For quite a number of preparations of herbal/natural origin in pharmacies or shops, claims are made that they have anxiolytic and/or sedative-hypnotic properties. Your textbook (Katz) discusses a number of these preparations in Chapter 64. Use that information together with a search on the internet and compile a brief report on the use of these alternative medicines in the treatment of anxiety and insomnia. You may use any search engine (e.g. Google) and keywords such as “botanicals” and “anxiety” and “insomnia”. 

botanicals for anxiety 

1. ginkgo biloba 

increases blood flow, reduces blood viscosity and promotes vasodilation thus enhancing tissue perfusion. enhancement of nitric oxide effects such as relaxing, this is used for anxiety 

side effects : 

do not give patients with allergic and asthmatic bronchoconstriction 

drug interactions 

ginkgo has an antiplatelet effect but do not use with other antiplatelets and anticoagulation medications 

virologic failure with combination to efavirenz

sedation with triazolam 

priapism with risperidone 

seizures with valproic acid phenytoin 

dosage 

ginkgo biloba is standardized to contain 24%flavone glycoside and 6%terpene lactones

daily dose of 120 to 240 mg of the dried extract in two or three divided doses.

2. ST. John’s wort ( hypercium perforatum )

indicated for anxiety 

side effects : 

photosensitization is related to hypericin and pseudohypericin. advice patients to use sunscreen and eye protection while of the this product 

drug interactions: 

inhibit reuptake of various amines transmitters .

use with caution antidepressants or avoid  due to serotonin syndrome 

inducer of hepatic CYP enzymes

HIV medication

anticonvulsants and cyclosporine

drug dosage:

product standardized to have 2-5% hyperforin 

for moderate depression  dose of 900 mg of the dried extract per day 

onset of effect may take 2 to 4 weeks 

botanicals for insomnia 

1. melatonin 

It improves sleep onset, duration and quality when administered to healthy volunteers. it also increases rapid eye movement 

side effects 

next day dizziness, fatigue, headaches and irritability 

affect blood pressure 

drug interactions:

antidepressants

NSAIDs 

B-Adrenoceptor agonists and antagonists 

sodium valproate 

metabolized by CYP450 1A2

dosage :

0.3 to 10 mg of the immediate release formulation given orally once nightly 

Valeriana officinalis

Valerian is one of the most popularly used herbal medicines for insomnia and is also used to treat anxiety. Hydroalcoholic and aqueous extracts of valerian roots have shown affinity for the GABA-A receptor in the brains of rats

 reference 

Zehnder, J., Katzung, S.M. and Trevor, A., 2019. Basic and clinical pharmacology. 12th Ed. New York: McGraw-Hill Medical