Generalized anxiety disorder 

 

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Valerian (Valerian Tea, Valeriana Officinalis) [12, 56, 57, 58, 59, 60, 61]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (Although animal studies have shown that Valerian can have some benefit in treating anxiety, clinical trials have yielded conflicting results. More research is needed. )

Grade of Evidence: Moderate quality of evidence

St John's Wort (Goatweed, tipton weed, Hypericum Perforatum) [12, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (Available evidence does not support claims that St Johns Wort can help to treat Anxiety.)

Grade of Evidence: Low quality of evidence

Peppermint Oil [12, 39, 40, 41, 42, 43, 44]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (There is insufficient evidence to support claims that peppermint helps to treat anxiety)

Grade of Evidence: Very low of evidence

Mugwort (Artemisa Vulgaris) [1, 36, 37, 38]:

Please note, this management does NOT treat the condition itself. It has been proposed only as a weak supportive symptomatic support, and even then, has been discounted due life-threatening side effects

Recommendation: No recommendation (There is insufficient evidence to support claims that mugwart helps to treat symptoms of anxiety. More research is needed.)

Grade of Evidence: Very low quality of evidence

Cannabis (Marijuana, weed, hemp) [12, 27, 28, 29, 30, 31, 32, 33, 34, 35]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly in favor (Evidence shows that smoking or ingesting cannabis may help in relieving symptoms of  anxiety disorder, although some studies have yielded mixed results)

Grade of Evidence: Low quality of evidence

Kava (Piper Methysticum) [12, 23, 24, 25, 26]:

WARNING: In rare cases, kava may lead to liver failure and other life threatening problems. The FDA warns that those who have had liver problems, or are on medicacations which may affect the liver, patients should check with their doctors before taking Kava. Other side effects include headache, upset stomach, drowsiness, weight loss, bloody urine, and muscle weakness.

Recommendation: No recommendation (Early studies indicate that Kava may be helpful in reducint the symptoms of mild anxiety. However, subsequent studies have yielded contradictory results. More research is needed.)

Grade of Evidence: Very low quality of evidence

Indian Snakeroot (Rauvolfia, Rawolfia Serpentina) [12, 21, 22]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Strongly in favor (Reserpine, a drug which is extracted from indian snakeroot, is known to be an effective treatment for high blood pressure, as well as a tranquilizer.)

Grade of Evidence: High quality of evidence

Glyconutrients [12, 19, 20]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation  (Available evidence does not support claims that glyconutrients help to treat anxiety. More studies are needed.)

Grade of Evidence: Low quality of evidence

Ginseng [12, 15, 16, 17, 18]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation  (There is insufficient evidence to support claims that ginseng helps to treat anxiety. More studies are needed.)

Grade of Evidence: Low quality of evidence

Flower Remedies [12, 13, 14]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation  (There is insufficient evidence to support claims that flower remedies help to treat anxiety)

Grade of Evidence: Very low quality of evidence

Therapeutic Touch:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly in favor (one scientific review has shown positive effects of therapeutic touch on anxiety, but more study is needed)

Grade of Evidence: Low quality of evidence

Reiki:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (there have been ambiguous reports about the effect of Reiki on anxiety)

Grade of Evidence: Very low quality of evidence

Massage:

Recommendation: Weakly in favor (studies have demonstrated the positive effects of massage on anxiety)

Grade of Evidence: Low quality of evidence

Hydrotherapy:

Recommendation: Weakly in favor (it has been often reported that hydrotherapy can help promote a reduction in anxiety)

Grade of Evidence: Low quality of evidence

Yoga:

Recommendation: Weakly in favor (randomized control trials have shown that yoga may help reduce anxiety)

Grade of Evidence: Low quality of evidence

Qi Gong:

Recommendation: Weakly in favor (one study has shown that Qigong can help with a short-term reduction in anxiety)

Grade of Evidence: Low quality of evidence

Aromatherapy:

Recommendation: No recommendation (Clinical research is still in its early phases. Currently, there is insufficient evidence supporting Aromatherapy in the treatment of anxiety)

Grade of Evidence: Very low quality of evidence

Creative Art Therapy (Expressive Therapy):

Recomendation: No recommendation (potential exists for treatment of anxiety with expressive therapy. However, this still needs to be researched)

Grade of Evidence: Very low quality of evidence

Biofeedback:

Recommendation: No recommendation (insufficient evidence supporting Biofeedback as a useful treatment for Anxiety)

Grade of Evidence: Very low quality of evidence

Breathing Exercises (Breathwork):

Recommendation: Weakly in favor (there is very little evidence that breathwork can help with anxiety, but these few indications have had positive results)

Grade of Evidence: Very low quality of evidence

Hypnosis:

Recommendation: Strongly in favor (many reports have demonstrated that hypnotherapy helps reduce anxiety)

Grade of Evidence: Moderate quality of evidence

Image Therapy:

Recommendation: No recommendation (results of studies have had ambiguous results, some showing Image Therapy reducing anxiety, and others showing very little or no signifcant effect at all)

Grade of Evidence: Low quality of evidence

Meditation:

Recommendation: Weakly in favor (there have been many clinical trials that have demonstrated the positive effect of meditation on anxiety)

Grade of Evidence: Low quality of evidence

Music Therapy:

Recommendation: Strongly in favor  (Music therapy has been shown to help with anxiety at the beginning of treatment. These effects, however gradually decrease over time)

Grade of Evidence: Moderate quality of evidence

 

Shamanism:

 

Recommendation: No recommendation (available scientific evidence shows no proof that Shamanism helps reduce anxiety)

Grade of Evidence: Very low quality of evidence

Roseroot (Rhodiola Rosea):

Recommendation: No recommendation (There is insufficient evidence to support claims that roseroot is able to help those with anxiety. More studies are needed)

Grade of Evidence: Very low quality of evidence

Magnolia Officinalis Extracts [63]:

Recommendation: Weakly in favor (Studies show that magnolia officinalis extracts may be able to help those with anxiety. More studies are needed)

Grade of Evidence: Low quality of evidence

Phellodendron Amurense (Relora) Extracts [64, 65]:

Recommendation: Weakly in favor (Studies show that phellodendron amurense extracts may be able to help those with anxiety. More studies are needed)

Grade of Evidence: Low quality of evidence

Scutellaria Lateriflora (Skullcap) [66, 67]:

Recommendation: Weakly in favor (Studies show that scutellaria lateriflora may be able to help those with anxiety. More studies are needed)

Grade of Evidence: Low quality of evidence

* www.gradeworkinggroup.org

 

 

Summary References

Treatment:

1. A Guide to Understanding Cognitive and Behavioral Psychotherapies", British Association of Behavioural and Cognitive Psychotherapies. Accessed 29 May 2007.

2. "Generalized anxiety disorder", Mayo Clinic. Accessed 29 May 2007.

3. Barlow, D. H.: (2007) Clincical Handbook of Psychological Disorders, 4th ed.

4. http://www.ncbi.nlm.nih.gov/pubmed/2795526?dopt=Abstract

5. http://www.ncbi.nlm.nih.gov/pubmed/12744913?dopt=Abstract

6. http://www.ncbi.nlm.nih.gov/pubmed/17712234?dopt=Abstract

7. http://www.ncbi.nlm.nih.gov/pubmed/18307390?dopt=Abstract

8. http://www.ncbi.nlm.nih.gov/pubmed/18426577?dopt=Abstract

9. http://www.ncbi.nlm.nih.gov/pubmed/12652886?dopt=Abstract

10. http://www.aafp.org/afp/980515ap/tips.html#12

11. http://www.ncbi.nlm.nih.gov/pubmed/19341989?dopt=Abstract

12. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

13. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/flower-remedies

14. http://www.ncbi.nlm.nih.gov/pubmed/12635462

15. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-ginseng.html

16. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/ginseng

17. Shin HR, Kim JY, Yun TK, Morgan G, Vainio H (2000). "The cancer-preventive potential of Panax ginseng: a review of human and experimental evidence". Cancer Causes Control 11 (6): 565–576.

18. McElhaney JE et al. (2004). "A placebo-controlled trial of a proprietary extract of North American ginseng (CVT-E002) to prevent acute respiratory illness in institutionalized older adults". J Am Geriatr Soc 52 (1): 13–19

19. http://abcnews.go.com/2020/story?id=3228488

20. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/glyconutrients

21. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/indian-snakeroot

22. http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/seven/000092149.htm

23. http://www.publish.csiro.au/?act=view_file&file_id=SP05005.pdf

24. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/kava

25. http://www.kavazen.com/pages/library.htm#KavaZen and Kava Safety

26. http://nccam.nih.gov/health/kava/index.htm

27. http://www.nlm.nih.gov/medlineplus/marijuana.html

28. http://nccam.nih.gov/research/extramural/awards/2004/

29. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/marijuana

30. http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/treatments/complementary--alternative-medicine/marijuana/index.aspx

31. http://www.ncbi.nlm.nih.gov/pubmed/16957511

32. http://www.ncbi.nlm.nih.gov/pubmed/12965981

33. http://www.ncbi.nlm.nih.gov/pubmed/17589370

34. http://mct.aacrjournals.org/content/6/11/2921.long

35. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562334/?tool=pmcentrez 

36. Anliker MD, Borelli S, Wüthrich B. Occupational protein contact dermatitis from spices in a butcher: a new presentation of the mugwort-spice syndrome. Contact Dermatitis. 2002;46:72-74.

37. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/mugwort

38. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. Philadelphia, PA: Lippincott Williams & Wilkins; 2004.

39. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/peppermint

40. http://www.ncbi.nlm.nih.gov/pubmed/17420159

41. http://www.ncbi.nlm.nih.gov/pubmed/19507027

42. http://www.medicine.ox.ac.uk/bandolier/booth/alternat/AT022.html

43. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-peppermint.html

44. http://nccam.nih.gov/health/peppermintoil/index.htm

45. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/st-johns-wort

46. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-stjohnswort.html

47. http://www.ncbi.nlm.nih.gov/pubmed/18843608

48. http://www.ncbi.nlm.nih.gov/pubmed/11939866

49. http://nccam.nih.gov/health/stjohnswort/ataglance.htm

50. http://nccam.nih.gov/health/stjohnswort/sjw-and-depression.htm

51. http://www.nimh.nih.gov/health/publications/depression/how-is-depression-detected-and-treated.shtml

52. http://www.ncbi.nlm.nih.gov/pubmed/11939872

53. http://www.ncbi.nlm.nih.gov/pubmed/12132963

54. http://www.ncbi.nlm.nih.gov/pubmed/16423519

55. http://jama.ama-assn.org/cgi/content/full/299/22/2633

56. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-valerian.html

57. http://nccam.nih.gov/health/valerian/index.htm

58. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/valerian

59. http://ods.od.nih.gov/factsheets/Valerian.asp

60. http://www.ncbi.nlm.nih.gov/pubmed/12725454

61. http://www.ncbi.nlm.nih.gov/pubmed/9757514

62. Taibi DM et al. 'A systematic review of valerian as a sleep aid: safe but not effective.' Sleep Med Rev. 2007;11:209-30.

63. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3750820/

64. http://www.jissn.com/content/10/1/37

65. http://www.nutritionj.com/content/7/1/11

66. http://www.ncbi.nlm.nih.gov/pubmed/23878109

67. http://www.ncbi.nlm.nih.gov/pubmed/12652886