Lavender (Silexan) for Anxiety

Lavender (Lavandula) is a great herb for relieving stress and anxiety, as well as helping improve sleep. I have been using Lavender in tablet and liquid herbal mixes since the beginning of my career. Some people don’t like the strong smell in liquid herbal mixes so I either have to mask it with other herbs or use tablet form. There are a number of retail and practitioner products in tablet form.

As we are heading into the Christmas New Year period, stress and anxiety levels can increase. Sleep can also be a problem with stress levels and the summer heat. Lavender combined with the herbs Chamomile, Passionflower, and Ziziphus, can have great benefits in reducing stress levels and improving sleep. Ashwagandha is also very helpful in reducing stress and anxiety (and one of my favourite herbs). Magnesium will also be beneficial as it reducing muscle aches and pains, relaxes the muscles and nerves, and is a good all-rounder. I generally prescribe 150-200 mg twice daily.

Below are 2 trials on a Lavender product called Silexan. The dosages of Silexan range from 80-160 mg:

A 6 week controlled clinical study was performed to evaluate the efficacy of Silexan, an oral lavender oil capsule preparation, versus a benzodiazepine, in adults with generalised anxiety disorder. The primary target variable was the change in the Hamilton Anxiety Rating Scale (HAM-A-total score) as an objective measurement of the severity of anxiety between baseline and week 6. The results suggested that Silexan effectively ameliorates generalised anxiety comparable to a common benzodiazepine (lorazepam). The mean of the HAM-A-total score decreased clearly and to a similar extent in both groups (by 11.3+/-6.7 points (45%) in the Silexan group and by 11.6+/-6.6 points (46%) in the lorazepam group, from 25+/-4 points at baseline in both groups). During the active treatment period, the two HAM-A subscores “somatic anxiety” (HAM-A subscore I) and “psychic anxiety” (HAM-A subscore II) also decreased clearly and to a similar extent in both groups. The changes in other subscores measured during the study, such as the SAS (Self-rating Anxiety Scale), PSWQ-PW (Penn State Worry Questionnaire), SF 36 Health survey Questionnaire and Clinical Global Impressions of severity of disorder (CGI item 1, CGI item 2, CGI item 3), and the results of the sleep diary demonstrated comparable positive effects of the two compounds. In conclusion, our results demonstrate that Silexan is as effective as lorazepam in adults with GAD. The safety of Silexan was also demonstrated.

In a randomised, double-blind, double-dummy trial was conducted on 539 adults with GAD according to DSM-5 criteria and a Hamilton Anxiety Scale (HAMA) total score ⩾ 18 points. Participants received 160 or 80 mg Silexan, 20 mg paroxetine, or placebo once daily for 10 weeks. The primary efficacy endpoint was the HAMA total score reduction between baseline and treatment end. The HAMA total score decreased by 14.1 ± 9.3 points for Silexan 160 mg per day, 12.8 ± 8.7 points for Silexan 80 mg per day, 11.3 ± 8.0 points for paroxetine, and 9.5 ± 9.0 points for placebo (mean ± s.d.). Silexan 160 and 80 mg per day were superior to placebo in reducing the HAMA total score (p < 0.01). In the Silexan 160 mg per day group 73/121 patients (60.3%) showed a HAMA total score reduction ⩾ 50% of the baseline value and 56 (46.3%) had a total score <10 points at treatment end, compared to 70/135 (51.9%) and 45 (33.3%) for Silexan 80 mg per day, 57/132 (43.2%) and 45 (34.1%) for paroxetine, and 51/135 (37.8%) and 40 (29.6%) for placebo. In addition, Silexan showed a pronounced antidepressant effect and improved general mental health and health-related quality of life.

A review found: Hamilton Anxiety Scale (HAMA) total score reductions between baseline and end of treatment were significantly superior for Silexan compared to placebo in patients with subsyndromal anxiety and comparable to lorazepam in its starting dose in patients with generalised anxiety disorder. Silexan had beneficial effects on typical co-morbidity symptoms of anxiety disorders, for example, disturbed sleep, somatic complaints, or decreased quality of life.

References:

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.

Kasper S et al. 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.

Kasper S. An orally administered lavandula oil preparation (Silexan) for anxiety disorder and related conditions: an evidence based review. Int J Psychiatry Clin Pract. 2013 Nov; 17 Suppl 1: 15-22.