Abstract: Can passion flower treat anxiety?
Jaqueline Simpson, Brenae Ashton, Cassandra Wilson
Background: Discovered by Spanish explorers, the Passion flower was named to symbolize the passion of Christ for its striking purple and white flowers. The tree, also called Passiflora incarnata, and is more known for the fruit it produces, the passion fruit. It is native to central and south America, and is also found in parts of south-eastern United States.
Mechanism of action: Similarly to benzodiazepines, passion flower is thought to disrupt GABA uptake in the synapses of neurons; additionally passionflower has shown an affinity for both GABA𝛼 and GABAᵦ receptors. The result of these actions is similar to those of benzodiazepines, resulting in sedative and anti-anxiolytic effects.1
Side effects: Overall, passion flower is generally well tolerated, but can cause side effects often seen with CNS depressants like: confusion, dizziness, and sedation.1
Drug interactions: Due to its sedative effects, passion flower is thought to have an interaction with CNS depressants, causing an additive effect and increasing the likelihood of side effects.1 Passionflower is also thought to have a minor interaction with organic anion-transporting polypeptide (OATP) substrates by reducing the bioavailability of OATP2B1 and OATP1A2.1
Clinical Evidence: One study aimed to examine the effects of dried passion flower extract in the treatment of
non-specific anxiety. 2,928 patients were enrolled in the multicentre, open-label, observational study. Patients’ anxiety was measured using the Hamilton Anxiety Rating Scale (HAM-A) at visit 1 and visit 2 to determine efficacy via a reduction in HAM-A scores. Patients were given 400 mg of passion flower extract to be taken twice daily at visit 1 until their follow-up visit 2-8 weeks later (visit 2). The results of the study showed that there was a 41% decrease in HAM-A scores at visit 2 that ranged from 25.6 (SD = 8.3) to 15.4 (SD = 7.7). It was also noted that 15.6% of participants in the general study population and 7.1% in the ITT study population were considered to be in remission at visit 2 identified by a HAM-A score ≤ 7. The author’s concluded that the dry extract of passion flower shows therapeutic evidence for the treatment of anxiety. However, despite promising results, the study had multiple limitations that included a lack of control group, randomization, blinding, and any record of compliance to treatment.1,2
Another study aimed to evaluate the efficacy of passion flower in reducing anxiety before dental procedures. A randomized, one-sided clinical trial of 63 patients with moderate, high and severe anxiety in need of periodontal work were randomly divided into 3 groups consisting of 21 participants each. Levels of anxiety were measured and averaged in each group both before and after the procedure using the Corah’s DAS-R questionnaire. The first group was administered passion flower drops (90 drops) before and after treatment. The second group was given a placebo, administered in the same manner as described previously. The third group did not receive any treatment or placebo and was considered the negative control group. Results showed that anxiety levels in each group dropped from 12.09 to 8.47, 12.00 to 10.52, and 11.66 to 11.23 for each group, respectively. The authors of the study concluded that administration of passion flower as a premedication is to be considered very effective in reducing overall anxiety. Since this is the first study of its kind, additional research and studies must be conducted in order to accurately consider passion flower as an anxiolytic remedy.3
Conclusion: Passion Flower uses vary from treating anxiety, to diabetes, to cough. However, it is not recommended for treatment of any disease due to lack of quality studies.1
- Natural Medicines Comprehensive Database. https://naturalmedicines-therapeuticresearch-com.ezproxy.lib.utah.edu/databases/food,-herbs-supplements/professional.aspx?productid=871
- Ansseau M, Seidel L, Crosset A, Dierckxsens Y, Albert A. A dry extract of Passiflora incarnata L. (Sedanxio) as first intention treatment of patients consulting for anxiety problems in general practice. Acta Psychiatrica Belgica 2012;112(3):5-11.
- com. https://www.drugs.com/npp/passion-flower.html
- Kaviani N, Tavakoli M, Tabanmehr M, Havaei R. The efficacy of passiflora incarnata linnaeus in reducing dental anxiety in patients undergoing periodontal treatment. J Dent (Shiraz). 2013 Jun;14(2):68-72.
- National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/passionflower
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