Elsevier

Phytomedicine

Volume 19, Issues 8–9, 15 June 2012, Pages 825-835
Phytomedicine

Short communication
Is lavender an anxiolytic drug? A systematic review of randomised clinical trials

https://doi.org/10.1016/j.phymed.2012.02.013Get rights and content

Abstract

Background

Lavender (Lavandula angustifolia) is often recommended for stress/anxiety relief and believed to possess anxiolytic effects.

Aim

To critically evaluate the efficacy/effectiveness of lavender for the reduction of stress/anxiety.

Methods

Seven electronic databases were searched to identify all relevant studies. All methods of lavender administration were included. Data extraction and the assessment of the methodological quality of all included trials were conducted by two independent reviewers.

Results

Fifteen RCTs met the inclusion criteria. Two trials scored 4 points on the 5-point Jadad scale, the remaining 13 scored two or less. Results from seven trials appeared to favour lavender over controls for at least one relevant outcome.

Conclusion

Methodological issues limit the extent to which any conclusions can be drawn regarding the efficacy/effectiveness of lavender. The best evidence suggests that oral lavender supplements may have some therapeutic effects. However, further independent replications are needed before firm conclusions can be drawn.

Introduction

Lavender (Lavandula angustifolia) has a long history of medicinal use and is purported to possess anxiolytic, sedative and calming properties (Cavanagh and Wilkinson 2002). Most commonly it is recommended for oral administration. More recently, lavender is also being employed in aromatherapy (Setzer 2009) although specific pharmacological effects of lavender aromatherapy are difficult to distinguish from any innate or learned preferences to this, or any other, odour (Bradley et al. 2009).

The chemical composition of lavender is complex and several of its constituents (e.g. linalool and linalyl acetate) have been proposed as being responsible for the perceived anxiolytic effects (Setzer 2009). In animal models, linalool has been found to inhibit GABA(A) binding reception in the CNS inducing a relaxed state (Brum et al., 2001, Hossain et al., 2004). Until recently, this activity had not been noted in human studies.

Anxiety is a common disorder (14% of the EU population suffer from one or more anxiety disorders each year (Wittchen et al. 2011)) but can be severe and debilitating, often requiring medication. Lavender may provide a gentler treatment option than conventional anxiolytic drugs. Apart from rare allergic reactions (Coulson and Khan 1999) and gastrointestinal complaints (after excessive intake) (Leung and Foster 1996), lavender intake seems to be reasonably safe.

This systematic review is aimed at critically evaluating the data from randomised clinical trials (RCTs) of all types of lavender preparations (oral, olfactory, topical) for the treatment of anxiety.

Section snippets

Methods

The following electronic databases were searched from their inception up to December 2010: Medline, EMBASE and PsychInfo (via OVID), AMED and CINAHL (via EBSCO), The Cochrane Library, and ISI Web of Knowledge. The search terms used included lavender, and anxiety or stress, and derivatives of these terms (see Appendix A for electronic search strategy). Our own departmental files and the reference lists of all selected articles were searched for further relevant studies.

Articles were included if

Results

The literature search identified 440 potentially relevant titles and abstracts. Fifteen RCTs involving 1565 participants met the inclusion criteria (Fig. 1). Where possible, between-group analyses of the main anxiety outcomes are presented in Table 1. The included studies were published between 1995 and 2010, originated from six countries and were all written in English. Sample sizes ranged from 16 to 340. The majority of trials used Lavandula angustifolia unless otherwise stated.

Eight trials (

Discussion

Our review included 15 RCTs of lavender for anxiety or stress. The majority of trials used either the STAI or HAD as the main self-reported outcome measure, whilst blood pressure, heart rate and galvanic skin response were reported as physiological outcome measures. Seven trials (Braden et al., 2009, Bradley et al., 2009, Dunn et al., 1995, Kasper et al., 2010, Kritsidima et al., 2010, Kutlu et al., 2008, Motomura et al., 2001) showed results appearing to favour the lavender intervention for at

Conclusions

Only few RCTs of lavender, for anxiety/stress are available using diverse administration methods (i.e. oral, olfactory and as a massage oil). The evidence for oral lavender is promising but, until independent replications emerge with long-term follow-up data, remains inconclusive. The use of more widely used forms of lavender administration (aromatherapy, inhalation, massage etc.) is not currently supported by good evidence of efficacy. Future trials, well-reported and adopting stringent

Conflict of interest

None.

Funding

None.

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