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British Journal of Clinical Pharmacology Feb 2021To present an updated overview on the safety of concurrent use of food, herbal or dietary supplement and warfarin. (Review)
Review
AIMS
To present an updated overview on the safety of concurrent use of food, herbal or dietary supplement and warfarin.
METHODS
A systematic literature review was performed on 5 databases from inception up to 31 December 2019. These interactions were classified depending on the likelihood of interaction and supporting evidences.
RESULTS
A total of 149 articles describing 78 herbs, food or dietary supplements were reported to interact with warfarin. These reports described potentiation with 45 (57.7%) herbs, food or dietary supplements while 23 (29.5%) reported inhibition and 10 (12.8%) reported limited impact on warfarin pharmacokinetics and pharmacodynamics. Twenty unique herb and dietary supplements also reported to result in minor bleeding events, such as purpura and gum bleeding as well as major events such as intracranial bleeding that led to death.
CONCLUSION
While most food, herbs and supplements can be safely taken in moderation, healthcare professionals should be aware of the increased risk of bleeding when taking several food and herbs. These include Chinese wolfberry, chamomile tea, cannabis, cranberry, chitosan, green tea, Ginkgo biloba, ginger, spinach, St. John's Wort, sushi and smoking tobacco. Patients should be counselled to continue to seek advice from their healthcare professionals when starting any new herbs, food or supplement.
Topics: Dietary Supplements; Ginkgo biloba; Herb-Drug Interactions; Humans; Phytotherapy; Warfarin
PubMed: 32478963
DOI: 10.1111/bcp.14404 -
The Cochrane Database of Systematic... Apr 2023Cranberries contain proanthocyanidins (PACs), which inhibit the adherence of p-fimbriated Escherichia coli to the urothelial cells lining the bladder. Cranberry products... (Review)
Review
BACKGROUND
Cranberries contain proanthocyanidins (PACs), which inhibit the adherence of p-fimbriated Escherichia coli to the urothelial cells lining the bladder. Cranberry products have been used widely for several decades to prevent urinary tract infections (UTIs). This is the fifth update of a review first published in 1998 and updated in 2003, 2004, 2008, and 2012.
OBJECTIVES
To assess the effectiveness of cranberry products in preventing UTIs in susceptible populations.
SEARCH METHODS
We searched the Cochrane Kidney and Transplant Specialised Register up to 13 March 2023 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register Search Portal (ICTRP) and ClinicalTrials.gov.
SELECTION CRITERIA
All randomised controlled trials (RCTs) or quasi-RCTs of cranberry products compared with placebo, no specific treatment or other intervention (antibiotics, probiotics) for the prevention of UTIs were included.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed and extracted data. Information was collected on methods, participants, interventions and outcomes (incidence of symptomatic UTIs, positive culture results, side effects, adherence to therapy). Risk ratios (RR) with 95% confidence intervals (CI) were calculated where appropriate. Study quality was assessed using the Cochrane risk of bias assessment tool. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
MAIN RESULTS
For this update 26 new studies were added, bringing the total number of included studies to 50 (8857 randomised participants). The risk of bias for sequence generation and allocation concealment was low for 29 and 28 studies, respectively. Thirty-six studies were at low risk of performance bias, and 23 studies were at low risk of detection bias. Twenty-seven, 41, and 17 studies were at low risk of attrition bias, reporting bias and other bias, respectively. Forty-five studies compared cranberry products with placebo or no specific treatment in six different groups of participants. Twenty-six of these 45 studies could be meta-analysed for the outcome of symptomatic, culture-verified UTIs. In moderate certainty evidence, cranberry products reduced the risk of UTIs (6211 participants: RR 0.70, 95% CI 0.58 to 0.84; I² = 69%). When studies were divided into groups according to the treatment indication, cranberry products probably reduced the risk of symptomatic, culture-verified UTIs in women with recurrent UTIs (8 studies, 1555 participants: RR 0.74, 95% CI 0.55 to 0.99; I² = 54%), in children (5 studies, 504 participants: RR 0.46, 95% CI 0.32 to 0.68; I² = 21%) and in people with a susceptibility to UTIs due to an intervention (6 studies, 1434 participants: RR 0.47, 95% CI 0.37 to 0.61; I² = 0%). However, in low certainty evidence, there may be little or no benefit in elderly institutionalised men and women (3 studies, 1489 participants: RR 0.93, 95% CI 0.67 to 1.30; I² = 9%), pregnant women (3 studies, 765 participants: RR 1.06, 95% CI 0.75 to 1.50; I² = 3%), or adults with neuromuscular bladder dysfunction with incomplete bladder emptying (3 studies, 464 participants: RR 0.97, 95% CI 0.78 to 1.19; I² = 0%). Other comparisons were cranberry products with probiotics (three studies) or antibiotics (six studies), cranberry tablets with cranberry liquid (one study), and different doses of PACs (two studies). Compared to antibiotics, cranberry products may make little or no difference to the risk of symptomatic, culture-verified UTIs (2 studies, 385 participants: RR 1.03, 95% CI 0.80 to 1.33; I² = 0%) or the risk of clinical symptoms without culture (2 studies, 336 participants: RR 1.30, 95% CI 0.79 to 2.14; I² = 68%). Compared to probiotics, cranberry products may reduce the risk of symptomatic, culture-verified UTIs (3 studies, 215 participants: RR 0.39, 95% CI 0.27 to 0.56; I = 0%). It is unclear whether efficacy differs between cranberry juice and tablets or between different doses of PACs as the certainty of the evidence was very low. The number of participants with gastrointestinal side effects probably does not differ between those taking cranberry products and those receiving placebo or no specific treatment (10 studies, 2166 participants: RR 1.33, 95% CI 1.00 to 1.77; I² = 0%; moderate certainty evidence). There was no clear relationship between compliance with therapy and the risk for repeat UTIs. No difference in the risk for UTIs could be demonstrated between low, moderate and high doses of PACs.
AUTHORS' CONCLUSIONS
This update adds a further 26 studies taking the total number of studies to 50 with 8857 participants. These data support the use of cranberry products to reduce the risk of symptomatic, culture-verified UTIs in women with recurrent UTIs, in children, and in people susceptible to UTIs following interventions. The evidence currently available does not support its use in the elderly, patients with bladder emptying problems, or pregnant women.
Topics: Male; Female; Child; Adult; Humans; Aged; Vaccinium macrocarpon; Urinary Tract Infections; Kidney; Anti-Bacterial Agents; Phytotherapy; Plant Extracts
PubMed: 37068952
DOI: 10.1002/14651858.CD001321.pub6 -
Journal of Evidence-based Integrative... 2020Sleep problems are widely prevalent and associated with various comorbidities including anxiety. Valerian ( L.) is a popular herbal medicine used as a sleep aid, however... (Meta-Analysis)
Meta-Analysis
Sleep problems are widely prevalent and associated with various comorbidities including anxiety. Valerian ( L.) is a popular herbal medicine used as a sleep aid, however the outcomes of previous clinical studies are inconsistent. This study was conducted to update and re-evaluate the available data in order to understand the reason behind the inconsistent outcomes and to provide a broader view of the use of valerian for associated disorders. PubMed, ScienceDirect, and Cochrane Library were searched to retrieve publications relevant to the effectiveness of valerian as a treatment of sleep problems and associated disorders. A total of 60 studies (n=6,894) were included in this review, and meta-analyses were performed to evaluate the effectiveness to improve subjective sleep quality (10 studies, n=1,065) and to reduce anxiety (8 studies, n=535). Results suggested that inconsistent outcomes were possibly due to the variable quality of herbal extracts and that more reliable effects could be expected from the whole root/rhizome. In addition, therapeutic benefits could be optimized when it was combined with appropriate herbal partners. There were no severe adverse events associated with valerian intake in subjects aged between 7 and 80 years. In conclusion, valerian could be a safe and effective herb to promote sleep and prevent associated disorders. However, due to the presence of multiple active constituents and relatively unstable nature of some of the active constituents, it may be necessary to revise the quality control processes, including standardization methods and shelf life.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anxiety; Anxiety Disorders; Child; Female; Humans; Hypnotics and Sedatives; Male; Middle Aged; Phytotherapy; Plant Extracts; Plant Roots; Rhizome; Sleep; Sleep Initiation and Maintenance Disorders; Valerian; Young Adult
PubMed: 33086877
DOI: 10.1177/2515690X20967323 -
Nutrients Aug 2021Adaptogens are synthetic compounds (bromantane, levamisole, aphobazole, bemethyl, etc.) or plant extracts that have the ability to enhance the body's stability against... (Meta-Analysis)
Meta-Analysis
Adaptogens are synthetic compounds (bromantane, levamisole, aphobazole, bemethyl, etc.) or plant extracts that have the ability to enhance the body's stability against physical loads without increasing oxygen consumption. Extracts from , , , , and are considered to be naturally occurring adaptogens and, in particular, plant adaptogens. The aim of this study is to evaluate the use of plant adaptogens in the past and now, as well as to outline the prospects of their future applications. The use of natural adaptogens by humans has a rich history-they are used in recovery from illness, physical weakness, memory impairment, and other conditions. About 50 years ago, plant adaptogens were first used in professional sports due to their high potential to increase the body's resistance to stress and to improve physical endurance. Although now many people take plant adaptogens, the clinical trials on human are limited. The data from the meta-analysis showed that plant adaptogens could provide a number of benefits in the treatment of chronic fatigue, cognitive impairment, and immune protection. In the future, there is great potential to register medicinal products that contain plant adaptogens for therapeutic purposes.
Topics: Adaptation, Physiological; Adolescent; Adult; Animals; Female; History, 20th Century; History, 21st Century; Humans; Male; Middle Aged; Phytotherapy; Plant Extracts; Stress, Physiological; Young Adult
PubMed: 34445021
DOI: 10.3390/nu13082861 -
Asian Nursing Research Dec 2021The recent evidence suggested substantial anxiolytic efficacy of lavender. The aim of this study was to examine the efficacy of lavender for anxiety, depression, and... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The recent evidence suggested substantial anxiolytic efficacy of lavender. The aim of this study was to examine the efficacy of lavender for anxiety, depression, and physiological parameters and to elucidate the differential effects of lavender on anxiety and depression by study characteristics.
METHODS
A systematic review and meta-analysis was performed following the PRISMA guidelines. We searched PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index of Nursing and Allied Health Literature databases for randomized controlled trials investigating the efficacy of lavender on anxiety, depression, or physiological parameters in humans. We assessed the risk of bias within studies with the revised Cochrane risk of bias tool for randomized trials. We used random effect model to estimate the average effect and computed bias-corrected standardized mean difference as effect size metric, Hedges' ĝ for all outcomes.
RESULTS
Lavender was superior to placebo or no treatment in reducing anxiety (Hedges' ĝ = -0.72, 95% confidence interval [CI] -0.90 to -0.55, p value <.001), depression (Hedges' ĝ = -0.43, 95% CI, -0.59 to -0.27, p value <.001), and systolic blood pressure (Hedges' ĝ = -0.23, 95% CI, -0.41to -0.05, p value = .01). The moderator analysis by meta-regression indicated that route of administration accounted 6.5% (p value = .187) for the heterogeneity in anxiolytic effects, sessions of treatment accounted 13.2% (p value = .055), and participants' health state accounted 8.9% (p value = .131) for the variance in anxiolytic effects.
CONCLUSION
Lavender aromatherapy showed substantial effect in reducing anxiety and depression, and sessions of administration increased the anxiolytic effects. The effects on physiological parameters showed small with inconsistent significances and randomized controlled trials on the effect of lavender on depression were scarce. Future trials on depression and physiological parameters are recommended, and increasing the sessions of administration is recommended.
Topics: Anxiety; Anxiety Disorders; Aromatherapy; Depression; Humans; Lavandula
PubMed: 34775136
DOI: 10.1016/j.anr.2021.11.001 -
Ethiopian Journal of Health Sciences May 2020Aromatherapy as an alternative and complementary medicine is a well-known method for reducing the symptoms of various physiological processes such as labor experience....
BACKGROUND
Aromatherapy as an alternative and complementary medicine is a well-known method for reducing the symptoms of various physiological processes such as labor experience. The aim of this study was to systematically review the currently available evidences evaluating the use of aromatherapy for management of labor pain and anxiety.
METHODS
In a systematic review, 5 databases (PubMed, SCOPUS, Web of Science, Google Scholar and Scientific Information Database [SID]) were searched, from database inception up to December 2019. Keywords used included (aromatherapy OR ""essential oil" OR "aroma*") AND (pain OR anxiety) AND (labor OR delivery). Using the Cochrane Collaboration's 'Risk of bias' method; the risk of bias in the included studies was evaluated.
RESULTS
A total of 33 studies were verified to meet our inclusion criteria. Most of the included studies were conducted in Iran. Aromatherapy was applied using inhalation, massage, footbath, birthing pool, acupressure, and compress. The most popularly used essential oil in the studies was lavender (13 studies), either as a single essential oil or in a combination with other essential oils. Most of included studies confirmed the positive effect of aromatherapy in reducing labor pain and anxiety.
CONCLUSION
The evidences from this study suggest that aromatherapy, as a complementary and alternative modality, can help in relieving maternal anxiety and pain during labor.
Topics: Anxiety; Aromatherapy; Female; Humans; Labor Pain; Obstetric Labor Complications; Pain Management; Pregnancy; Treatment Outcome
PubMed: 32874088
DOI: 10.4314/ejhs.v30i3.16 -
BMC Complementary Medicine and Therapies Apr 2021Magnesium supplementation is often purported to improve sleep; however, as both an over-the-counter sleep aid and a complementary and alternative medicine, there is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Magnesium supplementation is often purported to improve sleep; however, as both an over-the-counter sleep aid and a complementary and alternative medicine, there is limited evidence to support this assertion. The aim was to assess the effectiveness and safety of magnesium supplementation for older adults with insomnia.
METHODS
A search was conducted in MEDLINE, EMBASE, Allied and Complementary Medicine, clinicaltrials.gov and two grey literature databases comparing magnesium supplementation to placebo or no treatment. Outcomes were sleep quality, quantity, and adverse events. Risk of bias and quality of evidence assessments were carried out using the RoB 2.0 and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approaches. Data was pooled and treatment effects were quantified using mean differences. For remaining outcomes, a modified effects direction plot was used for data synthesis.
RESULTS
Three randomized control trials (RCT) were identified comparing oral magnesium to placebo in 151 older adults in three countries. Pooled analysis showed that post-intervention sleep onset latency time was 17.36 min less after magnesium supplementation compared to placebo (95% CI - 27.27 to - 7.44, p = 0.0006). Total sleep time improved by 16.06 min in the magnesium supplementation group but was statistically insignificant. All trials were at moderate-to-high risk of bias and outcomes were supported by low to very low quality of evidence.
CONCLUSION
This review confirms that the quality of literature is substandard for physicians to make well-informed recommendations on usage of oral magnesium for older adults with insomnia. However, given that oral magnesium is very cheap and widely available, RCT evidence may support oral magnesium supplements (less than 1 g quantities given up to three times a day) for insomnia symptoms.
Topics: Aged; Dietary Supplements; Female; Humans; Magnesium; Male; Phytotherapy; Sleep Initiation and Maintenance Disorders
PubMed: 33865376
DOI: 10.1186/s12906-021-03297-z -
Frontiers in Public Health 2022Anxiety and depression are highly prevalent in people with cancer. Medical therapies are usually prescribed to alleviate anxiety and depression, but they are associated... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Anxiety and depression are highly prevalent in people with cancer. Medical therapies are usually prescribed to alleviate anxiety and depression, but they are associated with a variety of adverse effects. Recently, aromatherapy showed potential as a complementary medicine to improve psychological health and wellbeing. However, its effectiveness on relieving anxiety and depression has not been established.
OBJECTIVE
This study explored the beneficial effects of aromatherapy on psychological symptoms such as anxiety and depression in people with cancer.
METHODS
We searched international databases including PubMed, Web of Science, Cochrane Library, Embase, Medline, Ebscohost, ProQuest and Scopus from inception to 31 May 2021. The risk of bias was assessed using the Cochrane Collaboration's tool for assessing risk of bias. The systematic review and meta-analysis were performed according to the PRISMA guidelines. Quantitative analysis was performed on the studies that met our inclusion criteria, and Meta-analysis was performed on the studies with available data by RevMan software.
RESULTS
The quality of the literatures were assessed carefully by two researchers, a total of 17 studies were included in the systematic review and 10 articles were conducted in meta-analysis. The aromatherapy was effective in relieving anxiety (SMD = -0.49, < 0.05) in people with cancer. Subgroup analysis suggested that most effective methods were aromatic massage ( = -0.70, < 0.005), aromatherapy with lavender essential oils ( = -1.12, < 0.01), short-time interventions (duration < 4weeks) ( = -0.87, < 0.05) and studies in Asia ( = -0.83, < 0.05). Regarding depression and psychological wellbeing, there were no difference between aromatherapy and control groups.
CONCLUSION
In cancer patients, the aromatherapy was effective for relieving anxiety. However, there was no beneficial effect on depression and psychological wellbeing.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, identifier: 42021272465.
Topics: Anxiety; Anxiety Disorders; Aromatherapy; Depression; Humans; Neoplasms
PubMed: 35757624
DOI: 10.3389/fpubh.2022.853056 -
Nutrients Dec 2020Stress is a natural response of the body, induced by factors of a physical (hunger, thirst, and infection) and/or psychological (perceived threat, anxiety, or concern)...
BACKGROUND
Stress is a natural response of the body, induced by factors of a physical (hunger, thirst, and infection) and/or psychological (perceived threat, anxiety, or concern) nature. Chronic, long-term stress may cause problems with sleep, concentration, and memory, as well as affective disorders. The passionflower () is a perennial plant with documented therapeutic properties. The literature data suggest that the passionflower itself, as well as its preparations, helps reduce stress and can therefore be helpful in the treatment of insomnia, anxiety, and depression. The objective of this systematic review was to evaluate in terms of its neuropsychiatric effects.
METHODS
The scientific databases PubMed, ClinTrials.gov, and Embase were searched up to 22 October 2019. The search identified randomized clinical trials describing the effects of in neuropsychiatric disorders.
RESULTS
The systematic review included nine clinical trials. The duration of the studies included in the analysis varied widely, from one day up to 30 days. Study participants were no less than 18 years old. In each of the papers, the effects of passionflower were measured by using a number of different tests and scales. The majority of studies reported reduced anxiety levels following the administration of preparations, with the effect less evident in people with mild anxiety symptoms. No adverse effects, including memory loss or collapse of psychometric functions, were observed.
CONCLUSION
may be helpful in treating some symptoms in neuropsychiatric patients.
Topics: Adult; Anti-Anxiety Agents; Anxiety Disorders; Female; Humans; Male; Memory; Passiflora; Phytotherapy; Plant Extracts; Randomized Controlled Trials as Topic; Sleep; Sleep Initiation and Maintenance Disorders; Stress, Physiological; Young Adult
PubMed: 33352740
DOI: 10.3390/nu12123894 -
Nutrients Aug 2020Fibromyalgia syndrome (FMS) is characterised by chronic widespread pain alongside fatigue, poor sleep quality and numerous comorbidities. It is estimated to have a...
Fibromyalgia syndrome (FMS) is characterised by chronic widespread pain alongside fatigue, poor sleep quality and numerous comorbidities. It is estimated to have a worldwide prevalence of 1.78%, with a predominance in females. Treatment interventions for fibromyalgia have limited success, leading to many patients seeking alternative forms of treatment, including modifications to their diet and lifestyle. The effectiveness of dietary changes in fibromyalgia has not been widely researched or evaluated. This systematic review identified twenty-two studies, including 18 randomised control trials (RCTs) and four cohort studies which were eligible for inclusion. In total these studies investigated 17 different nutritional interventions. Significant improvements in reported pain were observed for those following a vegan diet, as well as with the low fermentable oligo di-mono-saccharides and polyols (FODMAP) diets. Supplementation with green algae, coenzyme Q10, acetyl-l-carnitine or a combination of vitamin C and E significantly improved measures of pain. Interpretation of these studies was limited due to the frequent poor quality of the study design, the wide heterogeneity between studies, the small sample size and a high degree of bias. Therefore, there is insufficient evidence to recommend any one particular nutritional intervention for the management of fibromyalgia and further research is needed.
Topics: Acetylcarnitine; Ascorbic Acid; Chlorella; Diet, Vegan; Dietary Supplements; Fermented Foods; Fibromyalgia; Humans; Nigella sativa; Pain; Phytotherapy; Quality of Life; Randomized Controlled Trials as Topic; Seeds; Treatment Outcome; Ubiquinone; Vitamin E
PubMed: 32878326
DOI: 10.3390/nu12092664