Lavender

Background:

Lavender is a plant that is native to a few countries such as France, Spain and Italy. It is in the same family as mint and actually comes in colors other than purple, such as pink and white.

Some animals like mosquitoes and rodents do not like the smell of lavender, so it can be used as a repellent.

Mechanism of action:

The parts of the lavender plant that are used for medicinal purposes include the flowers, leaves and oil. There are a few chemical compounds that may cause its health benefits such as cineole, borneol, and linalool.

How lavender helps with depression and anxiety is not completely understood. One study showed that lavender may have NMDA antagonistic effects and bind to the serotonin transporter.1

Aromatherapy with lavender oil may increase the sleep hormone melatonin.2

Additionally, lavender shows anti-inflammatory effects in animal models and inflammatory markers are commonly elevated in people with depression.

Dosing:

A specific oral lavender oil product called Silexan, has commonly been used at doses between 80-160 mg per day.

Lavender oil administered via inhalation is commonly diluted to between a 1-5% concentration and added to a diffuser or placed on a cotton ball or other absorbent material for easy inhalation.

Lavender may also be administered topically, it can be applied to the palms or applied during a massage.

Effectiveness:

Effectiveness for depression

(1) A study out of Germany had 50 patients take a pill called Silexan daily for 6 weeks. Silexan is a product in Germany that contains 80 mg of lavender oil. This trial tracked many components of mental illness and depression scores decreased by 32% on average by the end of the trial.3 

(2) A 4-week trial from Iran included 48 patients and compared lavender tincture to a prescription antidepressant called imipramine. A third group recieved both the lavender tincture and imipramine together. The results of the study were that lavender tincture was the least effective, imipramine was next, and the most effective treatment was combining imipramine with the lavender tincture. The imipramine group had more dry mouth and urinary retention, while the lavender tincture group had more headaches as side effects.4

(3) Another study from Iran aimed to see if twice daily lavender tea (2 g) would help elderly people with their anxiety and depression. There were 60 participants in total and small benefits were seen in both the depression and anxiety levels after 2 weeks of treatment.5

(4) A third study from Iran compared lavender 2 g, lemon balm 2 g, and fluoxetine 20 mg daily for 8 weeks. All three groups had their depression scores decreased. The average decrease is the lavender group was 7.8, the average decrease in the fluoxetine group was 9.8 and the average decrease in the lemon balm group was 8.46.6

(5) The next study assessed if inhaled lavender oil would be helpful in treating postpartum anxiety and depression. 140 women were in the trial and the treatment group would rub 3 drops of lavender oil onto their palms every 8 hours and inhale. The results showed a significant effect on depression and anxiety at 2, 4, and 12 weeks.7

Effectiveness for anxiety

(1) A study was published out of Germany with 77 patients. 40 patients received the Silexan lavender product and 37 patients received an anti-anxiety medication called lorazepam. Lorazepam is a benzodiazepine that has long term risks and can be addicting. The HAM-A anxiety scale decreased by just over 11 points in both groups! This showed that lavender is not inferior to lorazepam in treating generalized anxiety disorder. Side effects in the lavender group included gastrointestinal distress and dyspepsia.8

(2) A large study out of Germany included 539 adults and wanted to see if the lavender product, Silexan, would treat anxiety. Participants were split into four groups. The groups were Silexan 80 mg, Silexan 160 mg, a prescription antidepressant called paroxetine, or placebo. The study was 10 weeks long and used the Hamilton Anxiety scale (HAMA) to track changes in symptoms. The HAMA total score decreased by 14.1 ± 9.3 points for Silexan 160 mg/d, 12.8 ± 8.7 points for Silexan 80 mg/d, 11.3 ± 8.0 points for paroxetine, and 9.5 ± 9.0 points for placebo.9

Safety:

The FDA has given Lavender GRAS status in the United States when used as a food product. GRAS stands for “generally recommended as safe.”

Using lavender in medicinal amounts is considered to be “possibly safe.” Oral lavender has been used safely for 10 weeks in studies. Topical lavender oil has been used safely for 7 months in studies. Inhaled lavender has been safely used for 12 weeks in studies.

Medication interactions

Lavender may potentiate the effects of other medications that are sedating.

Side effects:

Lavender is generally well tolerated. Some common oral side effects include burping, constipation, diarrhea, and headache. Topical side effects include the possibility of an allergic reaction.

Some rare side effects include palpitations and gynecomastia

References:

  1. López V, Nielsen B, Solas M, Ramírez MJ, Jäger AK. Exploring Pharmacological Mechanisms of Lavender (Lavandula angustifolia) Essential Oil on Central Nervous System Targets. Front Pharmacol. 2017;8:280. Published 2017 May 19. doi:10.3389/fphar.2017.00280.
  2. Velasco-Rodríguez R, Pérez-Hernández MG, Maturano-Melgoza JA, Hilerio-López ÁG, Monroy-Rojas A, Arana-Gómez B, Vásquez C. The effect of aromatherapy with lavender (Lavandula angustifolia) on serum melatonin levels. Complement Ther Med. 2019 Dec;47:102208. doi: 10.1016/j.ctim.2019.102208. Epub 2019 Oct 5. PMID: 31780012.
  3. Uehleke B, Schaper S, Dienel A, Schlaefke S, Stange R. Phase II trial on the effects of Silexan in patients with neurasthenia, post-traumatic stress disorder or somatization disorder. Phytomedicine. 2012 Jun 15;19(8-9):665-71. doi: 10.1016/j.phymed.2012.02.020. Epub 2012 Apr 3. PMID: 22475718.
  4. Akhondzadeh S, Kashani L, Fotouhi A, Jarvandi S, Mobaseri M, Moin M, Khani M, Jamshidi AH, Baghalian K, Taghizadeh M. Comparison of Lavandula angustifolia Mill. tincture and imipramine in the treatment of mild to moderate depression: a double-blind, randomized trial. Prog Neuropsychopharmacol Biol Psychiatry. 2003 Feb;27(1):123-7. doi: 10.1016/s0278-5846(02)00342-1. PMID: 12551734.
  5. Bazrafshan MR, Jokar M, Shokrpour N, Delam H. The effect of lavender herbal tea on the anxiety and depression of the elderly: A randomized clinical trial. Complement Ther Med. 2020 May;50:102393. doi: 10.1016/j.ctim.2020.102393. Epub 2020 Mar 30. PMID: 32444033.
  6. Araj-Khodaei M, Noorbala AA, Yarani R, Emadi F, Emaratkar E, Faghihzadeh S, Parsian Z, Alijaniha F, Kamalinejad M, Naseri M. A double-blind, randomized pilot study for comparison of Melissa officinalis L. and Lavandula angustifolia Mill. with Fluoxetine for the treatment of depression. BMC Complement Med Ther. 2020 Jul 3;20(1):207. doi: 10.1186/s12906-020-03003-5. PMID: 32620104; PMCID: PMC7333290.
  7. Kianpour M, Mansouri A, Mehrabi T, Asghari G. Effect of lavender scent inhalation on prevention of stress, anxiety and depression in the postpartum period. Iran J Nurs Midwifery Res. 2016 Mar-Apr;21(2):197-201. doi: 10.4103/1735-9066.178248. PMID: 27095995; PMCID: PMC4815377.
  8. Woelk H, Schläfke S. A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. Phytomedicine. 2010 Feb;17(2):94-9. doi: 10.1016/j.phymed.2009.10.006. Epub 2009 Dec 3. PMID: 19962288.
  9. Kasper S, Gastpar M, Müller WE, Volz HP, Möller HJ, Schläfke S, Dienel A. Lavender oil preparation Silexan is effective in generalized anxiety disorder–a randomized, double-blind comparison to placebo and paroxetine. Int J Neuropsychopharmacol. 2014 Jun;17(6):859-69. doi: 10.1017/S1461145714000017. Epub 2014 Jan 23. PMID: 24456909.
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