Effects of Passion Flower Extract, as an Add-on Treatment to Sertraline, on Reaction Time in Patients with Generalized Anxiety Disorder: a Double-blind Placebo-Controlled Study
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Abstract
Objective: Because of functional impairment caused by generalized anxiety disorder and due to cognitive side effects of many anti-anxiety agents, in this study we aimed to evaluate the influence of Passion flower standardized extract on reaction time in patients with generalized anxiety disorder.
Method: Thirty patients aged 18 to 50 years of age, who were diagnosed with generalized anxiety disorder and fulfilled the study criteria, entered this double-blind placebo-controlled study. Reaction time was measured at baseline and after one month of treatment using computerized software. Correct responses, omission and substitution errors and the mean time of correct responses (reaction time) in both visual and auditory tests were collected. The analysis was performed between the two groups and within each group utilizing SPSS PASW- statics, Version 18. P-value less than 0.05 was considered statistically significant.
Results: All the participants were initiated on Sertraline 50 mg/day, and the dosage was increased to 100 mg / day after two weeks. Fourteen patients received Pasipy (Passion Flower) 15 drops three times daily and 16 received placebo concurrently. Inter-group comparison proved no significant difference in any of the test items between assortments while a significant decline was observed in auditory omission errors in passion flower group after on month of treatment using intra-group analysis.
Conclusion: This study noted that passion flower might be suitable as an add-on in the treatment of generalized anxiety disorder with low side effects. Further studies with longer duration are recommended to confirm the results of this study.
Brown TA, O’Leary TA, Barlow DH. Generalized Anxiety Disorder. In: Barlow DH, ed. Clinical Handbook of Psychiatry Disorders. 3rd ed. New York: Guilford Publications; 2001. Chapter 4.P. 154-208.
Newman MG, Llera SJ, Erickson TM, Przeworski A , Castonguay LG. Worry and generalized anxiety disorder: a review and theoretical synthesis of evidence on nature, etiology, mechanisms, and treatment. Annual review of clinical psychology 2013; 9: 275-297.
Hanrahan F, Field AP, Jones FW, Davey GC. A meta-analysis of cognitive therapy for worry in generalized anxiety disorder. Clinical psychology review 2013; 33: 120-132.
Roemer L, Orsillo SM. Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/ acceptance-based approaches with existing cognitive-behavioral models. Clin Psychol: Science and Practice 2006; 9: 54.
Hoyer J, Van der Heiden C, Portman ME. Psychotherapy for generalized anxiety disorder. Psychiatr Ann 2011; 41: 87-94
Wells BG, Dipiro JT, Schwinghammer TL, Dipiro CV, eds. Pharmacotherapy handbook. United States of America: 2009; The McGraw-Hill companies; 2009. Section 13.P. 740-747.
Durham RC. Treatment of generalized anxiety disorder. Psychiatry 2007; 6: 183-187.
Wensel TM, Powe KW, Cates ME. Pregabalin for the treatment of generalized anxiety disorder. Annals of Pharmacotherapy 2012; 46: 424-429.
El-Mallakh RS, Ghaemi SN. Bipolar depression: A comprehensive guide. American Psychiatric Pub. Arlington: 2007; p. 158.
Martins HR, Zanetti R, Santos CCd, Manzano GM, Tierra-Criollo CJ. Current perception threshold and reaction time in the assessment of sensory peripheral nerve fibers through sinusoidal electrical stimulation at different frequencies. Revista Brasileira de Engenharia Biomédica 2013; 29: 278-285.
Ratcliff R. Parallel-processing mechanisms and processing of organized information in human memory. Parallel Models of Associative Memory: Updated Edition 2014: 309.
Brown SD, Heathcote A. The simplest complete model of choice response time: linear ballistic accumulation. Cognitive psychology 2008; 57: 153-178.
Lieberman HR, Wurtman RJ, Emde GG, Roberts C, Coviella IL. The effects of low doses of caffeine on human performance and mood. Psychopharmacology 1987; 92: 308-312.
Howland J, Rohsenow DJ, Arnedt JT, Bliss CA, Hunt SK, Calise TV, et al. The acute effects of caffeinated versus non-caffeinated alcoholic beverage on driving performance and attention/reaction time. Addiction (Abingdon, England) 2011; 106: 335-341.
Slezak JM, Katz JL. An influence of delayed reinforcement on the effectiveness of psychostimulants to enhance indices of attention under a five-choice serial reaction time procedure in male rats. American Psychological Association 2013; 21: 355-362.
Jurado JL, Fernandez-Mas R , Fernandez-Guardiola A. Effects of 1 week administration of two benzodiazepines on the sleep and early daytime performance of normal subjects. Psychopharmacology 1989; 99: 91-93.
Hessen E, Lossius MI, Reinvang I , Gjerstad L. Influence of major antiepileptic drugs on attention, reaction time, and speed of information processing: results from a randomized, double-blind, placebo-controlled withdrawal study of seizure-free epilepsy patients receiving monotherapy. Epilepsia 2006; 47: 2038-2045.
Demyttenaere K, Jaspers L. Review: Bupropion and SSRI-induced side effects. Journal of psychopharmacology (Oxford, England) 2008; 22: 792-804.
Davies SJC, Christmas DM. Side-effects of Pregabalin treating generalized anxiety disorder and social anxiety disorder: A systematic review and meta-analysis. In: International College of Affective Neuroscience eds. 2011 ICANS poster session abstract book. Florence: International master in affective neuroscience; 2011. P. 17-18.
Viladesau R. The Beauty of the Cross: The Passion of Christ in Theology and the Arts from the Catacombs to the Eve of the Renaissance. City: Oxford University Press; 2005.
Dhawan K, Kumar S , Sharma A. Anxiolytic activity of aerial and underground parts of Passiflora incarnata. Fitoterapia 2001; 72: 922-926.
Krenn L. [Passion Flower (Passiflora incarnata L.)--a reliable herbal sedative]. Wiener medizinische Wochenschrift (1946) 2002; 152: 404-406.
Appel K, Rose T, Fiebich B, Kammler T, Hoffmann C, Weiss G. Modulation of the gamma-aminobutyric acid (GABA) system by Passiflora incarnata L. Phytotherapy research: PTR 2011; 25: 838-843.
Akhondzadeh S, Naghavi HR, Vazirian M, Shayeganpour A, Rashidi H , Khani M. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. Journal of clinical pharmacy and therapeutics 2001; 26: 363-367.
Dhawan K, Kumar S, Sharma A. Anti-anxiety studies on extracts of Passiflora incarnata Linneaus. Journal of ethnopharmacology 2001; 78: 165-170.
M.Nojoumi M. Investigation of Reaction Time after taking Passifloraincarnata (Passion Flower) as an add-on therapy in patients with Generalized Anxiety Disorder and Healthy volunteers [dissertation]. [Tehran]: Islamic Azad University of Pharmaceutical Sciences; 2012. 154p
LaTour MS, Rotfeld HJ. There are threats and (maybe) fear-caused arousal: Theory and confusions of appeals to fear and fear arousal itself. Journal of advertising 1997; 26: 45-59.
Chambless DL, Gracely EJ. Fear of fear and the anxiety disorders. Cognitive Therapy and Research 1989; 13: 9-20.
Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®). City: American Psychiatric Pub; 2013.
Hayes-Skelton SA, Roemer L, Orsillo SM. A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder. Journal of consulting and clinical psychology 2013; 81: 761-773.
Perna R. Benzodiazepines and antipsychotics: cognitive side effects. The Journal of head trauma rehabilitation 2004; 19: 516-518.
Price J, Cole V, Goodwin GM. Emotional side-effects of selective serotonin reuptake inhibitors: qualitative study. The British Journal of Psychiatry 2009; 195: 211-217.
Newman MG, Fisher AJ. Mediated moderation in combined cognitive behavioral therapy versus component treatments for generalized anxiety disorder. Journal of consulting and clinical psychology 2013; 81: 405-414.
Ramaiya SD, Bujang JS, Zakaria MH. Assessment of total phenolic, antioxidant, and antibacterial activities of Passiflora species. The Scientific World Journal 2014; 2014.
Simmen U, Burkard W, Berger K, Schaffner W , Lundstrom K. Extracts and constituents of Hypericum perforatum inhibit the binding of vario
us ligands to recombinant receptors expressed with the Semliki Forest virus system. Journal of Receptors and Signal Transduction 1999; 19: 59-74.
Lolli LF, Sato CM, Romanini CV, Villas-Boas Lde B, Santos CA, de Oliveira RM. Possible involvement of GABA A-benzodiazepine receptor in the anxiolytic-like effect induced by Passiflora actinia extracts in mice. Journal of ethnopharmacology 2007; 111: 308-314.
Appel K, Rose T, Fiebich B, Kammler T, Hoffmann C, Weiss G. Modulation of the gamma-aminobutyric acid (GABA) system by Passiflora incarnata L. Phytotherapy research: PTR 2011; 25: 838-843.
Aslanargun P, Cuvas O, Dikmen B, Aslan E, Yuksel MU. Passiflora incarnata Linneaus as an anxiolytic before spinal anesthesia. Journal of anesthesia 2012; 26: 39-44.
Movafegh A, Alizadeh R, Hajimohamadi F, Esfehani F , Nejatfar M. Preoperative oral Passiflora incarnata reduces anxiety in ambulatory surgery patients: a double-blind, placebo-controlled study. Anesthesia and analgesia 2008; 106: 1728-1732.
Dimpfel W, Koch K, Weiss G. Single dose effects of Pascoflair® on current source density (CSD) of human EEG. Neuroscience and Medicine 2012; 3: 130.
Movafegh A, Alizadeh R, Hajimohamadi F, Esfehani F , Nejatfar M. Preoperative oral Passiflora incarnata reduces anxiety in ambulatory surgery patients: a double-blind, placebo-controlled study. Anesthesia and analgesia 2008; 106: 1728-1732.
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| Issue | Vol 11 No 3 (2016) | |
| Section | Original Article(s) | |
| Keywords | ||
| Generalized Anxiety Disorder Mental Processing Passion Flower Reaction Time Sertraline | ||
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