Herbal treatment for anxiety: Is it effective?

Some herbal remedies have been studied as treatments for anxiety, but more research is needed to understand the risks and benefits. Keep in mind that there are other ways to help manage anxiety. This includes, for example, using stress management techniques, staying physically active and talking with a therapist to learn ways to cope with anxiety.

Here's what we know — and don't know — about some herbal supplements:

• Kava. Some people use kava as a short-term treatment for anxiety. But reports of serious liver damage — even with short-term use — caused the U.S. Food and Drug Administration (FDA) to issue warnings about the use of dietary supplements containing kava. Although these initial reports of liver toxicity have been questioned, use extra caution and talk with your doctor or other medical professional first if you're thinking about using products that contain kava. Do not use kava if you're pregnant or breastfeeding.
• Passion flower. A few small clinical trials have suggested that passion flower might help with anxiety. In many commercial products, passion flower is combined with other herbs, making it difficult to tell the unique qualities of each herb. When used short-term, passion flower is likely safe when taken as directed. Do not use if you're pregnant or breastfeeding. Some studies found that passion flower can cause sleepiness, dizziness and confusion.
• Valerian. In some studies, people who used valerian reported less anxiety and stress. In other studies, people reported no benefit. Valerian is likely safe at recommended doses for a short time. Because long-term safety trials are lacking, don't take it for more than a few weeks at a time, unless your doctor or other medical professional approves. Do not use if you're pregnant or breastfeeding. Valerian can cause side effects such as headache, dizziness and sleepiness.
• Chamomile. Limited data shows that short-term use of chamomile is likely safe and can be effective in lessening symptoms of anxiety. But chamomile may raise the risk of bleeding when used with blood-thinning medicines, especially if taken at high doses. Use of chamomile can cause allergic reactions in some people who are sensitive to the family of plants that includes chamomile. Other members of this family are ragweed, marigolds, daisies and chrysanthemums. Do not use if you're pregnant or breastfeeding.
• Lavender. Some evidence suggests that oral lavender or aromatherapy with lavender can reduce anxiety. But evidence is limited. Oral lavender can cause constipation, upset stomach and headache. Children and teens should not take oral lavender because it can disrupt hormones. There is not enough evidence to know whether oral lavender is safe to take during pregnancy or when breastfeeding, so do not use it.
• Lemon balm. Some small research studies show that lemon balm can lessen certain symptoms of anxiety, such as worry and excitability. Lemon balm is usually well tolerated and considered safe for short-term use. There is not enough evidence to know whether lemon balm is safe to take during pregnancy or when breastfeeding, so do not use it. Lemon balm sometimes can cause nausea and belly pain.

The FDA does not monitor herbal supplements the same way it monitors medicines. Although improved quality control regulations are in place, the quality of some supplements may still vary. Remember, natural doesn't always mean safe.

If you're thinking about taking any herbal supplement as a treatment for anxiety, talk with your doctor or other medical professional first, especially if you take other medicines. The interaction of some herbal supplements and certain medicines can cause serious side effects.

Some herbal supplements taken for anxiety can cause you to feel sleepy, so they may not be safe to take when driving or doing dangerous tasks. They also can increase the sedative effect of other medicines and supplements. Your doctor or other medical professional can help you understand possible risks and benefits if you choose to try an herbal supplement.

If your anxiety is getting in the way of your daily activities, talk with your medical professional or a mental health professional for advice on ways to manage it. A form of talk therapy called cognitive behavioral therapy often helps reduce anxiety symptoms. It involves working with a therapist to change behavior to reduce anxiety symptoms. High levels of continuing anxiety often need medical treatment along with talk therapy for symptoms to get better.

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