|Year : 2023 | Volume
| Issue : 2 | Page : 113-123
Pharmacological activity of Ayurveda herbal medicines in anxiety and depression: A review
Snehal Sonani, Tukaram S Dudhamal
Department of Shalya Tantra, Institute of Teaching and Research in Ayurveda, Jamnagar, Gujarat 361008, India
|Date of Submission||16-Nov-2022|
|Date of Acceptance||08-Feb-2022|
|Date of Web Publication||31-Mar-2023|
Dr. Snehal Sonani
Department of Shalya Tantra, Institute of Teaching and Research in Ayurveda, Jamnagar, Gujarat 361008
Source of Support: None, Conflict of Interest: None
Research area of herbal psychopharmacology has been increased in this era. It is demand of the era to have comprehensive review of preclinical studies of Ayurveda herbal drugs as antidepressant, anxiolytic, and hypnotic psychopharmacology. On the basis of these findings, further clinical uses as well as better understanding of its mode of action and dosage form can be planned. In this review, search engines such as Ayush Portal, PubMed, DHARA, Research Gate, Scopus, AYU, Google Scholar, Academia, and Google were used to find out widely used psychotropic herbal medicines (last 20 years). A review was conducted to determine mechanisms of action of those drugs, in addition to a scientific review of preclinical trials for the treatment of most common psychiatric clinical conditions, i.e., anxiety and depression. Specific prominence was given to most apparent herbal medicines. Neurochemical as well as epigenetic activities were evident by results of individual herbal medicines in this review. Some drugs were found to be more effective in psychotropic activity, i.e., Kava (Piper methysticum G. Forst.) and Klamath Weed (Hypericum perforatum L.) for anxiety and depression disorders, respectively. However, because many researches have not been produced, caution should be exercised when interpreting the findings.
Keywords: Antidepressant, anxiolytic, Ayurvedic drug, herbal medicine, psychopharmacology
|How to cite this article:|
Sonani S, Dudhamal TS. Pharmacological activity of Ayurveda herbal medicines in anxiety and depression: A review. J Drug Res Ayurvedic Sci 2023;8:113-23
|How to cite this URL:|
Sonani S, Dudhamal TS. Pharmacological activity of Ayurveda herbal medicines in anxiety and depression: A review. J Drug Res Ayurvedic Sci [serial online] 2023 [cited 2023 Jun 10];8:113-23. Available from: http://www.jdrasccras.com/text.asp?2023/8/2/113/373019
| Introduction|| |
Need of herbal drugs as a psychotropic
Research in the field of psychotropic action of drugs is well developed after new concept of active constitute. But evaluation of herbal drugs with regard to psychotropic mode of action is still in infancy. However, preclinical studies such as in vivo and in vitro have played a major role in upbringing of herbal medicines and in evaluation of its cellular pharmacology. All these scientific researches are mainly based on extraction of active constitute from the extract of some Ayurveda herbal plants, which is sometimes self-limiting to give synergetic effect. Ayurveda mentioned to use a drug as a whole in crude form, which is now famed as “polypharmacy.” Whole drug effect (polyvalence) describes all biological activities which is performed by all active principles or constituents present within that drug simultaneously. The same concept of polyvalence can be applied for extract evaluation in preclinical studies as there are a number of chemicals having different physiological and pharmacological effects, or only one chemical persisting a number of disease-related physiological effects. The high demand of herbal drugs in the field of psychiatry overcomes the side effects caused by conventional medicines. Hence, it is need of the hour to prepare scientific data of psychotropic herbal drugs as ready reference. With this due aim, the present review was planned to review preclinical data for anxiolytic and antidepressant Ayurveda herbal drugs.
Understanding concepts of anxiety
Anxiety defined as a major health problem comprises psychosomatic symptoms, i.e., staggering feelings of fear, ungovernable thoughts, uncomfortable stomach, collywobbles, etc. According to ICD-10 as well as DSM-IV, anxiety disorder is classified by panic disorders, social anxiety disorders, particular phobias, and generalized anxiety disorders. It is common that at some phase in life, everyone underwent a feeling of anxiety, i.e., facing difficulty at work, before appearing in exams. In contrast, anxiety is distinct which can affect normal routine life of individuals.
Epidemiological studies depict anxiety as a most prevalent psychic disorder occurring in one-third of the population more in their midlife and commonly in women. The physiology study revealed that in central nervous system (CNS), norepinephrine, serotonin, dopamine, and gamma-aminobutyric acid with some other neurotransmitters, i.e., corticotrophins releasing factor, and in peripherally, autonomic nervous system, are major factors which generate symptoms of anxiety.
Impact of the depression
Depression is also a major mental health condition which affects 322 million populations worldwide. It is a major factor according to global disability by 7.5% according to the data of 2015 and is also a major contributor to suicide accounting to approximately 800,000 annually, majorly in elderly., Depression is getting to the top of future disease burden by increasing day by day; it is assumed to reach 19% by 2050, which was 8.6% earlier in 2011. Depression seems to be affected in elderly age groups more than other age groups because of additional factors found in them, i.e., various systemic disease with more co-morbidity, lower physical activity, family problems, and also loss of income. It can be an aggravating factor to bad prognosis in associated disease as well as deprivation to healthy life style. So, there is a need for early identification and management of depression and should be considered as a serious health issue.
WHO and mental health
Concepts of mental well-being by the WHO (World Health Organization) are comprised of physical and mental capacity to cope with all the hurdles throughout life as well as to overcome from that and work productively. As per recent surveys, mental health issues are at very low awareness rate among communities, not dealt like other physical conditions. To overcome such issues, the WHO had launched such mental awareness schemes, i.e., Mental Health Gap Action Program (mhGAP) (launched in 2008) and Mental Health Action Plan (2031–2020).
Aim of the present study
Many studies over herbal drug have been conducted, including clinical and preclinical in the field of psychology till date, but these have focussed either on complete psychology or on single drug action. Review of preclinical studies which includes medicinal plant and its efficacy on anxiety and depression was not found till date. While research area in the field of herbal psychopharmacology is too much expanded to date, no exhausting reviews exist, which analyze the use of herbal medicines for anxiety and depression disorders. Survey data are suggestive of its high comorbidity and also found to have similar pathophysiology. As herbal medicines have action over psychological pathology, it is quite important to make a review which entertains such topic. So, the present review was carried out with the aim to review all preclinical data regarding herbal medicine efficacy on anxiety and depression.
| Materials and Methods|| |
An electronic search was done on Ayush Portal, PubMed, Dhara, Research Gate, Scopus, Ayu, Google Scholar, Academia, and Google to review evidence of herbal medicine on anxiety and depression. All collected databases were analyzed specifically for preclinical studies regarding efficacy of herbal medicines over psychological conditions. Keywords used for database analysis were “Anxiolytic,” “Anti-anxiety,” “Anti depression,” “Psychological action,” “Anxiety disorders,” “Post traumatic anxiety” with combined terminologies of “herbal drug/medicines,” “Ayurvedic drugs,” “Medicinal plants,” “Herbs,” “integrative therapy,” “botanical herbs” and other specific Latin or Sanskrit names of specific psychological Ayurvedic drugs.
| Results|| |
Preclinical studies on herbal drugs as anxiolytic and antidepressant
The included studies of herbal drug over mental health with special reference to anxiolytic and antidepressant are presented in the following [Table 1].
|Table 1: Review of pre-clinical studies over Ayurveda plant-based medicine|
Click here to view
| Discussion|| |
There is growing attention in the usage of herbal medicines to treat psychiatric disorders in Western and non-Western societies, instead of using synthetic and chemical drugs. With due interest, experimental studies have been designed with the aspect to check dose dependency, effectivity, and adverse effects. The present review suggests that there is plenty of development of preclinical studies which focus on herbal medicines for their psychotropic activity, which is vastly used for the management of depression and anxiety. Main hurdling issue among these researches is that in-vitro evidence of many herbal medicines has not yet been tested beyond preclinical trials. Viewing other side, in-vivo studies show that drug converts into a new chemical structure via biometabolic changes that occur in plant constituents during enzymatic and hepatic processes. So, it will be blind view to pretend drug’s efficacy based on just preclinical studies, and direct extrapolation to clinical trial is not feasible. So, this concept is a new door to potential future research.
Lacking knowledge of tissue uptake and tissue distribution of herbal drugs, it is out of the way to establish such data of cellular and mechanical changes in body due to herbal drugs. Some experimental studies, i.e., inhalation of essential oils and its tissue distribution, were also carried out to understand tissue distribution of such drugs, which will help in understanding its effectiveness as well as complications.
Proper drug dose is imperative for proper activity of the drug. Some of the experimental studies are framed to settle dependency of drug dose and its pharmacology, i.e., Sphaeranthus indicus L, which exhibits anxiolytic activity at a lower dose of 100 mg/kg p.o. Human clinical trials can also be done with reference to experimental drug doses, helping in pharmacokinetics as well.
These preclinical or pharmacological research studies also provide data related to wide acceptance due to no side effects, i.e., decreased motor coordination which is the most common disadvantage in modern medicines such as diazepam.
Generalized evaluation by clinical efficacy assessment of medicinal plants is a quite complicated task, as herbal preparations have multiple chemical compositions. Drug composition is dependent on many factors, i.e., genetic value differences; different types of environmental factors; various qualities of soil; airborne vectors; used plant parts; and method of preparation. Consequently, it is too difficult to create standard extracts with reproducible chemical composition and pharmacological activity, specifically when extracts are produced by different manufacturers. Sometimes, main active constituents of preclinical studies are helpful, but same evidence cannot guarantee similar efficacy of the total extract in replicated batches.
Minimal data related to aroma as a psychotropic offer subsequent giant steps in the field of herbal psychopharmacology. Also proven and combination herbal drug preclinical evaluation is the need of the hour.
| Conclusion|| |
Review was carried out on the current experimental evidence regarding herbal medicine treatments for anxiety and depressive disorders. These reviews only meant to preclinically tested medicinal plants to give way for their clinical uses as a byproduct of effectiveness and safety in research works. In conclusion, this literature provides motivating evidence for usage of herbal medicines in depression, anxiety, and insomnia, and further researches utilize robust methodology and good manufacturing practice by using biotechnologies and genetic technologies ensuring that bioequivalence of product is still required to promote confidence in this area. These will open the door to the next step to the field of herbal psychopharmacology.
Design, writing, and proofing of the manuscript were contributed by all the authors.
We would like to acknowledge Prof. Dr. Anup Thakar, Director, Institute of Teaching and Research in Ayurveda, Jamnagar, for his support and encouragement.
Financial support and sponsorship
Financially support for this study was given by the Institute of Teaching and Research in Ayurveda, Jamnagar.
Conflicts of interest
The authors have no conflicts of interest.
| References|| |
Bandelow B, Michaelis S Epidemiology of anxiety disorders in the 21st
century. Dialog Clin Neurosci 2015;17:327-35.
Freitas-Ferrari MC, Hallak JE, Trzesniak C, Filho AS, Machado-de-Sousa JP, Chagas MH, et al
. Neuroimaging in social anxiety disorder: A systematic review of the literature. Prog Neuropsychopharmacol Biol Psychiatry 2010;34:565-80.
Friedrich MJ Depression is the leading cause of disability around the world. JAMA 2017;317:1517.
Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Aziz R, Steffens DC What are the causes of late-life depression? Psychiatr Clin North Am 2013;36:497-516.
Agarwal A, Lubet A, Mitgang E, Mohanty S, Bloom DE Population aging in India: Facts, issues, and options, Bonn; 2016 (Discussion Papers-PGDA Working Papers 13216), Program on the Global Demography of Aging. Report No. 10162.
Fiske A, Wetherell JL, Gatz M Depression in older adults. Annu Rev Clin Psychol 2009;5:363-89.
Pilania M, Bairwa M, Kumar N, Khanna P, Kurana H Elderly depression in India: An emerging public health challenge. Australas Med J 2013;6:107-11.
Anonymous World mental health report: transforming mental health for all. Geneva: World Health Organization 2022, 36-38. Licence: CC BY-NC-SA 3.0 IGO.
Fadaki F, Modaresi M, Sajjadian I The effects of ginger extract and diazepam on anxiety reduction in animal model. Ind J Pharma Educ Res 2017;51:s159-62.
Topic B, Hasenöhrl RU, Häcker R, Huston JP Enhanced conditioned inhibitory avoidance by a combined extract of Zingiber officinale
and Ginkgo biloba
. Phytother Res 2002;16:312-5.
Vishwakarma SL, Pal SC, Kasture VS, Kasture SB Anxiolytic and antiemetic activity of Zingiber officinale
. Phytother Res 2002;16:621-6.
Sharma PK, Singh V, Ali M, Kumar S Effect of ethanolic extract of Zingiber officinale
Roscoe on central nervous system activity in mice. Indian J Exp Biol 2016;54:664-9.
Galani VJ, Patel BG Effect of hydroalcoholic extract of Sphaeranthus indicus
against experimentally induced anxiety, depression and convulsions in rodents. Int J Ayurveda Res 2010;1:87-92.
Esfandiari E, Ghanadian M, Rashidi B, Mokhtarian A, Vatankhah AM The effects of Acorus calamus
L. in preventing memory loss, anxiety, and oxidative stress on lipopolysaccharide-induced neuroinflammation rat models. Int J Prev Med 2018;9:85.
] [Full text]
Wanasuntronwong A, Tantisira MH, Tantisira B, Watanabe H Anxiolytic effects of standardized extract of Centella asiatica
(ECa 233) after chronic immobilization stress in mice. J Ethnopharmacol 2012;143:579-85.
Wijeweera P, Arnason JT, Koszycki D, Merali Z Evaluation of anxiolytic properties of Gotukola-(Centella asiatica
) extracts and asiaticoside in rat behavioral models. Phytomedicine 2006;13:668-76.
Ceremuga TE, Valdivieso D, Kenner C, Lucia A, Lathrop K, Stailey O, et al
. Evaluation of the anxiolytic and antidepressant effects of asiatic acid, a compound from Gotu kola or Centella asiatica
, in the male Sprague Dawley rat. AANA J 2015;83:91-8.
Hosseinzadeh H, Noraei NB Anxiolytic and hypnotic effect of Crocus sativus
aqueous extract and its constituents, crocin and safranal, in mice. Phytother Res 2009;23:768-74.
Mokhtari Hashtjini M, Pirzad Jahromi G, Meftahi GH, Esmaeili D, Javidnazar D Aqueous extract of saffron administration along with amygdala deep brain stimulation promoted alleviation of symptoms in post-traumatic stress disorder (PTSD) in rats. Avicenna J Phytomed 2018;8:358-69.
Pitsikas N, Boultadakis A, Georgiadou G, Tarantilis PA, Sakellaridis N Effects of the active constituents of Crocus sativus
L., Crocins, in an animal model of anxiety. Phytomedicine 2008;15:1135-9.
Ceremuga TE, Ayala MP, Chicoine CRW, Chun CSM, DeGroot CJM, Henson DT, et al
. Investigation of the anxiolytic and antidepressant effects of Crocin, a compound from saffron (Crocus sativus
L.), in the male Sprague-Dawley rat. AANA J 2018;86:225-33.
Sharma A, Kalotra S, Bajaj P, Singh H, Kaur G Butanol extract of Tinospora cordifolia
ameliorates cognitive deficits associated with glutamate-induced excitotoxicity: A mechanistic study using hippocampal neurons. Neuromol Med 2020;22:81-99.
Mishra R, Manchanda S, Gupta M, Kaur T, Saini V, Sharma A, et al
. Tinospora cordifolia
ameliorates anxiety-like behavior and improves cognitive functions in acute sleep deprived rats. Sci Rep 2016;6:25564.
Sharma K, Arora V, Rana A, Bhatnagar M Anxiolytic effect of Convolvulus pluricaulis
Choisy petals on elevated plus maze model of anxiety in mice. Ind J Exp Biol 2009;3:41-6.
Malik J, Karan M, Vasisht K. Nootropic, anxiolytic and CNS-depressant studies on different plant sources of Shankhpushpi
. Pharma Biol 2011;49:1234-42.
Heba M, Faraz S, Banerjee S Effect of Shankhpushpi on alcohol addiction in mice. Pharmacogn Mag 2017;13(Suppl. 1):S148-53. Epub April 7, 2017.
Bora KS, Sharma A Evaluation of anxiolytic effect of Medicago sativa
in mice. Pharmaceut Biol 2012:50:878-82.
Kafeel H Anxiolytic activity of ethanolic extract of aerial parts of Tribulus terrestris
in mice. J Phytopharmacol 2015;4:7-21.
Garrett KM, Basmadjian G, Khan IA, Schaneberg BT, Seale TW Extracts of kava (Piper methysticum
) induce acute anxiolytic-like behavioral changes in mice. Psychopharmacology (Berl) 2003;170:33-41.
Thaxter KA, Young LE, Young RE, Parshad O, Addae J An extract of neem leaves reduces anxiety without causing motor side effects in an experimental model. West Indian Med J 2010;59:245-8.
Cícero Bezerra Felipe F, Trajano Sousa Filho J, de Oliveira Souza LE, Alexandre Silveira J, Esdras de Andrade Uchoa D, Rocha Silveira E, et al
. Piplartine, an amide alkaloid from Piper tuberculatum
, presents anxiolytic and antidepressant effects in mice. Phytomedicine 2007;14:605-12.
Netto S,Warela R, Fechine M, Queiroga M, Quintans-Júnior L. Anxiolytic-like effect of Rauvolfia ligustrina
Willd: Ex Roem. & Schult., Apocynaceae, in the elevated plus-maze and hole-board tests. Rev Brasil De Farmacognosia-Braz J Pharmacogn-Rev Bras Farmacogn 2009;19:888-92.
Bisong SA, Brown R, Osim EE Comparative effects of Rauwolfia vomitoria
and chlorpromazine on locomotor behaviour and anxiety in mice. J Ethnopharmacol 2010;132:334-9.
Anuradha H, Srikumar BN, Shankaranarayana Rao BS, Lakshmana M Euphorbia hirta
reverses chronic stress-induced anxiety and mediates its action through the GABA(A) receptor benzodiazepine receptor-Cl(-) channel complex. J Neural Transm (Vienna) 2008;115:35-42.
Kumar V, Jaiswal AK, Singh PN, Bhattacharya SK Anxiolytic activity of Indian Hypericum perforatum
Linn.: An experimental study. Indian J Exp Biol 2000;38:36-41.
Kumar V, Singh RK, Jaiswal AK, Bhattacharya SK, Acharya SB Anxiolytic activity of Indian Abies pindrow
Royle leaves in rodents: An experimental study. Indian J Exp Biol 2000;38:343-6.
Kannan S, Manickam S, RajaMohammed MA Anxiolytic, sedative, and hypnotic activities of aqueous extract of Morinda citrifolia
fruit. J Ayurveda Integr Med 2014;5:73-5.
Nirwane AM, Gupta PV, Shet JH, Patil SB Anxiolytic and nootropic activity of Vetiveria zizanioides
roots in mice. J Ayurveda Integr Med 2015;6:158-64.
Kader SM, Masum MA, Kabir MS, Uddin MS, Jony MN, Chowdhury MS, et al
. Sedative and anxiolytic activities of methanol extract of Boehmeria platyphylla
D Don leaves. Int J Pharm 2016;6;292-8.
Deole Yogesh S, Ashok BK, Vinay S, Ravishankar B, Chandola HM Psycho-pharmacological study on antidepressant and anxiolytic effect of Brahmi Ghrita. AYU J 2008;29:77-83.
Sharma L, Sharma A, Dash AK, Bisht GS, Gupta GL A standardized polyherbal preparation Pol-6 diminishes alcohol withdrawal anxiety by regulating Gabra1, Gabra2, Gabra3, Gabra4, Gabra5 gene expression of GABAA receptor signaling pathway in rats. BMC Complement Med Ther 2021;21:13.
Deole YS, Chavan SS, Ashok BK, Ravishankar B, Thakar AB, Chandola HM Evaluation of anti-depressant and anxiolytic activity of Rasayana Ghana Tablet (a compound Ayurvedic formulation) in albino mice. Ayu 2011;32:375-9.
Gupta K, Ashok BK, Ravishankar B, Thakar AB Anti-anxiety and anti-depressant activities of Sarasvata choorna in experimental animals. Ayu 2011;32:590-3.
de Araújo FY, Silva MI, Moura BA, de Oliveira GV, Leal LK, Vasconcelos SM, et al
. Central nervous system effects of the essential oil of the leaves of Alpinia zerumbet
in mice. J Pharm Pharmacol 2009;61:1521-7.
Satou T, Murakami S, Matsuura M, Hayashi S, Koike K Anxiolytic effect and tissue distribution of inhaled Alpinia zerumbet
essential oil in mice. Nat Prod Commun 2010;5:143-6.
Carvalho-Freitas MI, Costa M Anxiolytic and sedative effects of extracts and essential oil from Citrus aurantium
L. Biol Pharm Bull 2002;25:1629-33.
Hailu E, Engidawork E, Asres K The essential oil of Myrtus communis
L. produces a non-sedating anxiolytic effect in mice models of anxiety. Ethiop Pharm J 2011;29:1-12.