann VF, Meyer HJ. Studies on the analgesic efficacy of the kava constituents dihydrokavain (DHK) and dihydromethysticin (DHM) [in German; English abstract]. Arzneimittelforschung. 1963;13:407-409.
4 Meyer HJ. Pharmacology of the active compounds of the Kava rhizome ( Piper methysticum Forst) [translated from German]. Arch Int Pharmacodyn Ther. 1962;138:505-535.
5 Meyer HJ, May HU. Local anaesthetic properties of natural Kava pyrones [translated from German]. Klin Wochenschr. 1964;42:407.
6 Meyer HJ, Kretzschmar R. Kawa Pyrones - a new kind of substance group of central muscle relaxants of the mephenesin type [translated from German]. Klin Wochenschr. 1966;44:902-903.
7 Singh YN. Effects of kava on neuromuscular transmission and muscle contractility. J Ethnopharmacol. 1983;7:267-276.
8 Andreatini R, Sartori VA, Seabra ML, et al. Effect of valepotriates (valerian extract) in generalized anxiety disorder: a randomized placebo-controlled pilot study. Phytother Res. 2002;16:650-654.
9 Wolfson P, Hoffmann DL. An investigation into the efficacy of Scutellaria lateriflora in healthy volunteers. Altern Ther Health Med. 2003;9:74-78.
10 Wang SM, Kain ZN. Auricular acupuncture: a potential treatment for anxiety. Anesth Analg. 2001;92:548-553.
11 Cooke B, Ernst E. Aromatherapy: a systematic review. Br J Gen Pract. 2000;50:493-496.
12 Malsch U, Klement S. Randomized placebo-controlled double-blind clinical trial of a special extract of kava roots (WS 1490) in patients with anxiety disorders of non-psychotic origin [abstract]. Eur Phytojournal [serial online]. 2000. The European Scientific Cooperative on Phytotherapy website. Available at: http://www.escop.com/issue%5F1 . Accessed May 10, 2001.
13 Woelk H, Kapoula O, Lehrl S, et al. The treatment of patients with anxiety. A double blind study: kava extract WS 1490 versus benzodiazepine [translated from German]. Z Allg Med. 1993;69:271-277.
14 Jussofie A, Schmiz A, Hiemke C. Kavapyrone enriched extract from Piper methysticum as modulator of the GABA binding site in different regions of rat brain. Psychopharmacology. 1994;116:469-474.
28 Kohnen R, Oswald WD. The effects of valerian, propranolol, and their combination on activation, performance and mood of healthy volunteers under social stress conditions. Pharmacopsychiatry. 1988;21:447-448.
29 Eich H, Agelink MW, Lehmann E, et al. Acupuncture in patients with minor depressive episodes and generalized anxiety. Results of an experimental study [in German; English abstract]. Fortschr Neurol Psychiatr. 2000;68:137-144.
30 Carroll D, Ring C, Suter M, et al. The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: a double-blind placebo-controlled trial. Psychopharmacology (Berl). 2000;150:220-225.
31 Kahn RS, Westenberg HG, Verhoeven WM, et al. Effect of a serotonin precursor and uptake inhibitor in anxiety disorders; a double-blind comparison of 5-hydroxytryptophan, clomipramine and placebo. Int Clin Psychopharmacol. 1987;2:33-45.
32 Naguib M, Samarkandi AH. Premedication with melatonin: a double-blind, placebo-controlled comparison with midazolam. Br J Anaesth. 1999;82:875-880.
33 Naguib M, Samarkandi AH. The comparative dose-response effects of melatonin and midazolam for premedication of adult patients: a double-blinded, placebo-controlled study. Anesth Analg. 2000;91:473-479.
34 Bradwejn J, Zhou Y, Koszycki D, et al. A double-blind, placebo-controlled study on the effects of Gotu Kola (Centella asiatica) on acoustic startle response in healthy subjects. J Clin Psychopharmacol. 2000;20:680-684.
35 Akhondzadeh S, Naghavi HR, Vazirian M, et al. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther. 2001;26:363-367.
36 Moore NC. A review of EEG biofeedback treatment of anxiety disorders. Clin Electroencephalogr. 2000;31:1-6.
37 Field T, Morrow C, Valdeon C, et al. Massage reduces anxiety in child and adolescent psychiatric patients. Am Acad Child Adolesc Psychiatry. 1992;31:125-131.
38 Wachelka D, Katz RC. Reducing test anxiety and improving academic self-esteem in high school and college students with learning disabilities. J Behav Ther Exp Psychiatry. 1999;30:191-198.
39 Thompson MB, Coppens NM. The effects of guided imagery on anxiety levels and movement of clients undergoing magnetic resonance imaging. Holist Nurs Pract. 1994;8:59-69.
40 Kabat-Zinn J, Massion AO, Kristeller J, et al. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry. 1992;149:936-943.
41 Walach H, Rilling C, Engelke U. Efficacy of Bach-flower remedies in test anxiety: a double-blind, placebo-controlled, randomized trial with partial crossover. J Anxiety Disord. 2001;15:359-366.
42 Armstrong NC, Ernst E. A randomized, double-blind placebo-controlled trial of a Bach Flower Remedy. Complement Ther Nurs Midwifery. 2001;7:215-221.
43 Morris N, Birtwistle S, Toms M. Anxiety reduction by aromatherapy: anxiolytic effects of inhalation of geranium and rosemary. Int J Aromatherapy. 1995;7:33-39.
44 Hanus M, Lafon J, Mathieu M. Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of a fixed combination containing two plant extracts ( Crataegus oxyacantha and Eschscholtzia californica ) and magnesium in mild-to-moderate anxiety disorders. Curr Med Res Opin. 2004;20:63-71.
45 Dhawan K, Kumar S, Sharma A. Comparative anxiolytic activity profile of various preparations of Passiflora incarnata Linneaus : a comment on medicinal plants’ standardization. J Altern Complement Med. 2002;8:283-291.
46 Kennedy DO, Wake G, Savelev S, et al. Modulation of mood and cognitive performance following acute administration of single doses of Melissa officinalis (lemon balm) with human CNS nicotinic and muscarinic receptor-binding properties. Neuropsychopharmacology. 2003. [Epub ahead of print]
47 Kennedy DO, Little W, Scholey AB. Attenuation of laboratory-induced stress in humans after acute administration of Melissa officinalis (lemon balm). Psychosom Med. 2004;66:607-613.
48 Kennedy DO, Little W, Haskell CF, et al. Anxiolytic effects of a combination of Melissa oficinalis and Valeriana oficinalis during laboratory induced stress. Phytother Res. 2006 Jan 27. [Epub ahead of print].
49 Viola H, Wolfman C, Levi de Stein M, et al. Isolation of pharmacologically active benzodiazepine receptor ligands from Tilia tomentosa (Tiliaceae). J Ethnopharmacol. 1994;44:47-53.
50 Coleta M, Campos MG, Cotrim MD, et al. Comparative evaluation of Melissa officinalis L., Tilia europaea L., Passiflora edulis Sims. and Hypericum perforatum L. in the elevated plus maze anxiety test. Pharmacopsychiatry. 2001;34(suppl 1):S20-S21.
51 Kennedy DO, Pace S, Haskell C, et al. Effects of Cholinesterase Inhibiting Sage (Salvia officinalis) on Mood, Anxiety and Performance on a Psychological Stressor Battery. Neuropsychopharmacology. 2005 Oct 5. [Epub ahead of print].
52 Samarkandi A, Naguib M, Riad W, et al. Melatonin vs. midazolam premedication in children: a double-blind, placebo-controlled study. Eur J Anaesthesiol. 2005;22:189-96
53 Sury MR, Fairweather K. The effect of melatonin on sedation of children undergoing magnetic resonance imaging. Br J Anaesth. 2006 Jun 17. [Epub ahead of print]
54 Capuzzo M, Zanardi B, Schiffino E, et al. Melatonin does not reduce anxiety more than placebo in the elderly undergoing surgery. Anesth Analg. 2006;103:121-123
55 Turkistani A, Abdullah KM, Al-Shaer AA, et al. Melatonin premedication and the induction dose of propofol. Eur J Anaesthesiol. 2006 Nov 10. [Epub ahead of print]
56 Karst M, Winterhalter M, Munte S, et al. Auricular acupuncture for dental anxiety: a randomized controlled trial. Anesth Analg. 2007;104:295-300.
57 Smriga M, Ando T, Akutsu M, et al. Oral treatment with L-lysine and L-arginine reduces anxiety and basal cortisol levels in healthy humans. Biomed Res. 2007;28:85-90.
58 Herrera-Arellano A, Jimenez-Ferrer E, Zamilpa A, et al. Efficacy and tolerability of a standardized herbal product from Galphimia glauca on generalized anxiety disorder. A randomized, double-blind clinical trial controlled with lorazepam. Planta Med. 2007 Jun 11. [Epub ahead of print]
59 Halberstein R, DeSantis L, Sirkin A, et al. Healing with Bach® Flower Essences: testing a complementary therapy. Complement Health Pract Rev. 2007;12:3-14.
60 Inoue K, Shirai T, Ochiai H, et al. Blood-pressure-lowering effect of a novel fermented milk containing gamma-aminobutyric acid (GABA) in mild hypertensives. Eur J Clin Nutr. 2003;57:490-495.
61 Evans S, Ferrando S, Findler M, et al. Mindfulness-based cognitive therapy for generalized anxiety disorder. J Anxiety Disord. 2007 Jul 22. [Epub ahead of print]
62 Lahmann C, Schoen R, Henningsen P, et al. Brief relaxation versus music distraction in the treatment of dental anxiety: a randomized controlled clinical trial. J Am Dent Assoc. 2008;139:317-24.
63 Horne-Thompson A, Grocke D. The effect of music therapy on anxiety in patients who are terminally ill. J Palliat Med. 2008;11:582-590.
64 Movafegh A, Alizadeh R, Hajimohamadi F, et al. Preoperative oral Passiflora incarnata reduces anxiety in ambulatory surgery patients: a double-blind, placebo-controlled study. Anesth Analg. 2008;106:1728-1732.
65 Nyklicek I, Kuijpers KF. Effects of mindfulness-based stress reduction intervention on psychological well-being and quality oflife: is increased mindfulness indeed the mechanism? Ann Behav Med. 2008 Jun 6.
66 Manzoni GM, Pagnini F, Castelnuovo G, et al. Relaxation training for anxiety: a ten-years systematic review with meta-analysis. BMC Psychiatry. 2008 Jun 2.
67 Sherman KJ, Ludman EJ, Cook AJ, et al. Effectiveness of therapeutic massage for generalized anxiety disorder: a randomized controlled trial. Depress Anxiety. 2010;27(5):441.
68 Lande RG, Williams LB, Francis JL, Gragnani C, Morin ML. Efficacy of biofeedback for post-traumatic stress disorder. Complement Ther Med. 2010;18(6):256-259.
69 Kiecolt-Glaser JK, Belury MA, Andridge R, et al. Omega-3 supplementation lowers inflammation and anxiety in medical students: A randomized controlled trial. Brain Behav Immun. 2011 Jul 19. [Epub ahead of print]
70 Erkkilä J, Punkanen M, Fachner J, et al. Individual music therapy for depression: randomised controlled trial. Br J Psychiatry. 2011;199(2):132-139.
71 Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17(1):21-35.
72 Javnbakht M, Hejazi Kenari R, Ghasemi M. Effects of yoga on depression and anxiety of women. Complement Ther Clin Pract. 2009;15:102-4.
73 Vadiraja HS, Raghavendra RM, Nagarathna R, et al. Effects of a yoga program on cortisol rhythm and mood states in early breast cancer patients undergoing adjuvant radiotherapy: a randomized controlled trial. Integr Cancer Ther. 2009;8:37-46.
74 Kovačič T, Kovačič M. Impact of relaxation training according to Yoga In Daily Life system on perceived stress after breast cancer surgery. Integr Cancer Ther. 2011;10(1):16-26.
75 Satyapriya M, Nagendra HR, Nagarathna R, Padmalatha V. Effect of integrated yoga on stress and heart rate variability in pregnant women. Int J Gynaecol Obstet. 2009;104:218-22.
76 Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17(1):21-35.
78 Chen KW, Berger CC, Manheimer E, et al. Meditative therapies for reducing anxiety: a systematic review and meta-analysis of randomized controlled trials. Depress Anxiety . 2012;29(7):545-562.
- Reviewer: EBSCO CAM Review Board
- Review Date: 09/2014 -
- Update Date: 09/18/2014 -