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Herbal remedies for depression and anxiety

Edzard Ernst qualified as a physician in Germany, where he was Professor of Physical Medicine and Rehabilitation (PMR) at Hannover Medical School. After a period as Head of the PMR Department at the University of Vienna (Austria) he came to the University of Exeter in 1993 to establish the first Chair in Complementary Medicine. He is Editor-in-Chief of the journal Focus on Alternative and Complementary Therapies (FACT) and founding editor of Perfusion. His work has been awarded 12 scientific prizes/awards and two Visiting Professorships. Professor Ernst served on the Medicines Commission of the British Medicines and Healthcare products Regulatory Agency (1994–2005) and on the Scientific Committee on Herbal Medicinal Products of the Irish Medicines Board. He is currently Director of Complementary Medicine at Peninsula Medical School (Universities of Exeter and Plymouth, 25 Victoria Park Road, Exeter EX2 4NT, UK. Email: Edzard. Ernst{at}pms.ac.uk).

Herbal remedies are used by many people suffering from anxiety or depression. It is therefore important to know whether they generate more good than harm. A systematic review of the published literature revealed trial data for Ginkgo biloba, Lavandula angustifolia, Hypericum perforatum, Valeriana officinalis, Crataegus oxyacantha, Eschscholzia californica, Matricaria recutita, Melissa officinalis, Passiflora incarnate and Piper methysticum. Only two of these herbal remedies are supported by sound evidence: Hypericum perforatum (St John’s wort) for mild to moderate depression and Piper methysticum (kava) for anxiety. Neither is free of risks. Our knowledge of herbal remedies is incomplete and the subject merits rigorous study.