Kava + Valerian: Internet Trial Questions Herbal Remedies for Anxiety + Inso

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Internet Trial Questions Herbal Remedies for Anxiety and Insomnia

25 Jul 2005 Medical News Today

Two popular herbal remedies - kava, commonly used for anxiety, and

valerian, used for insomnia - are no more effective than an inactive

placebo, concludes a study in the July issue of Medicine.

Dr. Bradly P. s and colleagues of University of California-San

Francisco performed an innovative Internet trial to evaluate the

effectiveness of kava and valerian. Potential subjects who reported

anxiety and insomnia were recruited through e-mail and websites. The

final study included 391 participants from 45 states.

By mail, one group of patients received kava plus an inactive

valerian-placebo and one group received valerian plus kava-placebo; a

third group received double placebos. After four weeks of treatment,

subjects used a secure website to complete follow-up questionnaires.

The herbal extracts were no more effective than placebo in reducing

the symptoms they were intended to treat. Anxiety scores decreased by

25 percent for patients taking placebo, compared to about 21 percent

with either kava or valerian.

The effects on insomnia were also similar-in all three groups,

insomnia scores and time to falling asleep decreased by about 50

percent. The results were comparable across patient subgroups, such

as those with higher vs lower depression scores.

Most side effects were comparable between groups, although patients

taking valerian had a higher rate of diarrhea. The study was

performed before recent safety warnings concerning liver damage

related to kava. However, none of the patients taking kava reported

any liver-related side effects.

Anxiety and insomnia are common symptoms that often occur together.

Kava and valerian are among the most popular herbal remedies, with

annual sales of over $28 million in the United States alone. However,

few scientific studies have been performed to evaluate their

effectiveness.

The new results question the true benefits of kava in reducing

anxiety, or valerian in improving sleep for people with insomnia.

Although many people trying these herbal remedies will feel better

within a few weeks, the results appear no better than with inactive

placebo treatment. Within the confines of a clinical trial

environment in which people are highly motivated to seek relief from

their medical condition, any improvements " may not be attributed to

the biological effects of kava or valerian, and if attributable are

no greater than the effect of placebo " Dr. s and colleagues

conclude.

The study is the first randomized, controlled clinical research trial

to be conducted entirely over the Internet. The " direct-to-

participant " method used for the study included measures to confirm

that the participants were who they claimed to be and were not

providing misleading information on outcomes. Internet studies may

provide a valuable new approach to enrolling appropriate research

subjects quickly, efficiently, and at lower cost than with

traditional research designs.

Medicine provides insight from leading scholars about the latest

results in clinical investigation. Relevant to both hospital and

office practice, the journal includes analytical reviews of Internal

Medicine, Dermatology, Neurology, and Pediatrics topics. The journal

is published by Lippincott & Wilkins of Philadelphia, PA,

and is available online at http://www.md-journal.com.