Alternative Medicines/Herbs- Part 3 - Anti-Anxiety- Sleep- Depression
Rest- Sleep- Relaxation= Improved Quality of Life
Kava Kava Leaves- Picture 1
Beginners Guide to Herbals
Valerian - Pictures 2 and 3
St John's Wart - Pictures 4 and 5
Growing Own Herbs
Passion Flower- Pictures 6 and 7
Herbs for Sleep, Anxiety and Depression
As I begin all my articles dealing with "natural" medicines such as herbs, I strive to stress that they are still drugs and need to be used with wisdom and knowledge. If you decide to use any, always make sure your doctor and pharmacist are aware of the usage. This class of meds I will give examples of have many benefits along with many potential side effects. Since one is basically self-medicating a cardinal rule to remember is more is not better. If the recommended dose does not work, taking extra rarely improves the outcome. Taking more than the recommended dose can magnify the side effects.
KAVA KAVA: (Picture 1) This is one I have seen used and recommended with great success. Some articles I have read report it is related to the diazepam family and has actually caused false positives in urine tests. It can be highly sedating and intoxicating. As with all meds in this class - RX and OTC- caution must be maintained when using machinery or driving. Many natives in the Pacific Islands have successfully used this herb for centuries by chewing the leaves. It has been found that a more potent source is the roots. Kava Kava can numb the mouth and lips if taken as a tea. It is contraindicated in people with pre-existing liver disease because Kava Kava is detoxified via the liver. It has an indirect benefit with menstrual cramps. When one is going through any discomfort, the resulting anxiety actually intensifies the problem so by relaxation, the cramps are often reduced.
VALERIAN: (Pictures 2 and 3) As beautiful as the flowers are, the source for Valerian is actually the root. The most common use is for insomnia though in lower doses, it can be used for anxiety, depression, tremors, headaches (including migraines) and depression. As with all sleeping medicines, usage should be short-term - no more than 28 days. Finding and dealing with the cause of the insomnia is always the better and longer lasting cure for insomnia. Like all potent meds- and valerian is potent- sometimes the opposite desire is attained such as insomnia, nervousness and headache. If one is taking the med for 28 days or longer and wishes to stop, it is recommended to taper down over a 1-2 week window to circumvent withdrawal symptoms. Caution should be followed if mixing with alcohol. As I gained experience as a pharmacist, patients would often ask if they could drink alcohol, I always knew and know that the best answer is no but I am realistic and would add a BIG qualifying IF "if you do drink" if I thought they would anyway. I am practical, never naïve with meds. If one is taking medicines such as Ativan, Halcion or Xanax then this should not be added or the RX med should be stopped before this is added. I have seen it added but with doctors approval and then we would reduce all doses appropriately. Valerian can interfere with the detoxification and therefore the blood levels of many RX medicines. Many meds utilize a substrate called Cytochrome P450 to detoxify and then be excreted and usually one drugs wins over the other(s). Valerian has caused problems with medicines such as Mevacor, Nizoral, Sporonax, Halcion, Xanax and the list goes on and on. This is why it is so important to make sure your doctor is aware what OTC's you are taking and just as importantly that your pharmacist adds the herbal to your profile in his computer. I have caught numerous potential side effects this way.
ST. JOHN'S WART: (Pictures 4 and 5) this herb is one of those medicinals that the more I learn, the more I realize that there are so many things I do not know. The most common use of SJW is for depression. It has often been found to help relieve anxiety and sleeplessness but this may be more due to the fact that those two symptoms are often the result of depression and therefore as the depression is alleviated, these symptoms are often reduced. We will leave that prognosis for armchair and actual psychologists. It has been shown to be effective for Seasonal Affective Disorder commonly known as SAD. SJW has been used for so many things such as Hepatitis C, HIV, Irritable Bowel Syndrome, ADHD and so many more. I will focus on the depression aspect as so many people who come in the pharmacy tell me, when they talk to me, about their bouts of depression. It is derived from the beautiful flowers and leaves of the plant I have pictured here. The ancient Greeks including Hippocrates were well aware of the benefits of SJW. A chemical in the herb called hypericon was first found to be effective with the depression. More recently, a chemical called hyperforin was found to play a bigger role. Side effects include: hypersensitivity to the sun, anxiety, restlessness, headache and diarrhea. It is contraindicated if pregnant and breast-feeding because of preliminary studies on rats. There can be major interactions with all the diazepam's (Valium, Xanax, Ativan, Temazepam, Halcion, etc.), amitriptyline(Elavil), birth control pills (making them less effective), digoxin, protease inhibitors (HIV), all antidepressants(Prozac, Zoloft, Paxil, etc.) and one I am extremely cautious about with many patients, warfarin(Coumadin), and many etc. As with Valerian, it also competes with an important enzyme called Cytochrome P-450. This herb is an excellent example why it is so important to make sure your doctor's office and pharmacy are aware of the herbs, minerals and vitamins you are taking. It is because of all the potential side effects and interactions that I have become very cautious with SJW. It is not that it is a bad herb, but it has great potential for problems if some caution is not exercised. No matter how busy I am, if I see a person looking at it in the aisle or buying it (actually any herb), I go over to make sure they gain some knowledge. This is not to scare but to educate.
PASSION FLOWER: (Pictures 6 and 7) this herb is most commonly used for insomnia and anxiety. The Spaniards in Peru in the 1500's found the Passion Flower to be medicinally effective which of course was the result of the use by local natives. It has also been found helpful with: GI upset, narcotic withdrawal (in combination with the RX medicine clonidine), muscle spams, pain relief, topically for abrasions, fibromyalgia, irregular heart beat, ADHD and others. In the US, it is against the law to advertise it as effective for insomnia, not because it does not work but because there are too few formal studies. This is a sad truth of many herbs. The FDA is overwhelmed with monitoring current and future RX drugs. This leaves independent companies to perform studies but these one has to sometimes research and question as motive has to be examined. I know it is "difficult" to believe, but earning potential has been known to "influence" results to favor increased sales. Side effects are not common as with St John's Wart, if one stays within recommended doses. Dosing is usually titrated in drops. Side effects include dizziness, confusion, GI upset and irregular coordination. It is unsafe if one is pregnant as it can cause the uterus to contract. Breastfeeding is not known to be safe or unsafe so I generally recommend not to breast feed. As with all the meds I talked about in this article, one should stop it, titrate down to 0, at least two weeks before surgery. Also, as with the other herbs in this article, if one is taking RX drugs for depression, insomnia or anxiety, dosing adjustments should be made. This is again the result of teamwork.
Before this article becomes too long and therefore less attractive to the reader, I will stop here. I will probably do an additional article sometime in the future on more mood altering herbs as there are so many and far too many people self-dosing due to the false belief hat "if it is natural, it must be safe". Please remember, that many POISONS are "natural" but of course deadly. Again, it is not my intent to scare but to educate. Herbs, in general, are excellent additions to our good-health regime. I would also recommend non-oral remedies for anxiety and sleep. I personally use running to deal with stress and sleep. It does not work 100% of the time but nothing, including herbs and prescription drugs, works all the time. Things such as meditation, yoga and changing ones' negative thought processes are excellent alternatives also. I will again say that an ounce of knowledge is worth a pound of cure.
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