Alternative medicines in treating anxiety and insomnia.

Extracts of valerian and valerenic acid are often used in the treatment of insomnia, as it activates 5-HT5a receptors. This is related to the release of melatonin, which controls the sleep-wake cycles of a person.

In China, Japan, Korea and other countries Semen Ziziphi Spinosae (SZS) – which is a safe sedative-hypnotic - is used to promote sleep quality, extend duration of sleep and increase NREM sleep. In Egypt, Lactuca sativa – also known as garden lettuce -has been used for centuries to promote sleep.

Kava-kava, a botanical, has the intended use to treat anxiety. However, it causes hepatotoxicity and should be avoided completely, especially by patients whom already suffer from liver impairment or liver failure.

Ginkgo, extracted from Ginkgo biloba was always used to treat many central nervous system insufficiencies, but mainly for dementia of the Alzheimer type. Recent studies show that ginkgo is effective for treatment of dementia, but anxiety and insomnia have been reported as adverse effects of the use thereof. Therefore, ginkgo should be avoided in the treatment of insomnia and anxiety.

Patients that use ginseng, derived from Panax, to increase central levels of acetylcholine, serotonin, norepinephrine and dopamine can expect insomnia, irritability and nervousness as adverse effects. Patients that are already suffering from insomnia and anxiety should therefore not use ginseng.

St. John’s wort is very effective in treating anxiety. There is however, very little evidence and too few cases to draw a conclusion regarding the efficacy of St. John’s wort as effective treatment for anxiety and other mood-related conditions. St. John’s wort causes sedation and restlessness as adverse effects in rare cases – which can lead to the relief of anxiety.

Morinda citrifolia fruit have shown to be GABAᴀ receptor agonists. Low central levels of GABA are linked to many disorders such as anxiety, hyperactivity (which in turn could be the cause of sleeplessness) and depression. Therefore, having increased central levels of GABAᴀ or GABAᴀ receptor agonists may reduce anxiety and promote sleep.

More herbal drugs used to treat insomnia:

• Chamomile
• Passionflower
• Hops
• Lemon balm
• Lavender oil

More herbal drugs to treat anxiety:

• Chamomile
• Lavender (in many forms)
• Galphimia glauca
• Green tea

There are also other alternative methods to treat insomnia and anxiety:

• Yoga
• Exercise
• Take relaxing bath
• Meditation
• Massage
• Accupuncture

References:

1. Barnett, R.A. 2019. 19 Natural Remedies for Anxiety. https://www.health.com/ condition/anxiety/19-natural-remedies-for-anxiety Date accessed: 4 March 2021.
2. Bingiin, L., Changhong, L., Lui, L., Pu, W., Yicun, W. & Yuxin, L. 2015. Herbal Medicine for Anxiety, Depression and Insomnia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4790408/#:~:text=Extracts%20of%20valerian%20(Valeriana%20officinalis,and%20promotes%20falling%20into%20sleep. Date accessed: 4 March 2021.
3. Cronkleton, E. 2018. 8 Home remedies for insomnia. https://www.healthline.com/ health/healthy-sleep/insomnia-home-remedies  Date accessed: 4 March 2021.
4. Katzung, B.G.  2018.  Basic & Clinical Pharmacology.  14^th ed. 
5. Pathak, N. 2020. Alternative Treatments for Insomnia. https://www.webmd.com/sleep-disorders/alternative-treatments-for-insomnia Date accessed: 4 March 2021.
6. Richards, L. 2020. 9 herbs for anxiety. https://www.medicalnewstoday.com/ articles/herbs-for-anxiety Date accessed: 4 March 2021.