Clinical applications of herbal medicines for anxiety and insomnia; targeting patients with bipolar disorder

Aust N Z J Psychiatry. 2014 Aug;48(8):705-15. doi: 10.1177/0004867414539198. Epub 2014 Jun 19.


Objectives: Patients with bipolar disorder frequently continue to experience residual anxiety and insomnia between mood episodes. In real-world practice, patients increasingly self-prescribe alternative medicines.

Methods: We reviewed case reports, open-label, and placebo-controlled trials investigating the use of herbal medicines to treat anxiety and insomnia, and discussed their potential applications for bipolar disorder.

Results: Eleven herbal medicines that have been studied in human subjects are included in this review. Mechanisms of action, efficacy, side effects, and drug-drug interactions are discussed. Based on currently available evidence, valerian seems to be the most promising candidate for insomnia and anxiety in bipolar disorder.

Conclusions: Adjunctive herbal medicines may have the potential to alleviate these symptoms and improve the outcomes of standard treatment, despite limited evidence. Physicians need to have a more in-depth understanding of the evidence of benefits, risks, and drug interactions of alternative treatments.

Keywords: Herbal medicine; adjunctive treatment; anxiety; bipolar disorder; insomnia.

Publication types

  • Review

MeSH terms

  • Anxiety / drug therapy*
  • Anxiety / etiology
  • Bipolar Disorder / complications
  • Bipolar Disorder / drug therapy*
  • Chamomile
  • Herbal Medicine* / methods
  • Humans
  • Melissa
  • Passiflora
  • Phytotherapy / methods
  • Sleep Initiation and Maintenance Disorders / drug therapy*
  • Sleep Initiation and Maintenance Disorders / etiology
  • Valerian