A diagnostic approach to anxiety

Nutraceuticals of note in treatment of anxiety:

Gotu kola (Centella asiatica) [Ayurvedic medicine]

Parts used: fresh & dried leaves & stem

Active constituents: triterpene acids

Dosage: Capsules: 400-600 mg.

Actions & uses: anti-inflammatory, anti-neoplastic, ulcer protective, wound healing, treats varicose veins & improves circulation in lower legs, improves memory & slows the aging process.

Side effects: Large doses may cause drowsiness. Some skin irritation from external applications.

Kava kava (Piper methysticum)

Parts used: peeled, dried, cut rhizome & roots

Efficacy: As effective as prescription drugs oxazepam (Serax) and bromazepam.

Active constituents: kava-lactones

Dosage: 100 mg. up to 3 X daily standardized to 70 mg. kava-lactones per capsule.

Kava kava plus St. John's Wort (300 mg. 3 X daily) is effective for moderate anxiety with depression.

Side effects: Slight morning tiredness. Dry, scaly skin with chronic heavy consumption.

Contraindications: Pregnancy & breastfeeding. Do not take with barbituates, alcohol or antidepressants. Kava is a dopamine antagonist. Contraindicated in endogenous depression because of increased risk of suicide.

Kava has been used by Pacific Island natives for thousands of years.

Panax ginseng or Panax quinquefolus [ aka Asian or American ginseng]

Medicinal parts: dried root

Efficacy: Works best for anxiety due to stress, and for anxious or fatigued elderly.

Active constituents: triterpene saponins, ginsenosides

Other actions & uses: Adaptogen, antioxidant, antineoplastic, antiplatelet, antiviral, hypolipidemic, antiarrhythmic, hypoglycemic, improves cognitive function.

Side effects: (High doses) Headache.

Contraindications: Pregnancy & breastfeeding. Do not take with antidepressants.

Drug interactions: Warfarin/NSAIDS/ antiplatelet agents. Concomitant use of Phenelzine (MAOI) reported to cause headache, tremors, mania. May decrease insulin requirement. Use caution with concomitant caffeine use.

Additional herbs for anxiety:

California Poppy (Eschscholzia californica) 1 tsp/cup steep 15 minutes 2-3 cups day/ 2 droppersful tincture 2-3 X day

Contraindications: Pregnancy/ MAOI antidepressants

Catnip (Nepeta cataria) 1 tsp dried leaves/cup Steep 5-10 minutes. Strain. 2-3 cups day Tincture: 30-40 drops in water 2-3 X day Contraindications: pregnancy

Chamomile (Matricaria recutita) 1 tsp dried flowers/cup 10 minutes. Strain 2-3 cups a day. Tincture: 30 drops in water, 3 X day.

Hops (Humulus lupulus) 1 heaping tsp strobiles/cup steep 10 mins Strain. 2-3 X day Tincture: 30-40 drops/water 2-3 X day

Lavender (Lavandula angustifolia) 1 tsp dried flowers/cup steep 5-10 minutes. Strain. 2-3 cups day. Essential oil of Lavender: Do not take internally! Add 3 drops to an aromatherapy difusser; 10-15 drops to a warm bath; 10-15 drops to an ounce of high quality oil (almond or sesame) for use as a massage oil.

Lemon balm (Melissa officinalis) 1 tsp dried leaf/cup Steep 10 minutes. 2-3 X day Tincture: 60 drops in water 3-4 X day.

Linden (Tilia x europea) 1 tsp dried flowers/cup. 2-3 cups per day. TIncture: 1 tsp in water 3-4 X day.

Passionflower (Passiflora incarnata) 1/2-1 tsp dried herb/cup Steep 10 minutes. Strain. 2-3 cups day. Tincture 30-40 drops 3-4 X day Note: Combines well with Valerian & Hops.

Skullcap (Scutellaria lateriflora) 1-2 tsp dried herb/cup. Steep 10 minutes. Strain. 3-4 X day. Tincture: 30 drops in water 3 X day.

Valerian (Valeriana officinalis) 300-500 mg capsule once or twice daily (Std to .5-.8% valeric acid)