International Journal of Nutrition, Pharmacology, Neurological Diseases

REVIEW ARTICLE
Year
: 2013  |  Volume : 3  |  Issue : 4  |  Page : 325--331

Anxiolytic potential of medicinal plants


Priyanka Thakur, AC Rana 
 Department of Pharmacology Division, Rayat Institute of Pharmacy, Railmajra, (Near Ropar), SBS Nagar, Punjab, India

Correspondence Address:
Priyanka Thakur
Rayat Institute of Pharmacy, Railmajra - 144 533, (Near-Ropar), SBS Nagar, Punjab
India

Abstract

There is a high prevalence of mental and neurological disorders worldwide; these account for 13% of total disability adjusted life years lost due to all diseases and injuries in the world. World Health Organization estimates that 450 million persons suffer from mental illness. Anxiety is widespread, with life-time prevalence rates ranging from 13.6% to 28.8% in Western countries. Individuals aged between 10 years and 25 years are at highest risk for developing an anxiety condition. A large number of herbs are used in the treatment of anxiety disorders. Herbs such as valerian, ginkgo, laghupatha, etc., are the herbs that are used to treat anxiety disorder. These anxiety herbs have lots of common adverse drug reactions such as drowsiness, dizziness, headache, etc. However, most of the herbal drugs are safe for treatment and although, the available pharmacological treatments for these disorders are not much effective, they have many limitations. We have not much treatment options that could safely and effectively alleviate anxiety. A review of the literature was conducted to ascertain and discuss the anxiolytic potential of some medicinal plants present in the lap of nature. It is hoped that the more efficient and effective application of natural products will improve the drug discovery in anxiety. Comprehensive review will pave a way to focus the anxiolytic potential of medicinal plants.



How to cite this article:
Thakur P, Rana A C. Anxiolytic potential of medicinal plants.Int J Nutr Pharmacol Neurol Dis 2013;3:325-331


How to cite this URL:
Thakur P, Rana A C. Anxiolytic potential of medicinal plants. Int J Nutr Pharmacol Neurol Dis [serial online] 2013 [cited 2019 Nov 22 ];3:325-331
Available from: http://www.ijnpnd.com/text.asp?2013/3/4/325/119838


Full Text

 Introduction



Anxiety is a complex progressive behavioral and physiological alteration of the organism, which ultimately leads to wide variety of central nervous system (CNS) disorders, if remain untreated. In addition to individual genetic factors external influences, such as nutrition, smoking, alcohol, socioeconomic status, environmental conditions etc., can strongly contribute to its anticipated appearance. [1] During the whole life a human being is confronted with social, psychological, and emotional stress. Chronic social stress is one of the most important factors responsible for precipitation of depressive disorder in humans. In recent years, the impact of social stress on the development of psychopathologies has been thoroughly investigated in pre-clinical animal studies. It is an emotional state, unpleasant in nature, associated with uneasiness, discomfort and concern or fear about some defined or undefined future threat. Some degree of anxiety is a part of normal life. Treatment is needed when it is disproportionate to the situation and excessive. Some psychotics and depressed patients also exhibit pathological anxiety. Anxiety is a universal phenomenon and to experience it in appropriate circumstances is the normal response. It may serve to enhance the vigilance and drive. However, if anxiety symptoms are frequent and persist in severe form, they are a cause of distress/suffering and markedly impair performance. It should be treated with drugs only when excessive and disabling in its own right. [1]

Types of anxiety

There are many types of anxiety such as General anxiety, Obsessive compulsive disorder, Panic disorder, Performance Anxiety, Post-traumatic stress disorder, Separation anxiety, Social anxiety, Specific phobias, State anxiety, and Trait anxiety. [2]

Symptoms of anxiety

Anxiety includes, mental, emotional, physical, behavioral and social symptoms. [3],[4] Mental symptoms of anxiety such as confusion, hyper-reactivity, hyper-sensitivity, hyper-vigilance, poor concentration, poor judgment, and poor memory. [5]

Some of the emotional symptoms of anxiety include: Agitation, Anger, Confusion, Fear about specific things, health problems, spiders, memories general fears for self and loved ones, safety, health, and financial security. [3] Some of the physical symptoms of anxiety include: Headaches, Heart palpitations, Joint pain, Muscle aches, Pain, Rapid breathing. Some of the physiological symptoms of anxiety include: Sweating. [6]

Some of the behavioral symptoms of anxiety include: As in the case of depression, people who suffer anxiety will tend to: Avoidance of performance, Avoidance of the feared thing, Drink excessively. Excessive attention to control or details in order to prevent mistakes, Indulge in promiscuity or reckless sex, other reckless behaviors such as excessive spending. Social avoidance, some people will avoid responsibility in order to decrease their anxiety. [4]

Pathophysiology of anxiety disorders

Behavioral traits are passed from parents to child, anxiety disorders tend to run through family structures. Studies comparing the risk of psychiatric illness in identical twins (who share 100% of their DNA) have found that, if one identical twin has a psychiatric condition, the risk that the other twin will have the same condition is approximately 50%. It appears that non-genetic factors, including, environmental influences occurring throughout the life-span, must also contribute to the risk of developing an anxiety disorder. The human body attempts to maintain homeostasis. Anything in the environment that disturbs homeostasis is defined as a stressor. Homeostatic balance is then re-established by physiologic adaptations that occur in response to the stress response. The stress response in humans involves a cascade of hormonal events, including, the release of corticotrophin releasing factor (CRF), which, stimulates the release of corticotropin leading to release of the stress hormones (glucocorticoids and epinephrine) from the adrenal cortex. The glucocorticoids typically exert negative feedback to the hypothalamus, thus, decreasing the release of CRF6. The stress response is hardwired into the brain of the typical mammal and is most often triggered when survival of the organism is threatened. The primate stress response can be triggered not only by a physical challenge, but also by the anticipation of a homeostatic challenge. As a result, when humans chronically believe that a homeostatic challenge is about to occur, they enter the realm of neurosis, anxiety, and paranoia. The amygdala is the primary modulator of the response to fear/anxiety inducing stimuli. It is registering the emotional significance of stressful stimuli and creating emotional memories. The amygdala receives input from neurons in the cortex and being stuck in traffic, in a crowded shopping mall, or on an airplane that may serve to trigger the anxiety response in a susceptible individual via this mechanism. The amygdala also receives sensory input that bypasses the cortex and tends to be subconscious. An example is that of a victim of sexual abuse who suddenly finds herself acutely anxious when interacting with a number of friendly people. [1] It may take her a few moments to realize that characteristics of the individuals with whom she is interacting remind her of the person who abused her. When activated, the amygdala stimulates regions of the midbrain and brain stem, causing autonomic hyperactivity, which can be correlated with the physical symptoms of anxiety. [7],[8] Thus, the stress response involves activation of the hypothalamic-pituitary-adrenal axis. This axis is hyperactivein depression and in anxiety disorders.

Neurotransmitters involved in anxiety

Neurotransmitters are chemicals located and released in the brain to allow an impulse from one nerve cell to pass to another nerve cell. There are approximately 50 neurotransmitters identified. Some common neurotransmitters are acetylcholine, norepinephrine, dopamine, serotonin, and gamma aminobutyric acid (GABA). Acetylcholine and norepinephrine are excitatory neurotransmitters while dopamine, serotonin, and GABA are inhibitory. Each neurotransmitter can directly or indirectly influence neurons in a specific portion of the brain, thereby affecting behavior. [8],[9]

Some of the receptors in the brain responsible for anxiety/anti-anxiety

Benzodiazepine receptors [10]Serotonin receptors (5-hydroxytriptamine): 5-hydroxytryptamine 1A (5 HT 1A ) [11]5-HT 3 receptor: 5-HT 3 receptor antagonism contributes the anxiolytic effect [12]Selective 5-HT reuptake inhibitors.y-aminobutyric acid receptor (GABA) [13],[14],[15]GABA A -benzodiazepine receptorHistamine receptor (H-receptor). H-receptor plays an important role in anxiety and other CNS disorders with reference to H 1 , H 2 , H 3 receptors [16]Opoid receptors [17]Adenosine A1 receptors [18]Dopaminergic receptor: (D 2 ) receptors [19]Somodendritic auto receptors [20],[21]Adrenergic receptors. [19]Some brand drugs used in anxiety

ENXOLAM, ALPRAX, ALPRAX SR, ANXIT, ANXYL, ANAX, ZOLAX, BUSPIN, EQUILLIBRIUM and LIBRIUM (chlordiazepoxide, common salt).

Side effect of allopathic formulations/anxiolytics

Anxiolytic substances, mostly belonging to the benzodiazepine group, occupy a prominent post in the ranking of the most utilized drugs by man [22] to minimize stress, tension and anxiety, [23] as a result of these effects, benzodiazepines are also able to treat insomnia. [24] However, the anxiolytic drugs have an unfavorable risk/benefit ratio, as they produce anterograde amnesia, dependence, abstinence syndrome, paradoxical reaction in humans and decay of psychomotor functions. [25],[26] These symptoms can lead to an increased possibility of car accidents and of fractures. Therefore, research has been conducted to identify safer, more specific medications possessing anxiolytic effect without the complications. In the past few years, several herbal medicines have been used for the management of anxiety in the world. [27]

Herbal/traditional medicinal plants with anxiolytic potential

Herbal medicines are popular as remedies for diseases and play a key role in the human health-care of a vast majority of world's population. World's populations rely on the use of traditional medicine, which is predominantly based on plant material. The traditional medicine refers to a broad range of ancient natural health care practices and these medicinal practices have originated from time immemorial and developed gradually, to a large extent, by relying or based on practical experiences, without significant references to modern scientific principles. Although, herbal medicines are effective in the treatment of various ailments, very often these drugs are unscientifically exploited or improperly used. Therefore, these plant drugs deserve detailed studies in the light of modern science.

Traditions are dynamic entities of unchanging knowledge. Traditional medicine is in an evolutionary process as communities and individuals continue to discover new techniques that can transform practices. Ethnopharmacology and drug discovery using natural products remain important issues in the current target-rich, lead-poor scenario. [28] Many modern drugs have their origin in ethnopharmacology. However, despite technological advances, the drug discovery process is facing a major innovation deficit that is adversely affecting the pharmaceutical industry. Many recent studies suggest that entry barriers have fallen over time for new drug introductions. [29] The ethnopharmacology knowledge and experimental base allows drug research from "Clinics to Laboratories" -a true Reverse Pharmacology Approach. [30] In this process, "safety" remains the most important starting point and the efficacy becomes a matter of validation. A golden triangle consisting of Traditional Knowledge, Modern Medicine, and Modern Science with systems orientation will converge to form an innovative discovery engine for newer, safer, affordable and effective therapies. [31] The medicinal plants that have anxiolytic potential are shown in [Table 1].{Table 1}

 Discussion and Conclusion



Life without natural products is unimaginable. It has provided mankind with oxygen, water, fire, food, clothing, shelter, and medicine. Its public health impact is considerably high, especially of traditional medicines/herbal products and nature-based modern drugs. The traditional medicines, despite its limitations, are addressing the health needs of millions of people worldwide. [68] From the earliest times, herbs have been prized for their pain-relieving and healing abilities and today we still rely largely on the curative properties of plants. According to World Health Organization, 80% of the people living in rural areas depend on medicinal herbs as primary healthcare system. Science has long acknowledged the value of healing substances found in nature, such as digitalis, aspirin, penicillin, insulin, steroids, etc. There has been a resurgence of interest, both scientifically and popularly, in the utilization of natural approaches. [69] There are many historical examples in which the natural product has not just been the medicinal product but has also helped reveal a novel aspect of physiology. During past few decades, the traditional system of medicine has gained importance in the field of medicine. In developing countries, most of the people prefer traditional system of medicine for their treatment. Traditional medicines are increasingly getting more popular mainly because: (a) It is holistic system with less side-effect; (b) it is evolving as an evidence-based medicine; (c) its ethnomedical knowledge is applicable to modern drug discovery programs. Probably, traditional medicines could provide a solution in fighting them both as a health-care delivery mechanism and as a means of chemotherapeutic pool. Knowledge of traditional medicines and their development pave way for a new drug discovery. [69]

The review covered all aspects of traditional medicines and revealed that a detailed experimental as well as standardization study is required to explore the plants and their uses to treat serious complication like anxiety or anxiety like behavior. It is hoped that the more efficient and effective application of natural products/medicinal plants will improve the drug discovery process.

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