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Group 4A Safety and Efficacy of Lavender Oil
Transcript of Group 4A Safety and Efficacy of Lavender Oil
to evaluate the use, safety, and efficacy of lavender essential oil in the treatment of minor anxiety
Describe the pathophysiology of anxiety
List the common medications used to treat anxiety
Discuss the pharmacology and clinically significant adverse effects and drug interactions of Benzodiazepines, SSRI's, and SNRI's
Identify strengths and limitations of primary literature evaluating lavender oil in the treatment of anxiety
Formulate an evidence-based therapeutic plan for patients with anxiety
What is Anxiety?
Anxiety can be classified as a disorder (GAD) or as an episode.
Why Do We Care ?
As pharmacists we will have someone came to the pharmacy and ask for a product to treat anxiety.
Everyone experiences anxiety at some point in their life!
Some people experience more anxiety than others.
Anxiety can decrease your quality of life and interfere with normal everyday activities.
Anxiety disorders are the most common mental illness in the U.S..
A multi-center, double-blind, randomized study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder
Is lavender an anxiolytic drug? A systematic review of randomized clinical trials
Hypersensitivity of autonomic nervous system ( increased NE release)
Chronic over activity of alpha 2 receptors leads to down regulation of these auto-receptors.
Decreased GABA activity.
Abnormalities with serotonin.
It is both psychological and physical.
N- non focused
X- excessive motion (restlessness)
E- energy (fatigue)
T- tension (muscles)
Y- yelling (irritable)
Used topically, orally, and via inhalation for treatment of many disease states.
Lavender inhaled or taken orally best treats anxiety.
Working on GABA- A receptors.
Shown to be safe when inhaled at appropriate concentrations.
Possibly unsafe in children when used topically
Gynecomastia in prepubescent boys
ADR: reversible neutropenia after high oral doses in patients with malignancy , CNS depression, additive effects with narcotics, N/V, dyspepsia, and anorexia
Is it Feasible?
Essential oil 1 fl. oz. = $7.59
Lavender 450 mg Capsules #30 = $15.00
Essential oil must be diluted before being taken orally. (concentration is crucial)
Potential Drug Interactions
Warfarin and Plavix
Lab Drug Interaction
Decreased cholesterol levels.
Due to decreasing serum cholesterol.
Have You Ever Googled Anxious Pharmacy Student?
Do you recognize anyone?
2 Parallel Treatment Groups
Diagnosis of GAD
Outpatient Treatment by General Practitioner
HAM-A Score <19 (Anxiety and Tension >1)
Prior to the trial each group received placebo for one week to ensure a wash-out current medications.
Patients (n=77) were enrolled for the 6 week trial and were randomized into two treatment groups:
Silexan 80mg (n=40)
Lorazepam 0.5mg (n=37)
Patients were evaluated based on HAM-A Score:
Response = 50% Reduction in Score
Remission = Score of less than 10
Safety was evaluated based on:
12 Lead ECG
Psychinfo (via OVID)
The Cochrane Library
Search Terms used:
A total of 440 trials were found pertaining to lavender and anxiety relief. Only 15 of these trials met the inclusion criteria.
Human subjects with or without clinical anxiety
Any type of pure lavender preparation
Should not delay conventional treatment.
If a patient is already using lavender for minor anxiety we will tolerate it.
We would not recommend a patient start initiation of lavender to treat anxiety.
Conventional Chronic Therapy (GAD)
Drugs: Fluoxetine, escitalopram, citalopram, and sertraline,
ADR: Sexual dysfunction, anorexia, N/V, and anxiety
Drug interactions: MAO-I, Linezolid, 2D6 substrates
Cost Range: $8.95 - $67.95
Drugs: Venlafaxine, desvenlafaxine, and duloxetine
ADR: Tachychardiea, sexual dysfunction, increased blood pressure, and tremor
Drug interactions: MAO-I, 2D6 inhibitors, Linezolid
Cost range: $108.95 - $215.95
Results and Conclusion
HAM-A Scores in both groups decreased similarly during the 6 week period (CI=90%)
This study demonstrated that Silexan is as effective as Lorazepam for the treatment of GAD in adults.
General Adverse Effects:
Drug Drug Interactions:
1. Benzodiazepines. In: Lexi-Drugs Online. Hudson (OH): Lexi-Comp. Inc; [updated 10/22/14; accessed 10/7/14]. http://cronline.comezproxy.samford.edu/lco/actio/doc/retrieve/docid/gdh_f
2. HHS resource page. U.S. Department of Health and Human Services Web Site.http://www.guidline.gov/content
3. Lavender. In: Lexi-Drugs Online. Hudson (OH): Lexi-Comp, Inc.;[updated not listed; accessed 10/7/14]. http://www.crlonline.com.ezproxy.samford.edu/lco/action/doc/rerieve/docid/disandroc/3852627
4. Lavender. In: Natural Standard. Somerville, (MA): Natural Standard. [updated: not listed; accessed 10/6/14].http://naturalmedicines-therapeuticsresearch-com.ezproxy.samford.edu/databases/foodds,-herbs-supplements/professional.aspx
5. Perry R, Terry R, Watson E. Is lavender an anxiolytic drug? A systematic review of randomized clinical trials. Phytomedicine. 2012; 19(8-9):825-835.
6. Woelk H, Schlafke S.A multi-center, double-blind, randomized study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. Phytomedicine. 2010; 17(2):94-99.
So Before You Ask Us Questions We have a Question for You!
Use of forms of lavender therapy such as aromatherapy and massage are not supported by good evidence
Oral administration of lavender oil is promising, and more attention should be placed on research involving this dosage form
By: Sean Altendorf, Blaise Aziagba, Whitney Bernreuter and Kellie Cameron
Inability to Blind
Variety of Treatment Conditions
Under Reporting of Dropouts
Now Its Your Turn !
Additionally, these trials showed lavender have a relatively safe side effect profile and no sedative effects or potential for abuse.