Citrus aurantium Aroma for Anxiety in Patients with Acute Coronary Syndrome: A Double-Blind Placebo-Controlled Trial

J Altern Complement Med. 2019 Aug;25(8):833-839. doi: 10.1089/acm.2019.0061. Epub 2019 Jun 18.


Objective: This study evaluated the antianxiety effect of Citrus aurantium aroma (neroli oil) inhalation on patients with acute coronary syndrome (ACS). Design: A double-blind, placebo-controlled randomized trial. Setting/Location: This study was conducted in the Coronary Care Unit of Torfeh Hospital in Tehran, Iran, from September 2017 to February 2018. Subjects: A total of 140 hospitalized ACS patients (mean age = 56.72 ± 11.38 years) Interventions: Eligible patients were randomly assigned to citrus aroma and placebo groups to receive inhalation aromatherapy 2 days after hospitalization. Citrus aroma was 30% essential oil of Citrus aurantium L. flowers in paraffin, which was administrated three times a day. The placebo group received paraffin similarly. Outcome measures: The rate of anxiety was measured at baseline and after intervention using the State-Trait Anxiety Inventory. Results: At baseline, citrus aroma and placebo groups were similar in demographic characteristics as well as anxiety scores. After intervention, mean anxiety scores in the two groups become significantly different; the scores were 34.66 ± 9.6 and 42.36 ± 6.4 for citrus aroma and placebo groups, respectively (p < 0.0001). No side effect was observed. Conclusions: According to the current findings, aromatherapy with Citrus aurantium L. aroma (neroli oil) may be a safe and efficient intervention and can be considered an easy and applicable method to reduce anxiety in patients with ACS.

Keywords: L; acute coronary syndrome; anxiety; aromatherapy; neroli oil; traditional Persian medicine.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acute Coronary Syndrome / complications*
  • Aged
  • Anxiety* / etiology
  • Anxiety* / therapy
  • Aromatherapy / methods*
  • Citrus*
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Medicine, Traditional
  • Middle Aged
  • Oils, Volatile / therapeutic use*


  • Oils, Volatile