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1.
Braz. J. Pharm. Sci. (Online) ; 59: e21025, 2023. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1439501

RESUMEN

Abstract The present study investigated the effects of valerian methanolic extract and valerenic acid on the expression of LL-37 gene and protein in A549 and MRC5 line cells. After preparing Valerian seeds, sowing them in March 2020, and harvesting the rhizome in October 2020, the extract was prepared from the valerian rhizome by maceration method. Valerian acid content was determined using high performance liquid chromatography (HPLC). Two cell lines (A549 and MRC-5) were used to study the effects of valerian extract, and the MTT test was used to evaluate cell viability. The expression of LL-37 mRNA and protein was assessed by Real-Time PCR and western blot, respectively. In vivo safety assessments and histopathological analysis were also conducted. Data was analyzed by Graphpad Prism 8 software. Valerian methanolic extract and valerenic acid upregulated the LL-37 mRNA and protein expression in both treated cell lines. Valerenic acid showed a greater effect on upregulating LL-37 expression than valerian methanolic extract. A549 cells were more sensitive to valerian methanolic extract compared to MRC5 cells, and its cell viability was reduced. Furthermore, liver and kidney-related safety assessments showed that valerian methanolic extract had no toxic effects. In general, it was concluded that the methanolic extract of valerian as well as the resulting valerenic acid as the most important component of the extract has the ability to upregulate LL-37expression. Therefore, methanolic extract of valerian and valerenic acid can be considered for improving the immune system.


Asunto(s)
Valeriana/efectos adversos , Extractos Vegetales/efectos adversos , Catelicidinas/efectos adversos , Western Blotting/instrumentación , Cromatografía Líquida de Alta Presión/métodos , Péptidos Catiónicos Antimicrobianos/agonistas , Células A549/clasificación , Genes/genética , Hígado/anomalías
2.
J Integr Med ; 17(5): 338-343, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31113761

RESUMEN

OBJECTIVE: Assessing adverse drug reactions (ADRs) is a proven method to estimate the safety of medicines. The ADRs to herbal medicines in Australia (and by inference, the safety of herbal medicines in Australia) remain unknown. This study examines spontaneous ADR cases to four of the most popular herbs in Australia from 2000 to 2015: echinacea (Echinacea purpurea), valerian (Valeriana officinalis), black cohosh (Actaea racemosa) and ginkgo (Ginkgo biloba). METHODS: ADRs of echinacea, valerian, black cohosh and ginkgo reported to the Australian Therapeutic Goods Administration (TGA) between 2000 and 2015 were obtained from the TGA database. Data were collated and analysed according to age, sex, severity, type of ADR and body system affected. Statistics were calculated using GraphPad Prism software. RESULTS: Most ADRs were mild or moderate. However, every herbal medicine was associated with life-threatening ADRs. In each life-threatening case, the herbal medicine was taken concomitantly with prescription medications. Black cohosh was associated with a significant number of severe ADRs (30.3% of the total), with 39.4% of these ADRs being associated with abnormal hepatic function, hepatitis or hepatotoxicity. CONCLUSION: This study highlights the lack of public awareness with regard to herb-drug interactions, since most of the severe ADRs involved a herb-drug interaction.


Asunto(s)
Cimicifuga/efectos adversos , Echinacea/efectos adversos , Ginkgo biloba/efectos adversos , Interacciones de Hierba-Droga , Preparaciones de Plantas/efectos adversos , Valeriana/efectos adversos , Adulto , Anciano , Australia/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Plantas Medicinales/efectos adversos
3.
Women Health ; 58(3): 297-304, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-28278010

RESUMEN

Valerian is one of the most widely used herbal supplements and a phytoestrogenic herb. The aim of this study was to determine the effect of Valerian on the severity and frequency of hot flashes. This triple-blind, randomized, controlled clinical trial was conducted during a three-month period in Hamadan, Iran, in 60 postmenopausal women aged 45-55 years. Participants were randomly assigned to one of two groups- either placebo or Valerian. An oral Valerian 530 mg capsule was given twice per day for two months. An oral placebo 530 mg capsule (starch) was similarly administered. The severity and frequency of hot flashes were determined by the Kupperman index, before the intervention, one month after, and two months after initiation of the intervention. The severity of hot flashes in the Valerian group was significantly lower than that in the placebo group at one (p = .048) and two months (p = .020) after initiation of the intervention. Compared with the placebo group, the mean frequency of hot flashes was significantly reduced two months after initiating the use of Valerian (p = .033). Health-care providers should consider Valerian to be effective for menopausal women with hot flashes.


Asunto(s)
Sofocos/tratamiento farmacológico , Menopausia/efectos de los fármacos , Valeriana/efectos adversos , Femenino , Sofocos/epidemiología , Humanos , Irán/epidemiología , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
4.
Braz. j. oral sci ; 14(1): 60-65, Jan-Mar/2015. tab, graf
Artículo en Inglés | LILACS | ID: lil-745780

RESUMEN

To evaluate in vivo the association of hypericum Hypericum perforatum, valerian Valeriana officinalis and kava Piper methysticum with analgesia by assessing their effects in reducing orofacial pain as well as the possible hepatic, hematologic and biochemical alterations induced by regular administration of these extracts. METHODS: Orofacial pain was induced in mice with the administration of 2.5% formalin in the upper lip. After 60 min, the animals were treated with saline, carbamazepine and hydroalcoholic plant extracts. The nociceptive intensity was determined by the timing at which the animal remained rubbing the injected area. To assess the hepatotoxic effect, mice were chronically treated for 25 days with saline, carbamazepine and hydroalcoholic extract. The animals were euthanized and the liver weighed, followed by a differential count of leukocytes and measurement of alanine transaminase and alkaline phosphatase. RESULTS: The evaluation of analgesic activity in phase 1 reduced the time of rubbing compared to the control by 86% 0.05 mL/10 g and 76% 0.10 mL/10 g. In phase 2, the extracts reduced rubbing time by 94% and 85%, respectively. In the evaluation of alkaline phosphatase, the groups treated with extracts at doses of 0.05 mL/10 g and 0.1 mL/10 g increased by 16.1% and 9.5% compared to the control group and a reduction of 8.5% and 9.1% in the evaluation of alanine transaminase respectively. It was demonstrated that in the differential counts showed an increase in eosinophils in the treated group with 0.05 mL/10 g. CONCLUSIONS: The use of hydroalcoholic extract of the associated plants reduced the orofacial formalin-induced pain with better results than carbamazepine, at both the neural conductor level of pain phase 1 and in inflammatory or later pain phase 2 without presenting hepatotoxicity. The observed eosinophilia is suggestive of a phenomenon called hormesis...


Asunto(s)
Animales , Ratas , Dolor Facial , Hypericum/efectos adversos , Kava/efectos adversos , Trastornos de la Articulación Temporomandibular , Valeriana/efectos adversos , Analgésicos/uso terapéutico , Anestésicos/uso terapéutico , Extractos Vegetales/uso terapéutico , Fitoterapia , Plantas Medicinales , Preparaciones de Plantas/uso terapéutico
5.
Psychiatr Clin North Am ; 36(1): 85-91, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23538079

RESUMEN

Many cultures have developed folk herbal remedies to treat symptoms of mental illness. An evidence-based view is now being developed for some of these so-called alternative herbal treatments. This article discusses clinically relevant scientific information on medicinal extracts of 4 herbs: saffron, passionflower, valerian, and sage.


Asunto(s)
Crocus , Trastornos Mentales/tratamiento farmacológico , Passiflora , Fitoterapia , Extractos Vegetales/uso terapéutico , Salvia officinalis , Valeriana , Crocus/efectos adversos , Humanos , Passiflora/efectos adversos , Fitoterapia/efectos adversos , Extractos Vegetales/efectos adversos , Salvia officinalis/efectos adversos , Valeriana/efectos adversos
6.
Pediatr Clin North Am ; 58(1): 33-54, x, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-21281847

RESUMEN

An increasing number of studies have evaluated the role of herbal supplements in pediatric disorders, but they have numerous limitations. This review provides an overview of herbal components, regulation of supplements, and importance of product quality assurance. Use of herbal supplements is discussed with reference to factors that influence use in the pediatric population. The remainder of the article discusses the use of St John's wort, melatonin, kava, valerian, eicosapentaenoic acid, and docosahexaenoic acid, focusing on indications, adverse effects, and drug interactions, and providing a limited efficacy review. Herbal supplements used for weight loss are also briefly discussed.


Asunto(s)
Medicina de Hierbas , Trastornos Mentales/tratamiento farmacológico , Fitoterapia/métodos , Preparaciones de Plantas/farmacología , Adolescente , Niño , Suplementos Dietéticos , Ácidos Docosahexaenoicos/efectos adversos , Ácidos Docosahexaenoicos/farmacología , Ácido Eicosapentaenoico/efectos adversos , Ácido Eicosapentaenoico/farmacología , Interacciones de Hierba-Droga , Humanos , Hypericum/efectos adversos , Kava/efectos adversos , Melatonina/efectos adversos , Melatonina/farmacología , Fitoterapia/efectos adversos , Preparaciones de Plantas/efectos adversos , Valeriana/efectos adversos
7.
Aesthet Surg J ; 29(2): 150-7, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19371848

RESUMEN

Most medications, herbal preparations, and nutraceutical supplements have notable effects on biochemical pathways and may influence wound healing, coagulation, and cardiovascular function. They can also interact with other drugs. A large portion of the data available regarding the effects of naturopathic medicines is anecdotal. Marketing of certain products may be misleading and potentially harmful, and quality control standards are highly variable. In order to ensure quality control and standardization of products, it is prudent to work with preparations manufactured by companies that adhere to pharmaceutical (good manufacturing practice [GMP]) standards. However, many of these higher-quality products are not readily available to the public over the counter. A large percentage of patients undergoing plastic surgery use one or more herbal medications, but the disclosure of such medications to allopathic providers is often incomplete. In addition, patients may not understand the importance of discontinuing such medications before surgery. The authors review research on the possible benefits and risks of commonly used herbal medications such as arnica montana, St. John's wort, bromelain, echinacea, ginkgo biloba, ephedra, valerian, and others, focusing on their potentially positive or negative impact during the perioperative period of aesthetic surgery. Good communication with surgical patients, including the administration of a presurgical questionnaire to help identify any use of herbal medications, is emphasized.


Asunto(s)
Suplementos Dietéticos/efectos adversos , Atención Perioperativa , Preparaciones de Plantas/efectos adversos , Procedimientos de Cirugía Plástica , Arnica/efectos adversos , Arnica/metabolismo , Bromelaínas/efectos adversos , Bromelaínas/metabolismo , Interacciones Farmacológicas , Echinacea/efectos adversos , Echinacea/metabolismo , Ephedra/efectos adversos , Ephedra/metabolismo , Ginkgo biloba/efectos adversos , Ginkgo biloba/metabolismo , Interacciones de Hierba-Droga , Humanos , Hypericum/efectos adversos , Hypericum/metabolismo , Preparaciones de Plantas/metabolismo , Control de Calidad , Cirugía Plástica , Valeriana/efectos adversos , Valeriana/metabolismo
8.
Orv Hetil ; 150(12): 555-7, 2009 Mar 22.
Artículo en Húngaro | MEDLINE | ID: mdl-19275973

RESUMEN

The use of valeriana was underplayed at the beginning of the 20th century because of its addictive and side effects. The 38-year-old woman, mother of a 20-month-old child from Eastern Europe, was treated with liver insufficiency and vascular, parenchymal decompensated cirrhosis needing plasmapheresis for the first time in our hospital. In case history, abusus of aethyl-alcohol and valeriana was found to be as toxic agent which was treated as the etiologic factor of the liver disease and liver failure. After intensive and conservative treatment her status was stabilised, during the follow-up she had no signs and symptoms, the laboratory results tend to be in normal range. Half year after her hospitalization intensive care treatment was necessary abroad due to gastric bleeding. In the background the histology of gastric biopsy taken during gastroscopic examination showed gastric sigillocellular carcinoma in our hospital. Total gastrectomy, omentectomy, lymphadenectomy were performed, the tumor was removed and she received cytostatic treatment. The use of valeriana and aethyl-alcohol is supposed to have a potential effect on tumorgenesis and on the increase of toxicity.


Asunto(s)
Alcoholismo/complicaciones , Carcinoma , Fallo Hepático , Neoplasias Gástricas , Valeriana/efectos adversos , Adulto , Carcinoma/complicaciones , Carcinoma/diagnóstico , Carcinoma/etiología , Carcinoma/terapia , Femenino , Hemorragia Gastrointestinal/etiología , Humanos , Hipnóticos y Sedantes/efectos adversos , Fallo Hepático/inducido químicamente , Fallo Hepático/diagnóstico , Fallo Hepático/etiología , Fallo Hepático/terapia , Plasmaféresis , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/etiología , Neoplasias Gástricas/terapia
9.
Rev. centroam. obstet. ginecol ; 14(1): 15-18, ene.-mar. 2009.
Artículo en Español | LILACS | ID: lil-644066

RESUMEN

Los trastornos por ansiedad y las alteraciones del sueño, representan un problema de salud de una alta incidencia y un importante efecto potencial en la calidad de vida de la población, especialmente en los países económicamente desarrollados. Ante este tipo de cuadros clínicos, es fundamental en todos los casos la valoración por parte de un especialista, para descartar la existencia de una patología orgánica y/o psiquiátrica de base.


Asunto(s)
Adulto , Passiflora/efectos adversos , Valeriana/efectos adversos
11.
Food Chem Toxicol ; 46(7): 2369-75, 2008 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-18474410

RESUMEN

This study was designed to determine whether the treatment with haloperidol (HP), valerian or both in association impairs the liver or kidney functions. Valerian alone did not affect oxidative stress parameters in the liver or kidney of rats. HP alone only increased glutathione (GSH) depletion in liver, but not in kidney. However, when HP was associated with valerian, an increase in lipid peroxidation levels and dichlorofluorescein (DCFH) reactive species production was observed in the hepatic tissue. Superoxide dismutase (SOD) and Catalase (CAT) activities were not affected by the HP plus valerian treatment in the liver and kidney of rats. HP and valerian when administered independently did not affect the activity of hepatic and renal delta-aminolevulinate dehydratase (delta-ALA-D), however, these drugs administered concomitantly provoked an inhibition of hepatic delta-ALA-D activity. The delta-ALA-D reactivation index was higher in rats treated with HP plus valerian than other treated groups. These results strengthen the view that delta-ALA-D can be considered a marker for oxidative stress. Serum aspartate aminotransferase (AST) activity was not altered by any treatment. However, serum alanine aminotransferase (ALT) activity was higher in the HP group and HP plus valerian group. Our findings suggest adverse interactions between haloperidol and valerian.


Asunto(s)
Haloperidol/efectos adversos , Riñón/efectos de los fármacos , Hígado/efectos de los fármacos , Valeriana/efectos adversos , Alanina Transaminasa/sangre , Alanina Transaminasa/metabolismo , Animales , Aspartato Aminotransferasas/sangre , Aspartato Aminotransferasas/metabolismo , Biomarcadores/sangre , Biomarcadores/metabolismo , Catalasa/sangre , Catalasa/metabolismo , Interacciones Farmacológicas , Glutatión/sangre , Glutatión/metabolismo , Glutatión Peroxidasa/sangre , Glutatión Peroxidasa/metabolismo , Haloperidol/uso terapéutico , Riñón/enzimología , Riñón/metabolismo , Riñón/fisiología , Peroxidación de Lípido/efectos de los fármacos , Hígado/enzimología , Hígado/metabolismo , Hígado/fisiología , Masculino , Oxidación-Reducción , Estrés Oxidativo/efectos de los fármacos , Porfobilinógeno Sintasa/antagonistas & inhibidores , Porfobilinógeno Sintasa/sangre , Porfobilinógeno Sintasa/metabolismo , Distribución Aleatoria , Ratas , Ratas Wistar , Superóxido Dismutasa/sangre , Superóxido Dismutasa/metabolismo
13.
Pharmacoepidemiol Drug Saf ; 17(2): 151-9, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17992658

RESUMEN

PURPOSE: To study characteristics of women using herbal drugs and the possible impact of use in early pregnancy on pregnancy outcome. METHODS: Data on the use of herbal drugs during pregnancy were obtained from the Swedish Medical Birth Register during the period 1st July 1995 to end of 2004. Women who reported use of herbal drugs were compared to all women giving birth during the period. Outcome variables were prematurity, birth weight, Apgar score, number of infants in delivery and congenital malformations. RESULTS: Among the 860 215 women in the register, 787 (0.9%) reported use of herbal drugs during early pregnancy. The most frequently used herbal drugs were Floradix (iron-rich herbs), ginseng and valerian. Use of such drugs was independently associated with high maternal age, normal weight and 14-15 years of education. Risk factors for valerian differed from those for other herbal drugs, for example with respect to maternal smoking and country of birth. Concomitant drug use was common and the most frequently used drugs were multivitamins, folic acid, cardiovascular drugs (mainly antihypertensive drugs), non-steroid anti-inflammatory drugs (NSAIDs), analgesics and psycholeptics. None of the infant characteristics studied were influenced significantly by the mother's use of the examined herbal drugs during early pregnancy. CONCLUSIONS: The most commonly reported herbal drugs used during pregnancy were Floradix (iron-rich herbs), ginseng and valerian. No signs of unfavourable effect on pregnancy outcome were seen. The number of exposures, however, was low and therefore effects on rare outcomes (e.g. specific malformations) cannot be excluded.


Asunto(s)
Fitoterapia/efectos adversos , Preparaciones de Plantas/efectos adversos , Plantas Medicinales/efectos adversos , Resultado del Embarazo , Adulto , Puntaje de Apgar , Peso al Nacer/efectos de los fármacos , Anomalías Congénitas/etiología , Escolaridad , Femenino , Humanos , Compuestos de Hierro/efectos adversos , Edad Materna , Panax/efectos adversos , Embarazo , Complicaciones del Embarazo/tratamiento farmacológico , Embarazo Múltiple , Nacimiento Prematuro/etiología , Sistema de Registros/estadística & datos numéricos , Factores de Riesgo , Suecia , Valeriana/efectos adversos
14.
Sleep ; 30(7): 881-4, 2007 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-17682659

RESUMEN

STUDY OBJECTIVE: Many people use dietary supplements or herbal products to help them sleep. We analyzed the associations between melatonin use and insomnia and between valerian use and insomnia in a representative sample of the United States population. DESIGN AND PARTICIPANTS: The data reported upon here were collected in the 2002 Alternative Health/Complementary and Alternative Medicine (CAM) Supplement to the National Health Interview Survey. This was a survey of 31,044 personal interviews that constituted an age-representative and socioeconomically representative sample of the civilian noninstitutionalized population of the United States. RESULTS: Of the survey sample, 5.9% used valerian and 5.2% used melatonin. Of those using valerian, 29.9% endorsed insomnia as 1 reason for CAM use, and, of melatonin users, 27.5% endorsed insomnia as 1 reason for CAM use. Relatively greater use occurred in individuals under age 60 years. The decision to use such substances was made in consultation with a health care provider less than half of the time. CONCLUSIONS: Large segments of the United States population used valerian or melatonin for insomnia within the year preceding the survey, and usage typically fell outside the purview of the health care system.


Asunto(s)
Antioxidantes/efectos adversos , Melatonina/efectos adversos , Trastornos del Inicio y del Mantenimiento del Sueño/inducido químicamente , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Encuestas y Cuestionarios , Valeriana/efectos adversos , Adulto , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología
15.
Sleep Med Rev ; 11(3): 209-30, 2007 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-17517355

RESUMEN

Valerian is an herb that is widely available in a variety of commercial preparations and is commonly used as a sleep aid. A recent systematic review and meta-analysis of valerian concluded that evidence in support of the effectiveness of the herb was inconclusive. Therefore, in an effort to more closely examine this issue, a systematic review was conducted to examine the evidence on the efficacy of valerian as a sleep aid with specific attention to the type of preparations tested and the characteristics of the subjects studied. A comprehensive search of studies investigating valerian was conducted through computerized databases and hand searches of reference lists. Standardized forms were used to summarize findings and standardized criteria were used to assess study quality. Out of 592 articles initially identified, a total of 36 articles describing 37 separate studies met criteria for review: 29 controlled trials evaluated for both efficacy and safety, and eight open-label trials evaluated for safety only. Most studies found no significant differences between valerian and placebo either in healthy individuals or in persons with general sleep disturbance or insomnia. None of the most recent studies, which were also the most methodologically rigorous, found significant effects of valerian on sleep. Overall, the evidence, while supporting that valerian is a safe herb associated with only rare adverse events, does not support the clinical efficacy of valerian as a sleep aid for insomnia.


Asunto(s)
Fitoterapia/métodos , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Valeriana , Seguridad de Productos para el Consumidor , Humanos , Resultado del Tratamiento , Valeriana/efectos adversos
16.
Xenobiotica ; 37(2): 113-23, 2007 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17484515

RESUMEN

Valerian preparations alone or in combination with hops are popular over-the-counter products used for sleep disturbances or anxiety. Therefore, it is important to characterize the effect of these products on the activity of human drug-metabolizing enzymes. The inhibitory effects of valerian and valerian/hops extracts as well as valerenic acid (a major constituent of valerian) on glucuronidation were evaluated in human liver microsomes and with expressed uridine 5'-diphosphate (UDP)-glucuronosyltransferases (UGT). Methanolic extracts of two herbal preparations caused significant reductions in the rate of formation of acetaminophen, oestradiol, morphine, and testosterone glucuronides. Oestradiol glucuronidation at the 3-hydroxy position was inhibited by nearly 87% in microsomal incubations. In addition, marked reductions in UGT1A1 and UGT2B7 activities were observed in the presence of the herbal extracts using oestradiol and morphine as probe substrates, respectively. Valerenic acid also demonstrated significant inhibitory effects on the glucuronidation of acetaminophen, oestradiol, and morphine with both microsomes and expressed UGTs. The relatively low IC50 values obtained for valerenic acid in microsomal incubations may indicate that this essential oil contributes to the effects observed with herbal extracts in inhibiting glucuronidation in vitro. Overall, these findings suggest that valerian-containing products may interfere with the glucuronidation of endo- and xenobiotics.


Asunto(s)
Glucurónidos/metabolismo , Indenos/efectos adversos , Extractos Vegetales/efectos adversos , Sesquiterpenos/efectos adversos , Valeriana/efectos adversos , Xenobióticos/metabolismo , Acetaminofén/metabolismo , Inhibidores Enzimáticos/efectos adversos , Estradiol/metabolismo , Glucuronosiltransferasa/antagonistas & inhibidores , Humanos , Humulus , Técnicas In Vitro , Cinética , Microsomas Hepáticos/efectos de los fármacos , Microsomas Hepáticos/metabolismo , Morfina/metabolismo , Fitoterapia/efectos adversos , Proteínas Recombinantes/antagonistas & inhibidores , Testosterona/metabolismo
18.
Medicine (Baltimore) ; 84(4): 197-207, 2005 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16010204

RESUMEN

The herbal extracts kava and valerian are the leading dietary supplements used in the self-management of anxiety and insomnia, respectively. There is limited evidence to support their effectiveness for these common symptoms. The Internet has been used to a limited extent for research, but it is not known whether randomized controlled trials can be conducted entirely using Internet technology. We performed a randomized, double-blind, placebo-controlled trial using a novel Internet-based design to determine if kava is effective for reducing anxiety and if valerian is effective for improving sleep quality. E-mail recruitment letters and banner advertisements on websites were used to recruit a large pool of interested participants (1551) from 45 states over an 8-week period. Participants were first asked to read study information, complete an online informed consent process, and undergo electronic identity verification. In order to be eligible for the study, participants were required to have 1) anxiety as documented by scores of at least 0.5 standard deviations above the mean on the State-Trait Anxiety Inventory State subtest (STAI-State) on 2 separate occasions, and 2) insomnia, defined as a "problem getting to sleep or staying asleep over the past 2 weeks." We randomly assigned 391 eligible participants to 1 of the following 3 groups, and mailed 28 days' supply: kava with valerian placebo (n = 121), valerian with kava placebo (n = 135), or double placebo (n = 135). The primary outcome measures were changes from baseline in anxiety (STAI-State questionnaire) and insomnia (Insomnia Severity Index [ISI]) compared with placebo. Participants receiving placebo had a 14.4 point decrease in anxiety symptoms on the STAI-State score and an 8.3 point decrease in insomnia symptoms on the ISI. Those receiving kava had similar reductions in STAI-State score (2.7 point greater reduction in placebo compared with kava; 95% confidence interval [CI], -0.8 to +6.2). Those receiving valerian and placebo had similar improvements in sleep (0.4 point greater reduction in the placebo than the valerian group; 95% CI, -1.3 to +2.1). Results were similar when limited to the 83% of participants who adhered to study compounds for all 4 weeks. Neither kava nor valerian relieved anxiety or insomnia more than placebo. This trial demonstrates the feasibility of conducting randomized, blinded trials entirely via the Internet.


Asunto(s)
Ansiedad/tratamiento farmacológico , Internet , Kava , Fitoterapia , Extractos Vegetales/uso terapéutico , Proyectos de Investigación , Trastornos del Inicio y del Mantenimiento del Sueño/tratamiento farmacológico , Valeriana , Adulto , Ansiedad/clasificación , Cápsulas , Método Doble Ciego , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Kava/efectos adversos , Masculino , Cooperación del Paciente , Placebos , Extractos Vegetales/administración & dosificación , Extractos Vegetales/efectos adversos , Reproducibilidad de los Resultados , Seguridad , Trastornos del Inicio y del Mantenimiento del Sueño/clasificación , Resultado del Tratamiento , Valeriana/efectos adversos
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