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Current Drug Discovery Technologies

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ISSN (Print): 1570-1638
ISSN (Online): 1875-6220

Review Article

Clinical Evidence for the Effectiveness of Herbal Medicines in the Treatment of an Obsessive- Compulsive Disorder: A Review Study

Author(s): Maryam Hosseini Abrishami*, Mohamad Reza Noras, Atefeh Soltanifar, Roshanak Salari, Lida Jarahi and Hamideh Khorram Pazhouh

Volume 19, Issue 5, 2022

Published on: 04 August, 2022

Article ID: e160622206086 Pages: 8

DOI: 10.2174/1570163819666220616122543

Price: $65

Abstract

Background: Obsessive-compulsive disorder (OCD) is a potentially debilitating disease that affects 1-4% of the general population. It is characterized by the presence of obsessions and compulsions which interfere with the individual’s life and functioning. Although conventional treatments such as drug therapies and cognitive behavioral therapy exist for OCD, these treatments are not universally successful and can cause side effects, which has created a demand for alternative and complementary therapies.

Methods: In this review, we summarize randomized clinical trials on the effectiveness of herbal medicines for the treatment of OCD, and review the possible mechanisms of action for these medicines. A search in PubMed, Scopus, and The Cochrane Library found 1022 studies, of which 7 were included in our review.

Results: The studies that we found were conducted over 6 to 12 weeks, and had an average sample size of 37. The plant species studied included Crocus sativus, Echium amoenum, Hypericum perforatum, Silybum marianum, Valeriana officinalis, and Withania somnifera. The trials demonstrated the effectiveness of all plants as treatments for OCD except H. perforatum. The phytochemicals found in these plants produce their effects through a variety of means such as inhibiting the reuptake of monoamines, GABAergic effects, and neuroendocrine modulation. The small number of studies and their small sample sizes, poor methodology, and lack of replication highlight the need for further research into herbal medicines for the treatment of OCD.

Conclusion: Overall, herbal medicines can be used as stand-alone therapies for OCD or in conjunction with other methods.

Keywords: Obsessive-compulsive disorder, treatment, herbal medicine, OCD, Crocus sativus, Echium amoenum, Hypericum perforatum.

Graphical Abstract
[1]
(a) Prajapati RP, Kalaria MV, Karkare VP, Parmar SK, Sheth NR. Effect of methanolic extract of Lagenaria siceraria (Molina) standley fruits on marble-burying behavior in mice: Implications for obsessive-compulsive disorder. Pharmacognosy Res 2011; 3(1): 62-6.
[http://dx.doi.org/10.4103/0974-8490.79118] [PMID: 21731398] ; (b) Prajapati R, Kalariya M, Umbarkar R, Parmar S, Sheth N. Colocasia esculenta: A potent indigenous plant. Int J Nutr Pharmacol Neurol Dis 2011; 1(2): 90.
[http://dx.doi.org/10.4103/2231-0738.84188] ; (c) Prajapati R, Umbarkar R, Parmar S, Sheth N. Antidepressant like activity of lagenaria siceraria (Molina) standley fruits by evaluation of the forced swim behavior in rats. Int J Nutr Pharmacol Neurol Dis 2011; 1(2): 152.
[http://dx.doi.org/10.4103/2231-0738.84206]
[2]
(a) Swedo SE, Leonard HL, Rapoport JL. Childhood-onset obsessive compulsive disorder. Psychiatr Clin North Am 1992; 15(4): 767-75.
[http://dx.doi.org/10.1016/S0193-953X(18)30207-7] [PMID: 1461794] ; (b) Glaser K. Problems in school attendance; school phobia and related conditions. Pediatrics 1959; 23(2): 371-83.
[http://dx.doi.org/10.1542/peds.23.2.371] [PMID: 13633355]
[3]
(a) Milman DH. School phobia in older children and adolescents: Diagnostic implications and prognosis. Pediatrics 1961; 28(3): 462-71.
[http://dx.doi.org/10.1542/peds.28.3.462] [PMID: 13770959] ; (b) Nazeer A, Latif F, Mondal A, Azeem MW, Greydanus DE. Obsessive-compulsive disorder in children and adolescents: Epidemiology, diagnosis and management. Transl Pediatr 2020; 9(S1)(Suppl. 1): S76-93.
[http://dx.doi.org/10.21037/tp.2019.10.02] [PMID: 32206586]
[4]
(a) Shavitt RG, de Mathis MA, Oki F, et al. Phenomenology of OCD: Lessons from a large multicenter study and implications for ICD-11. J Psychiatr Res 2014; 57: 141-8.
[http://dx.doi.org/10.1016/j.jpsychires.2014.06.010] [PMID: 25012187] ; (b) Drubach DA. Obsessive-compulsive disorder 2015; 21(3): 783-8.
[http://dx.doi.org/10.1212/01.CON.0000466666.12779.07] [PMID: 26039854] ; (c) Adam Y, Meinlschmidt G, Gloster AT, Lieb R. Obsessive-compulsive disorder in the community: 12-month prevalence, comorbidity and impairment. Soc Psychiatry Psychiatr Epidemiol 2012; 47(3): 339-49.
[http://dx.doi.org/10.1007/s00127-010-0337-5] [PMID: 21287144] ; (d) Westwell-Roper C, Stewart SE. Challenges in the diagnosis and treatment of pediatric obsessive-compulsive disorder. Indian J Psychiatry 2019; 61(7)(Suppl. 1): S119-30.
[http://dx.doi.org/10.4103/psychiatry.IndianJPsychiatry_524_18] [PMID: 30745685] ; (e) Veale D, Roberts A. Obsessive-compulsive disorder. BMJ 2014; 348(apr07 6): g2183.
[http://dx.doi.org/10.1136/bmj.g2183] [PMID: 24709802]
[5]
(a) Keeley ML, Storch EA, Dhungana P, Geffken GR. Pediatric obsessive-compulsive disorder: A guide to assessment and treatment. Issues Ment Health Nurs 2007; 28(6): 555-74.
[http://dx.doi.org/10.1080/01612840701354570] [PMID: 17613156] ; (b) Osland S, Arnold PD, Pringsheim T. The prevalence of diagnosed obsessive compulsive disorder and associated comorbidities: A population-based Canadian study. Psychiatry Res 2018; 268: 137-42.
[http://dx.doi.org/10.1016/j.psychres.2018.07.018] [PMID: 30025284]
[6]
Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the national comorbidity survey replication. Mol Psychiatry 2010; 15(1): 53-63.
[http://dx.doi.org/10.1038/mp.2008.94] [PMID: 18725912]
[7]
Weissman MM. Cross-national epidemiology of obsessive-compulsive disorder. CNS Spectr 1998; 3(S1): 6-9.
[http://dx.doi.org/10.1017/S1092852900007136]
[8]
Diagnostic and statistical manual of mental disorders. Arlington: American Psychiatric Association 2013.
[http://dx.doi.org/10.1176/appi.books.9780890425596]
[9]
Abramowitz JS, Taylor S, McKay D. Obsessive-compulsive disorder. Lancet 2009; 374(9688): 491-9.
[http://dx.doi.org/10.1016/S0140-6736(09)60240-3] [PMID: 19665647]
[10]
(a) Collins LM, Coles ME. A preliminary investigation of pathways to inflated responsibility beliefs in children with obsessive compulsive disorder. Behav Cogn Psychother 2018; 46(3): 374-9.
[http://dx.doi.org/10.1017/S1352465817000844] [PMID: 29338800] ; (b) Rosso IM, Olson EA, Britton JC, et al. Brain white matter integrity and association with age at onset in pediatric obsessive-compulsive disorder. Biol Mood Anxiety Disord 2014; 4(1): 13.
[http://dx.doi.org/10.1186/s13587-014-0013-6] [PMID: 25540681]
[11]
(a) Dell’Osso B, Nestadt G, Allen A, Hollander E. Serotonin-norepinephrine reuptake inhibitors in the treatment of obsessive-compulsive disorder: A critical review. J Clin Psychiatry 2006; 67(4): 600-10.
[http://dx.doi.org/10.4088/JCP.v67n0411] [PMID: 16669725] ; (b) Denys D, Van Nieuwerburgh F, Deforce D, Westenberg HG. Prediction of response to paroxetine and venlafaxine by serotonin-related genes in obsessive-compulsive disorder in a randomized, double-blind trial. J Clin Psychiatry 2007; 68(5): 747-53.
[http://dx.doi.org/10.4088/JCP.v68n0512] [PMID: 17503984] ; (c) Fineberg NA, Gale TM. Evidence-based pharmacotherapy of obsessive-compulsive disorder. Int J Neuropsychopharmacol 2005; 8(1): 107-29.
[http://dx.doi.org/10.1017/S1461145704004675] [PMID: 15450126] ; (d) Jenike MA. Clinical practice. Obsessive-compulsive disorder. N Engl J Med 2004; 350(3): 259-65.
[http://dx.doi.org/10.1056/NEJMcp031002] [PMID: 14724305]
[12]
Ayati Z, Sarris J, Chang D, Emami SA, Rahimi R. Herbal medicines and phytochemicals for obsessive-compulsive disorder. Phytother Res 2020; 34(8): 1889-901.
[http://dx.doi.org/10.1002/ptr.6656] [PMID: 32124509]
[13]
(a) Bahramsoltani R, Farzaei MH, Farahani MS, Rahimi R. Phytochemical constituents as future antidepressants: A comprehensive review. Rev Neurosci 2015; 26(6): 699-719.
[http://dx.doi.org/10.1515/revneuro-2015-0009] [PMID: 26146123] ; (b) Farahani MS, Bahramsoltani R, Farzaei MH, Abdollahi M, Rahimi R. Plant-derived natural medicines for the management of depression: An overview of mechanisms of action. Rev Neurosci 2015; 26(3): 305-21.
[http://dx.doi.org/10.1515/revneuro-2014-0058] [PMID: 25719303] ; (c) Farzaei MH, Bahramsoltani R, Rahimi R, Abbasabadi F, Abdollahi M. A systematic review of plant-derived natural compounds for anxiety disorders. Curr Top Med Chem 2016; 16(17): 1924-42.
[http://dx.doi.org/10.2174/1568026616666160204121039] [PMID: 26845556]
[14]
Camfield DA, Sarris J, Berk M. Nutraceuticals in the treatment of obsessive compulsive disorder (OCD): A review of mechanistic and clinical evidence. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35(4): 887-95.
[http://dx.doi.org/10.1016/j.pnpbp.2011.02.011] [PMID: 21352883]
[15]
Goodman WK, Price LH, Rasmussen SA, et al. The Yale-Brown obsessive compulsive scale: I. development, use, and reliability. Arch Gen Psychiatry 1989; 46(11): 1006-11.
[http://dx.doi.org/10.1001/archpsyc.1989.01810110048007] [PMID: 2684084]
[16]
Deacon BJ, Abramowitz JS. The Yale-Brown obsessive compulsive scale: Factor analysis, construct validity, and suggestions for refinement. J Anxiety Disord 2005; 19(5): 573-85.
[http://dx.doi.org/10.1016/j.janxdis.2004.04.009] [PMID: 15749574]
[17]
Esalatmanesh S, Biuseh M, Noorbala AA, et al. Comparison of saffron and fluvoxamine in the treatment of mild to moderate obsessive- compulsive disorder: A double blind randomized clinical trial. Iran J Psychiatry 2017; 12(3): 154-62.
[PMID: 29062366]
[18]
Sayyah M, Sayyah M, Kamalinejad M. A preliminary randomized double blind clinical trial on the efficacy of aqueous extract of Echium amoenum in the treatment of mild to moderate major depression. Prog Neuropsychopharmacol Biol Psychiatry 2006; 30(1): 166-9.
[http://dx.doi.org/10.1016/j.pnpbp.2005.10.005] [PMID: 16309809]
[19]
Taylor LH, Kobak KA. An open-label trial of St. John’s Wort (Hypericum perforatum) in obsessive-compulsive disorder. J Clin Psychiatry 2000; 61(8): 575-8.
[http://dx.doi.org/10.4088/JCP.v61n0806] [PMID: 10982200]
[20]
Kobak KA, Taylor LV, Bystritsky A, et al. St John’s wort versus placebo in obsessive-compulsive disorder: Results from a double-blind study. Int Clin Psychopharmacol 2005; 20(6): 299-304.
[http://dx.doi.org/10.1097/00004850-200511000-00003] [PMID: 16192837]
[21]
Sayyah M, Boostani H, Pakseresht S, Malayeri A. Comparison of Silybum marianum (L.) Gaertn. with fluoxetine in the treatment of obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34(2): 362-5.
[http://dx.doi.org/10.1016/j.pnpbp.2009.12.016] [PMID: 20035818]
[22]
Pakseresht S, Boostani H, Sayyah M. Extract of valerian root ( Valeriana officinalis L.) vs . placebo in treatment of obsessive-compulsive disorder: A randomized double-blind study. J Complement Integr Med 2011; 8(1)
[http://dx.doi.org/10.2202/1553-3840.1465] [PMID: 22718671]
[23]
Jahanbakhsh SP, Manteghi AA, Emami SA, et al. Evaluation of the efficacy of Withania somnifera (Ashwagandha) root extract in patients with obsessive-compulsive disorder: A randomized double-blind placebo-controlled trial. Complement Ther Med 2016; 27: 25-9.
[http://dx.doi.org/10.1016/j.ctim.2016.03.018] [PMID: 27515872]
[24]
Kashani L, Eslatmanesh S, Saedi N, et al. Comparison of saffron versus fluoxetine in treatment of mild to moderate postpartum depression: A double-blind, randomized clinical trial. Pharmacopsychiatry 2017; 50(2): 64-8.
[PMID: 27595298]
[25]
Khazdair MR, Boskabady MH, Hosseini M, Rezaee R. M Tsatsakis A. The effects of Crocus sativus (saffron) and its constituents on nervous system: A review. Avicenna J Phytomed 2015; 5(5): 376-91.
[PMID: 26468457]
[26]
Hooper D, McNair JB, Field H. Useful plants and drugs of Iran and Iraq.Field Museum of Natural History. 1937; Vol. 9: pp. 71-241.
[27]
Abed A, Vaseghi G, Jafari E, Fattahian E, Babhadiashar N, Abed M. Echium Amoenum Fisch. Et Mey: A review on its pharmacological and medicinal properties. Asian J Med Pharm Res 2014; 4: 21-3.
[28]
Sarris J, Panossian A, Schweitzer I, Stough C, Scholey A. Herbal medicine for depression, anxiety and insomnia: A review of psychopharmacology and clinical evidence. Eur Neuropsychopharmacol 2011; 21(12): 841-60.
[http://dx.doi.org/10.1016/j.euroneuro.2011.04.002] [PMID: 21601431]
[29]
Sarris J, Kavanagh DJ. Kava and St. John’s Wort: Current evidence for use in mood and anxiety disorders. J Altern Complement Med 2009; 15(8): 827-36.
[http://dx.doi.org/10.1089/acm.2009.0066] [PMID: 19614563]
[30]
Karcı KC, Celik GG. Nutritional and herbal supplements in the treatment of obsessive compulsive disorder. Gen Psychiatr 2020; 33(2): e100159.
[http://dx.doi.org/10.1136/gpsych-2019-100159] [PMID: 32215361]
[31]
Morazzoni P, Bombardelli E. Silybum marianum (Carduus marianus). Fitoterapia 1995; 66(1): 3-42.
[32]
Zi X, Mukhtar H, Agarwal R. Novel cancer chemopreventive effects of a flavonoid antioxidant silymarin: Inhibition of mRNA expression of an endogenous tumor promoter TNF α. Biochem Biophys Res Commun 1997; 239(1): 334-9.
[http://dx.doi.org/10.1006/bbrc.1997.7375] [PMID: 9345320]
[33]
De La Puerta R, Martinez E, Bravo L, Ahumada MC. Effect of silymarin on different acute inflammation models and on leukocyte migration. J Pharm Pharmacol 1996; 48(9): 968-70.
[http://dx.doi.org/10.1111/j.2042-7158.1996.tb06014.x] [PMID: 8910865]
[34]
Maghrani M, Zeggwagh N-A, Lemhadri A, El Amraoui M, Michel J-B, Eddouks M. Study of the hypoglycaemic activity of Fraxinus excelsior and Silybum marianum in an animal model of type 1 diabetes mellitus. J Ethnopharmacol 2004; 91(2-3): 309-16.
[http://dx.doi.org/10.1016/j.jep.2004.01.008] [PMID: 15120454]
[35]
Mikaili P, Shayegh J, Asghari MH, Sarahroodi S, Sharifi M. Currently used traditional phytomedicines with hot nature in Iran. Biol Res 2011; 2(5): 56-68.
[36]
(a) Hölzl J, Godau P. Receptor bindings studies with Valeriana officinalis on the benzodiazepine receptor. Planta Med 1989; 55(07): 642-2.
[http://dx.doi.org/10.1055/s-2006-962221] ; (b) 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: 291-1.; (c) Khom S, Baburin I, Timin E, et al. Valerenic acid potentiates and inhibits GABA(A) receptors: Molecular mechanism and subunit specificity. Neuropharmacology 2007; 53(1): 178-87.
[http://dx.doi.org/10.1016/j.neuropharm.2007.04.018] [PMID: 17585957]
[37]
Andreatini R, Sartori VA, Seabra ML, Leite JR. Effect of valepotriates (valerian extract) in generalized anxiety disorder: A randomized placebo-controlled pilot study. Phytother Res 2002; 16(7): 650-4.
[http://dx.doi.org/10.1002/ptr.1027] [PMID: 12410546]
[38]
Lacher SK, Mayer R, Sichardt K, Nieber K, Müller CE. Interaction of valerian extracts of different polarity with adenosine receptors: Identification of isovaltrate as an inverse agonist at A1 receptors. Biochem Pharmacol 2007; 73(2): 248-58.
[http://dx.doi.org/10.1016/j.bcp.2006.09.029] [PMID: 17097622]
[39]
Bhatnagar M, Sharma D, Salvi M. Neuroprotective effects of Withania somnifera dunal.: A possible mechanism. Neurochem Res 2009; 34(11): 1975-83.
[http://dx.doi.org/10.1007/s11064-009-9987-7] [PMID: 19444606]
[40]
(a) Gupta GL, Rana A. Withania somnifera (Ashwagandha): A review. Pharmacogn Rev 2007; 1(1): 129-36.; (b) Mishra L-C, Singh BB, Dagenais S. Scientific basis for the therapeutic use of Withania somnifera (ashwagandha): A review. Altern Med Rev 2000; 5(4): 334-46.
[PMID: 10956379] ; (c) Gupta SK, Dua A, Vohra BP. Withania somnifera (Ashwagandha) attenuates antioxidant defense in aged spinal cord and inhibits copper induced lipid peroxidation and protein oxidative modifications. Drug Metabol Drug Interact 2003; 19(3): 211-22.
[http://dx.doi.org/10.1515/DMDI.2003.19.3.211] [PMID: 14682611]
[41]
Bhattacharya SK, Bhattacharya A, Sairam K, Ghosal S. Anxiolytic-antidepressant activity of Withania somnifera glycowithanolides: An experimental study. Phytomedicine 2000; 7(6): 463-9.
[http://dx.doi.org/10.1016/S0944-7113(00)80030-6] [PMID: 11194174]
[42]
Zamani Z, Akhondzadeh S. Herbal medicine in the treatment of obsessive compulsive disorder: A Review. Faslnamah-i Giyahan-i Daruyi 2019; 3(71): 1-5.
[http://dx.doi.org/10.29252/jmp.3.71.1]
[43]
Hollander E, Friedberg J, Wasserman S, Allen A, Birnbaum M, Koran LM. Venlafaxine in treatment-resistant obsessive-compulsive disorder. J Clin Psychiatry 2003; 64(5): 546-50.
[http://dx.doi.org/10.4088/JCP.v64n0508] [PMID: 12755657]
[44]
Jenike MA, Baer L, Minichiello WE. Obsessive-compulsive disorders: Practical management. 3rd ed. St Louis: Mosby 1998; p. 885.
[45]
(a) Tamayo C, Diamond S. Review of clinical trials evaluating safety and efficacy of milk thistle ( Silybum marianum [L. Gaertn.). Integr Cancer Ther 2007; 6(2): 146-57.
[http://dx.doi.org/10.1177/1534735407301942] [PMID: 17548793] ; (b) Modaghegh M-H, Shahabian M, Esmaeili H-A, Rajbai O, Hosseinzadeh H. Safety evaluation of saffron (Crocus sativus) tablets in healthy volunteers. Phytomedicine 2008; 15(12): 1032-7.
[http://dx.doi.org/10.1016/j.phymed.2008.06.003] [PMID: 18693099]

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