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Valeriana para los trastornos de ansiedad

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Referencias

References to studies included in this review

Ir a:

Andreatini 2002 {published data only}

Andreatini R, Sartori VA, Seabra MLV, Leite JR. Effect of valepotriates (valerian extract) in Generalised Anxiety Disorder: a randomised placebo‐controlled pilot study. Phytotherapy Research 2002;16:650‐4.

References to studies excluded from this review

Ir a:

Bourin 1997 {published data only}

Bourin M, Bougerol T, Guitton B, Broutin E. A combination of plant extracts in the treatment of outpatients with adjustment disorder with anxious mood: controlled study versus placebo. Fundamental and Clinical Pharmacology 1997;11(2):127‐32.

Cerny 1998 {published data only}

Cerny A, Schmid K. Tolerability and efficacy of valerian/lemon balm in healthy volunteers ( a double‐blind placebo controlled multicentre study). Fitoterapia 1999;70:221‐8.

Delsignore 1992 {published data only}

Delsignore R, Orlando S, Costi D, Baroni MC, Butturini U. Clinical comparative evaluation of a stabilized valeriana extract and placebo [Avaliação clinica comparativa com placebo de um extrato estabilizado de valeriana]. A Folha Medica 1992;104(5):191‐196.

Maisenbacher 1992 {published data only}

Maisenbacher J, Podzuweit H. Valerian and Melissa ‐ Mild Psychopharmaceuticals. Therapiewoche 1992;42(37):2140‐2144.

McCutcheon 1996 {published data only}

McCutcheon LE. Treatment of anxiety with a homeopathic remedy. Journal of Applied Nutrition 1996;48(1,2):1‐5.

Panijel 1985 {published data only}

Panijel M. Treatment of moderately severe anxiety states. Therapiewoche 1985;41:4659‐68.

Rabezzana 1995 {published data only}

Rabezzana G. Tratamento dei disturbi d'ansia de grado lieve e medio con prodotti a base naturale: valutazione dell"efficacia e tollerabilità del Sedatol. Riv It Biol Med 1995;15:126‐133.

Additional references

Ir a:

Almeida‐Filho 1997

Almeida‐Filho N, Mari JJ, Coutinho E, Franca JF, Fernandes J, Andreoli SB, et al. Brazilian multicentric study of psychiatric morbidity: Methodological features and prevalence estimates. British Journal of Psychiatry 1997;171:524‐9.

APA 1987

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM‐III‐R). 3rd Edition. Washington DC: American Psychiatric Association, 1987.

APA 1994

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV). 4th Edition. Washington, DC: American Psychiatric Association, 1994.

BHMA 1992

British Herbal Medicine Association. British Herbal Compendium Vol. 1. Bournemouth: British Herbal Medicine Association, 1992.

Bijl 1998

Bijl RV, Ravelli A, van Zessen G. Prevalence of psychiatric disorder in the general population: Results of the Netherland Mental Health Survey and Incidence Study (NEMESIS). Social Psychiatry & Psychiatric Epidemiology 1998;33(12):587‐95.

Borkovec 1987

Borkovec TD, Mathews AM, Chambers AM, Ebrahimi S, Lytle R, Nelson R, et al. The effects of relaxation training with cognitive or nondirective therapy and the role of relaxation‐induced anxiety in the treatment of generalized anxiety disorder. Journal of Consulting & Clinical Psychology 1987;55(6):883‐8.

Borkovec 1993

Borkovec TD, Costello E. Efficacy of applied relaxation and cognitive behavioral therapy in the treatment of generalized anxiety disorder. Journal of Consulting & Clinical Psychology 1993;61(4):611‐9.

Clarke 2000

Clarke M, Oxman AD. Cochrane Collaboration Handbook. Oxford: Update Software, 2000.

Donath 2000

Donath F, Quispe S, Diefenbach K, Maurer A, Fietze I, Roots I. Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry 2000;33(2):47‐53.

Gould 1997

Gould RA, Otto MW, Pollack MH, Yap L. Cognitive behavioural and pharmacological treatment of generalized anxiety disorders: Preliminary meta‐analysis. Behavior Therapy 1997;28(2):285‐305.

Hamilton 1959

Hamilton M. The assessment of anxiety states by rating. British Journal of Medical Psychology 1959;32:50‐5.

Hendriks 1981

Hendriks H, Bos R, Allersma DP, Malingre TM, Koster AS. Pharmacological screening of valerenal and some other components of essential oil of Valeriana officinalis. Planta Medica 1981;42(1):62‐8.

Hunot 2006

Hunot V, Churchill R, Silva de Lima M, Teixeira V. Psychological therapies for generalised anxiety disorder. Cochrane Library 2006, Issue 4.

Jadad 1996

Jadad AR, Moore RA, Carrol D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Controlled Clinical Trials 1996;17(1):1‐12.

Kessler 1994

Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, et al. Lifetime and 12 month prevalence of DSM III‐R psychiatric disorders in United States. Archives of General Psychiatry 1994;51(1):8‐19.

Leathwood 1985

Leathwood PD, Chauffard F. Aqueous extract of valerian reduces latency to fall asleep in man. Planta Medica 1985;51(2):144‐8.

Mayer 1974

Mayer B, Springer E. Psychoexperimental studies on the effect of a valepotriate combination as well as the combined effects of valtratum and alcohol [Psyschoexperimentelle untersuchungen zur wirking einer Valepotriatkombination sowie zur Kombinierten wirkung von Valtratum und Alkohol]. Arzneimittel‐Forschung 1974;24(12):2066‐70.

Mendlowicz 2000

Mendlowicz MV, Stein MB. Quality of life in individuals with anxiety disorders. American Journal of Psychiatry 2000;157(6):669‐82.

Mennini 1993

Mennini T, Bernasconi P, Bombardelli E, Morazzoni P. In vitro study on the interaction of extracts and pure compounds from Valeriana officinalis roots with GABA, benzodiazepine and barbiturate receptors in rat brain. Fitoterapia 1993;64(4):291‐300.

Petkov 1974

Petkov VD, Manolov PN, Marekov NL, Popov SS, Handjieva NB. Pharmacological studies on a mixture of valepotrietes isolated from Valeriana officinalis. Doklady Bolgarskoi Akademii Nauk 1974;27:1007‐10.

Pittler 2002

Pittler MH, Ernst E. Kava extract for treating anxiety. Cochrane Library 2002, Issue 3.

Priest 1988

Priest RG, Montgomery SA, Priest RG, Montgomery SA. Benzodiazepines and dependance: a college statement. Bulletin of the Royal College of Psychiatrists 1988;12:107‐08.

Schmidt‐Voigt 1986

Schmidt‐Voigt J. Treatment of nervous sleep disorders and unrest with a sedative of purely vegetable origin [Die Behandlung nervoser schfstorungen und innerer unruhe mit einem rein pflanzlichen sedativum]. Therapiewoche 1986;36(7):663‐7.

Schulz 1995

Schulz KF, Chalmers I, Haves RJ, Altman DG. Empirical evidence of bias: Dimension of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995;273(5):408‐12.

Stevinson 2000

Stevinson C, Ernst E. Valerian for insomnia: a systematic review of randomized clinical trials. Sleep Medicine 2000;1(2):91‐9.

Taylor 1978

Taylor CB. In: Agras WS editor(s). Relaxation training and related techniques in behavioural modifications: Principles and clinical applications. Boston, MA: Little Brown, 1978.

Taylor 1988

Taylor CB, Arnow B. The nature and the treatment of anxiety disorders. New York, NY: Free Press, 1988.

Von Eickstedt 1969

Von Eickstedt KW, Rahman S. Psychopharmacologic effect of valepotriates [Psychopharmakologische wirkungen von valepotriaten]. Arzneimittel‐Forschung 1969;19(3):316‐9.

Vorbach 1996

Vorbach EU, Gortelmeyer R, Bruning J. Therapy of insomnia. The efficacy and tolerability of valerian [Therapie von Insomnien. Wirksamkeit und Vertraglichkeit eines Baldrianpraparats]. Psychopharmakotherapie 1996;3(3):109‐15.

Walley 1994

Walley EJ, Beebe DK, Clark JL. Management of common anxiety disorders. American Family Physician 1994;50(8):1745‐53.

Ziegler 2002

Ziegler G, Ploch M, Miettinen‐Baumann A, Collet W. Efficacy and tolerability of valerian extract LI 156 compared with oxazepam in the treatment of non‐organic insomnia, a randomized double blind comparative clinical study. European Journal of Medical Research 2002;7(11):480‐6.

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Ir a:

Andreatini 2002

Methods

Allocation: randomised (computer program)
Blindness: unclear
Design: parallel
Duration: 4 weeks
Analysis: non ITT
São Paulo, Brazil

Participants

N=36
Diagnosis: GAD (DSM‐III‐R)
Gender: 21 females
Age: mean of 41 years
Setting: ambulatory
History: most of patients presented an associated clinical disease

Interventions

1. Valerian 81,3 mg/day (N=12)

2. Diazepam 6,5 mg/day (N=12)

3. Placebo (N=12)

Outcomes

HAM‐A (LOCF)
STAI (LOCF)
Side‐effects
Dropouts

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment?

Unclear risk

B ‐ Unclear

HAM‐A ‐ Hamilton Anxiety Scale
LOCF ‐ Last Observartion Carried Forward
STAI ‐ State‐trait Anxiety Inventory

Characteristics of excluded studies [ordered by study ID]

Ir a:

Study

Reason for exclusion

Bourin 1997

Used a combination of six extracts.

Cerny 1998

Allocation: randomised
Participants: 98 healthy volunteers
Interventions: (1) Valeriana/lemon balm; (2) placebo ; 30 days
Outcomes: sleep quality.

Delsignore 1992

Allocation: randomised
Participants: 40 subjects with minor anxiety symptomatology and emotional tension disturbances
Interventions: (1) Valeriana 50 mg 3x day; (2) placebo 3x day; 21 days
Outcomes: clinical outcomes not available for meta‐analysis. Continuous data (HAM‐A) without SD.

Maisenbacher 1992

Allocation: not randomised
Participants: 2395 subjects with acute or subacute psychophysical ill‐health
Interventions: (1) Valeriana and Melissa; (2) placebo; 4 weeks
Outcomes: clinical outcomes not available for meta‐analysis.

McCutcheon 1996

Allocation: randomised
Participants: 72 subjects with minor anxiety symptomatology and emotional tension disturbances
Interventions: (1) Valeriana and other 8 homeophatic remedies; (2) placebo ; 15 days
Outcomes: . STAI trait and state, Mean, SD.

Panijel 1985

Valerian combined with hypericum for comparison with diazepam.

Rabezzana 1995

Standard deviations were not shown for continuous outcomes.

Data and analyses

Open in table viewer
Comparison 1. Valerian vs placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Reduction in anxiety symptoms (HAM‐A) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only
Analysis 1.1
Comparison 1 Valerian vs placebo, Outcome 1 Reduction in anxiety symptoms (HAM‐A).

Comparison 1 Valerian vs placebo, Outcome 1 Reduction in anxiety symptoms (HAM‐A).

1.1 total score

1

24

Mean Difference (IV, Fixed, 95% CI)

‐1.40 [‐7.93, 5.13]

1.2 somatic factor

1

24

Mean Difference (IV, Fixed, 95% CI)

0.40 [‐3.12, 3.92]

1.3 psychic factor

1

24

Mean Difference (IV, Fixed, 95% CI)

‐1.80 [‐6.22, 2.62]

2 Reduction in anxiety symptoms (STAI‐T) Show forest plot

1

24

Mean Difference (IV, Fixed, 95% CI)

0.70 [‐9.93, 11.33]
Analysis 1.2
Comparison 1 Valerian vs placebo, Outcome 2 Reduction in anxiety symptoms (STAI‐T).

Comparison 1 Valerian vs placebo, Outcome 2 Reduction in anxiety symptoms (STAI‐T).

3 Side effects Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only
Analysis 1.3
Comparison 1 Valerian vs placebo, Outcome 3 Side effects.

Comparison 1 Valerian vs placebo, Outcome 3 Side effects.

3.1 Somnolence

1

24

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 7.45]

4 Overall dropout Show forest plot

1

24

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.17, 5.98]
Analysis 1.4
Comparison 1 Valerian vs placebo, Outcome 4 Overall dropout.

Comparison 1 Valerian vs placebo, Outcome 4 Overall dropout.
Open in table viewer
Comparison 2. Valerian vs diazepam

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Reduction in anxiety symptoms (HAM‐A) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only
Analysis 2.1
Comparison 2 Valerian vs diazepam, Outcome 1 Reduction in anxiety symptoms (HAM‐A).

Comparison 2 Valerian vs diazepam, Outcome 1 Reduction in anxiety symptoms (HAM‐A).

1.1 total score

1

24

Mean Difference (IV, Fixed, 95% CI)

0.40 [‐6.22, 7.02]

1.2 somatic factor

1

24

Mean Difference (IV, Fixed, 95% CI)

‐0.20 [‐2.93, 2.53]

1.3 psychic factor

1

24

Mean Difference (IV, Fixed, 95% CI)

0.60 [‐3.82, 5.02]

2 Reduction in anxiety symptoms (STAI‐T) Show forest plot

1

24

Mean Difference (IV, Fixed, 95% CI)

11.40 [1.90, 20.90]
Analysis 2.2
Comparison 2 Valerian vs diazepam, Outcome 2 Reduction in anxiety symptoms (STAI‐T).

Comparison 2 Valerian vs diazepam, Outcome 2 Reduction in anxiety symptoms (STAI‐T).

3 Side effects Show forest plot

1

24

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 7.45]
Analysis 2.3
Comparison 2 Valerian vs diazepam, Outcome 3 Side effects.

Comparison 2 Valerian vs diazepam, Outcome 3 Side effects.

4 Overall dropout Show forest plot

1

24

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.17, 5.98]
Analysis 2.4
Comparison 2 Valerian vs diazepam, Outcome 4 Overall dropout.

Comparison 2 Valerian vs diazepam, Outcome 4 Overall dropout.

Comparison 1 Valerian vs placebo, Outcome 1 Reduction in anxiety symptoms (HAM‐A).
Figuras y tablas -
Analysis 1.1

Comparison 1 Valerian vs placebo, Outcome 1 Reduction in anxiety symptoms (HAM‐A).

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Comparison 1 Valerian vs placebo, Outcome 2 Reduction in anxiety symptoms (STAI‐T).
Figuras y tablas -
Analysis 1.2

Comparison 1 Valerian vs placebo, Outcome 2 Reduction in anxiety symptoms (STAI‐T).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Valerian vs placebo, Outcome 3 Side effects.
Figuras y tablas -
Analysis 1.3

Comparison 1 Valerian vs placebo, Outcome 3 Side effects.

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Comparison 1 Valerian vs placebo, Outcome 4 Overall dropout.
Figuras y tablas -
Analysis 1.4

Comparison 1 Valerian vs placebo, Outcome 4 Overall dropout.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2 Valerian vs diazepam, Outcome 1 Reduction in anxiety symptoms (HAM‐A).
Figuras y tablas -
Analysis 2.1

Comparison 2 Valerian vs diazepam, Outcome 1 Reduction in anxiety symptoms (HAM‐A).

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Comparison 2 Valerian vs diazepam, Outcome 2 Reduction in anxiety symptoms (STAI‐T).
Figuras y tablas -
Analysis 2.2

Comparison 2 Valerian vs diazepam, Outcome 2 Reduction in anxiety symptoms (STAI‐T).

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Comparison 2 Valerian vs diazepam, Outcome 3 Side effects.
Figuras y tablas -
Analysis 2.3

Comparison 2 Valerian vs diazepam, Outcome 3 Side effects.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2 Valerian vs diazepam, Outcome 4 Overall dropout.
Figuras y tablas -
Analysis 2.4

Comparison 2 Valerian vs diazepam, Outcome 4 Overall dropout.

Ir a la figura de la revisiónAbrir en una pestaña nueva
Comparison 1. Valerian vs placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Reduction in anxiety symptoms (HAM‐A) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 total score

1

24

Mean Difference (IV, Fixed, 95% CI)

‐1.40 [‐7.93, 5.13]

1.2 somatic factor

1

24

Mean Difference (IV, Fixed, 95% CI)

0.40 [‐3.12, 3.92]

1.3 psychic factor

1

24

Mean Difference (IV, Fixed, 95% CI)

‐1.80 [‐6.22, 2.62]

2 Reduction in anxiety symptoms (STAI‐T) Show forest plot

1

24

Mean Difference (IV, Fixed, 95% CI)

0.70 [‐9.93, 11.33]

3 Side effects Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Somnolence

1

24

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 7.45]

4 Overall dropout Show forest plot

1

24

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.17, 5.98]
Figuras y tablas -
Comparison 1. Valerian vs placebo
Ir a la tabla de la revisión
Comparison 2. Valerian vs diazepam

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Reduction in anxiety symptoms (HAM‐A) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 total score

1

24

Mean Difference (IV, Fixed, 95% CI)

0.40 [‐6.22, 7.02]

1.2 somatic factor

1

24

Mean Difference (IV, Fixed, 95% CI)

‐0.20 [‐2.93, 2.53]

1.3 psychic factor

1

24

Mean Difference (IV, Fixed, 95% CI)

0.60 [‐3.82, 5.02]

2 Reduction in anxiety symptoms (STAI‐T) Show forest plot

1

24

Mean Difference (IV, Fixed, 95% CI)

11.40 [1.90, 20.90]

3 Side effects Show forest plot

1

24

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 7.45]

4 Overall dropout Show forest plot

1

24

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.17, 5.98]
Figuras y tablas -
Comparison 2. Valerian vs diazepam
Ir a la tabla de la revisión