Nutritional-Based Nutraceuticals in the Treatment of Anxiety
This chapter will present evidence from human clinical trials regarding the efficacy of nutritional supplements which have emerged in recent years as viable treatments for anxiety disorders. B vitamins Magnesium Lysine and Arginine Myo-Inositol N-Acetyl-c
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Nutritional-Based Nutraceuticals in the Treatment of Anxiety David A. Camfield
5.1
Introduction
The term nutraceutical, which comes from a combination of the words ‘nutrition’ and ‘pharmaceutical’ [1], has been defined as ‘a food (or part of a food) that provides medical or health benefits, including the prevention and/or treatment of a disease’ [2]. However, in recent years, the use of the term has broadened beyond that of strictly food products, and in common practice is now typically used to refer to any over the counter nutritional substances and dietary supplements with medicinal effects. In the current chapter, these substances, rather than herbal extracts, will be the focus of discussion. Many nutraceuticals have been found to have acute and/or chronic neuropsychiatric effects, and varied mechanisms of action. These include antioxidant and anti-inflammatory effects, hypothalamic–pituitary–adrenal (HPA) axis regulation, together with more direct modulatory effects on neurotransmitter systems such as serotonin, dopamine and glutamate. Whilst clinical research into the efficacy of these substances in treating psychiatric disorders is still in its infancy, this emerging field of research has demonstrated great progress over the past 20 years. Promising lines of evidence suggest that the substances that are detailed in this chapter (B vitamins, magnesium, lysine, myo-inositol (MI) and N-acetylcysteine) have potential efficacy in reducing somatic, cognitive and affective anxiety symptoms across a range of disorders including panic disorder, obsessive-compulsive disorder (OCD), acute stress disorders and generalized anxiety disorder (GAD). Table 5.1 provides an overview of these nutritional medicines.
D.A. Camfield School of Psychology, University of Wollongong, Wollongong, NSW, Australia Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, Australia e-mail: [email protected] © Springer International Publishing Switzerland 2017 D. Camfield et al. (eds.), Evidence-Based Herbal and Nutritional Treatments for Anxiety in Psychiatric Disorders, DOI 10.1007/978-3-319-42307-4_5
81
100–300 mg
2640–3000 mg/day
L-lysine and L-arginine
B9 > 800 μg B12 > 1 mg
Dosage
Magnesium
Herbal medicine MV/B vitamins
GABA, serotonin
Glutamate (NMDA inhibition)
HCy lowering, HPA axis regulation
Mechanisms of action
Combined lysine/ arginine reduces trait and state anxiety in non-clinical samples
Reduces anxious distress in depression. Also may be effective in GAD
MV consistently reduces stress in non-clinical samples
Key evidence
Table 5.1 Nutritional substances with evidence of efficacy in the treatment of anxiety
Arginine may interact with some medications (e.g. blood pressure, Viagra)
Well tolerated with few side effects
Check all listed constituents if taking a broad spectrum MV
Potential AEs
Anxiety disorders, although further research required
Use in depression with anxious distress, as well as GAD, anxiety associated with premenstrual symptoms
Folic acid (B9) in depre
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