The antidepressant effects of lavender (Lavandula angustifolia Mill.): A systematic review and meta-analysis of randomized controlled clinical trials.

BACKGROUND AND AIMS: Antidepressant drugs are accompanied with high rate of adverse effects. Lavender is one of the most common herbal drugs mentioned in Traditional Persian literature with potential efficacy on mental disorders and less serious side effects. Thus, the aim of this study was to determine the efficacy of lavender on depression severity by preforming a systematic review and meta-analysis. METHODS: Databases including PubMed, Scopus, Cochrane library, Embase and Web of science were searched for relevant articles till December 2020. Quality of studies were evaluated by Jadad scale and the Cochrane collaboration tool. Depression as endpoint measure or as a subscale of any valid assessment tool was subjected to quantitative data analyses. Both fixed and random effects meta-analysis were conducted for data synthesis. RESULTS: Out of 342 screened studies, 17 articles were included in the meta-analysis. Results showed significant efficacy of lavender in decreasing depression scores compared to the control group (pooled Standardized Mean Difference (SMD)= -0.66, 95 % CI: -0.85 to -0.46;P < 0.001, I2 = 68.2 %;). Subgroup analysis proved that the effect of lavender was marginally more pronounced in participants with diagnosed depression (pooled SMD= -0.62, 95 % CI: -1.26 to 0.01, P = 0.055; I2 = 88.1 %) while its effect was statistically significant in patients having other diseases with concomitant depressive symptoms (pooled SMD= -0.65, 95 % CI: -1.84 to -0.46, P < 0.001; I2 = 52.1 %), and the oral route (pooled SMD= -0.56, 95 % CI: -1.07 to -0.05, P = 0.032; I2 = 85.2 %;) was the most effective route of administration. CONCLUSIONS: This systematic review and meta-analysis concluded that lavender has significant antidepressant effects. However, due to some limitations, further large clinical trials are recommended with more homogeneous populations and rigorous designs.

Lavender and dodder combined herbal syrup versus citalopram in major depressive disorder with anxious distress: A double-blind randomized trial.

BACKGROUND: Major depressive disorder (MDD) accompanied by anxious distress is a chronic and disabling disorder. Its conventional drug therapies often have low patient compliance due to drug-related side effects. In Persian medicine, lavender-dodder syrup is one formula often recommended for such disorders. OBJECTIVE: This study compares the effects of lavender-dodder syrup to the standard drug, citalopram, for treating MDD with anxious distress. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: This six-week, double-blind, randomized, clinical trial was carried out in a psychiatric outpatient clinic. During the six-week intervention period, patients in citalopram group received citalopram tablets 20 mg/d plus 5 mL placebo syrup every 12 h; patients in group B received placebo tablets once daily plus 5 mL of lavender-dodder herbal syrup every 12 h. MAIN OUTCOME MEASURES: Primary outcome measures, depression and anxiety, were evaluated using the Hamilton Depression/Anxiety Rating Scales, and were scored at the beginning of the study and at weeks three and six. Secondary outcome measures including response to treatment and remission rates were also compared between the two groups. RESULTS: Fifty-six participants with MDD and anxious distress were randomly assigned to two groups. Mean depression scores significantly decreased in citalopram and herbal groups at weeks three and six (time effect: P < 0.001), although the observed changes were not significantly different between the groups (intervention effect: P = 0.61). Mean anxiety scores were not significantly different between the two groups at week three (P = 0.75). However, at the end of week six, the observed decrease was significantly higher in the herbal syrup group than the citalopram group (intervention effect: P = 0.007). CONCLUSION: The herbal syrup is an effective and tolerable supplement for treating MDD with anxious distress. TRIAL REGISTRATION NUMBER: IRCT2016102430459N1 on Iranian Registry of Clinical Trials.

Epidemiology of multiple sclerosis in Iran: a systematic review.

BACKGROUND: There is a wide variation in the prevalence of multiple sclerosis (MS) in different geographical regions and the epidemiology of MS in Iran has been a major topic of concern during the last decade. Several population-based studies have shown a sharp increase in the prevalence and incidence of MS in this region. In this study, for the first time, the aim was to provide a comprehensive review regarding the incidence and prevalence of MS across Iran. METHODS: A comprehensive literature search was performed using PubMed, Embase, and Web of Science. We also did a manual search of reference lists from primary articles and relevant reviews. Databases of ongoing research and unpublished literature were also searched. RESULTS: A total of 22 relevant studies were reviewed and 11 studies met the inclusion criteria. Incidence data were found in 5 studies and ranged from 0.68 to 9.1/100,000 per year in the Iranian population. Prevalence was reported in all studies and ranged from 5.3 to 74.28/100,000 with the higher prevalence among females (female/male ratio ranged from 1.8 to 3.6). The most prevalent subtype of MS was the relapsing-remitting form (65.8-87.8%). The sensory disturbance was the most initial presentation. CONCLUSION: The incidence and prevalence of MS in Iran has been increasing rapidly, especially in females. Future research should focus on determining the epidemiological features of MS in the neglected provinces with different ethnicities. Such an effort along with further research towards improvement of data on previously studied areas can enable a field to be opened up to identify the patterns of MS in varied genetic backgrounds and environments of Iran.