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Herbal Medicines forManagement ofAlzheimer’s Disease
https://t.me/medicina_free
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188. Schliebs R, Liebmann A, Bhattacharya SK, Kumar A, Ghosal S, Bigl V.Systemic administration of dened extracts from Withania somnifera (Indian ginseng) and Shilajit differentially affects cho­linergic but not glutamatergic and GABAergic markers in rat brain. Neurochem Int. 1997;30(2):181–90.
189. Sehgal N, Gupta A, Vallia RK, Joshi SD, Mills JT, Hamel E, etal. Withania somnifera reverses Alzheimer’s disease pathology by enhancing low-density lipoprotein receptor-related protein in liver. Proc Natl Acad Sci U S A. 2012;109(9):3510–5.
190. Kurapati KR, Atluri VS, Samikkannu T, Nair MP. Ashwagandha (Withania somnifera) reverses beta-amyloid1-42 induced toxicity in human neuronal cells: implications in HIV-associated neuro­cognitive disorders (HAND). PLoS One. 2013;8(10):e77624.
191. Auddy B, Hazra J, Mitra A.A standardized Withania somnifera extract signicantly reduces stress-related parameters in chroni­cally stressed humans: a double-blind, randomized, placebo­controlled study. JANA. 2008;11(1):50–6.
192. Choudhary D, Bhattacharyya S, Bose S. Efcacy and safety of ashwagandha (Withania somnifera (L.) Dunal) root extract in improving memory and cognitive functions. J Diet Suppl. 2017;14(6):599–612.
193. Gupta M, Kaur G. Withania somnifera (L.) Dunal amelio­rates neurodegeneration and cognitive impairments associated with systemic inammation. BMC Complement Altern Med. 2019;19(1):217.
194. Bhatnagar M, Sisodia SS, Bhatnagar R.Antiulcer and antioxidant activity of Asparagus racemosa WILLD and Withania somnifera DUNAL in rats. Ann N Y Acad Sci. 2005;1056:261–78.
195. Gupta SK, Dua A, Vohra BP. Withania somnifera (ashwagandha) attenuates antioxidant defense in aged spinal cord and inhibits copper induced lipid peroxidation and protein oxidative modica­tions. Drug MetabDrug Interact. 2003;19:211–22.
196. Bhattacharya SK, Kumar A, Ghosal S.Effects of glycowithano­lides from Withania somnifera on an animal model of Alzheimer's disease and perturbed central cholinergic markers of cognition in rats. Phytother Res. 2006;9(2):110–3.
197. Kuboyama T, Tohda C, Komatsu K.Withanoside IV and its active metabolite, sominone, attenuate Aβ (25–35)-induced neurodegen­eration. Eur J Neurosci. 2006;23:1417–26.
198. Baitharu I, Jain V, Deep SN, Hota KB, Hota SK, Prasad D, et al. Withania somnifera root extract ameliorates hypobaric hypoxia induced memory impairment in rats. J Ethnopharmacol. 2013;145(2):431–41.
199. Baitharu I, Jain V, Deep SN, Shroff S, Sahu JK, Naik PK, etal. Withanolide a prevents neurodegeneration by modulating hip­pocampal glutathione biosynthesis during hypoxia. PLoS One. 2014;9(10):e105311.
200. Zhao J, Nakamura N, Hattori M, Kuboyama T, Tohda C, Komatsu K. Withanolide derivatives from the roots of Withania som- nifera and their neurite outgrowth activities. Chem Pharm Bull. 2002;50(6):760–5.
201. Tohda C, Joyashiki E.Sominone enhances neurite outgrowth and spatial memory mediated by the neurotrophic factor receptor. RET Br J Pharmacol. 2009;157(8):1427–40.
202. Uddin MS, Al Mamun A, Kabir MT, Jakaria M, Mathew B, Barreto GE, et al. Nootropic and anti-Alzheimer’s actions of medicinal plants: molecular insight into therapeutic potential to alleviate Alzheimer’s neuropathology. Mol Neurobiol. 2019;56:4925–44.
203. Kuboyama T, Tohda C, Komatsu K. Effects of ashwagandha (roots of Withania somnifera) on neurodegenerative diseases. Biol Pharm Bull. 2014;37(6):892–7.
204. Jayaprakasam B, Padmanabhan K, Nair MG. Withanamides in Withania somnifera fruit protect PC-12 cells from beta­amyloid responsible for Alzheimer's disease. Phytother Res. 2010;24(6):859–63.
205. Mahrous RSR, Ghareeb DA, Fathy HM, RMA EL-K, Omar AA.The protective effect of Egyptian Withania somnifera against Alzheimer’s. Med Aromat Plants. 2017;6(2):2167.
206. Remya C, Dileep K, Variayr E, Sadasivan C.An in silico guided identication of nAChR agonists from Withania somnifera. Front Life Sci. 2016;9(3):201–13.
207. Patil SP, Maki S, Khedkar SA, Rigby AC, Chan C.Withanolide a and asiatic acid modulate multiple targets associated with amyloid-β precursor protein processing and amyloid-β protein clearance. J Nat Prod. 2010;73(7):1196–202.
208. Jain S, Shukla SD, Sharma K, Bhatnagar M. Neuroprotective effects of Withania somnifera Dunn. In hippocampal sub-regions of female albino rat. Phytother Res. 2001;15(6):544–8.
209. Bhattacharya A, Muruganandam AV, Kumar V, Bhattacharya SK. Effect of poly herbal formulation, EuMil, on neurochemi­cal perturbations induced by chronic stress. Indian J Exp Biol. 2002;40(10):1161–3.
210. Akbar M, Shabbir A, Rehman K, Akash MSH, Shah MA. Neuroprotective potential of berberine in modulating Alzheimer’s disease via multiple signaling pathways. J Food Biochem. 2021;45(10):e13936.
211. Singh N, Sharma B.Toxicological effects of berberine and san­guinarine. Front Mol Biosci. 2018;5:21.
212. Huang M, Jiang X, Liang Y, Liu Q, Chen S, Guo Y. Berberine improves cognitive impairment by promoting autophagic clear­ance and inhibiting production of β-amyloid in APP/tau/PS1 mouse model of Alzheimer's disease. Exp Gerontol. 2017;91:25–33.
213. Mendelson K, Evans T, Hla T. Sphingosine 1-phosphate signal­ling. Development. 2014;141(1):5–9.
214. Liang Y, Ye C, Chen Y, Chen Y, Diao S, Huang M. Berberine improves behavioral and cognitive decits in a mouse model of Alzheimer’s disease via regulation of β-amyloid produc­tion and endoplasmic reticulum stress. ACS Chem Neurosci. 2021;12(11):1894–904.
215. Cai Z, Wang C, He W, Chen Y.Berberine alleviates amyloid-beta pathology in the brain of APP/PS1 transgenic mice via inhibit­ing β/γ-secretases activity and enhancing α-secretases. Curr Alzheimer Res. 2018;15(11):1045–52.
216. Wang Y-Y, Yan Q, Huang Z-T, Zou Q, Li J, Yuan M-H, et al. Ameliorating ribosylation-induced amyloid-β pathology by ber­berine via inhibiting mTOR/p70S6K signaling. J Alzheimers Dis. 2021;79(2):833–44.
217. Zhang H, Zhao C, Cao G, Guo L, Zhang S, Liang Y, etal. Berberine modulates amyloid-β peptide generation by activating AMP­activated protein kinase. Neuropharmacology. 2017;125:408–17.
218. Qin S, Tang H, Li W, Gong Y, Li S, Huang J, etal. AMPK and its activator berberine in the treatment of neurodegenerative diseases. Curr Pharm Des. 2020;26(39):5054–66.
219. Zhu F, Wu F, Ma Y, Liu G, Li Z, Sun Y, et al. Decrease in the production of beta-amyloid by berberine inhibition of the expression of beta-secretase in HEK293 cells. BMC Neurosci. 2011;12(125):1–17.
220. Wu Y, Chen Q, Wen B, Wu N, He B, Chen J.Berberine reduces Aβ42 deposition and tau hyperphosphorylation via ameliorating endoplasmic reticulum stress. Front Pharmacol. 2021;12:640758.
221. Wang S, He B, Hang W, Wu N, Xia L, Wang X, et al. Berberine alleviates tau hyperphosphorylation and axonopathy-associated with diabetic encephalopathy via restoring PI3K/Akt/GSK3β pathway. J Alzheimers Dis. 2018;65(4):1385–400.
222. Chen Y, Chen Y, Liang Y, Chen H, Ji X, Huang M.Berberine miti­gates cognitive decline in an Alzheimer’s disease mouse model by targeting both tau hyperphosphorylation and autophagic clear­ance. Biomed Pharmacother. 2020;121:109670.
223. He W, Wang C, Chen Y, He Y, Cai Z.Berberine attenuates cog­nitive impairment and ameliorates tau hyperphosphorylation by limiting the self-perpetuating pathogenic cycle between NF-κB
250
https://t.me/medicina_free
J. Malik et al.
signaling, oxidative stress and neuroinammation. Pharmacol Rep. 2017;69(6):1341–8.
224. Nam KN, Kim JH, Jung HJ, Park JM, Moon SK, Kim YS, etal. Berberine inhibits inammatory activation of rat brain microglia. Neural Regen Res. 2010;5(18):1384–90.
225. Sadraie S, Kiasalari Z, Razavian M, Azimi S, Sedighnejad L, Afshin-Majd S, etal. Berberine ameliorates lipopolysaccharide­induced learning and memory decit in the rat: insights into under­lying molecular mechanisms. Metab Brain Dis. 2019;34:245–55.
226. Chen N, Wang X-C, Fan L-L, Zhu Y-H, Wang Q, Chen Y-B.Berberine ameliorates lipopolysaccharide-induced cognitive impairment through SIRT1/NRF2/NF-κB signaling pathway in C57BL/6J mice. Rejuvenation Res. 2022;25(5):233–42.
227. Lin X, Zhang N. Berberine: pathways to protect neurons. Phytother Res. 2018;32(8):1501–10.
228. Chen M, Li L, Liu C, Song L.Berberine attenuates Aβ-induced neuronal damage through regulating miR-188/NOS1 in Alzheimer’s disease. Mol Cell Biochem. 2020;474:285–94.
Herbal Medicine fortheManagement
https://t.me/medicina_free
ofAnxiety, Depression, andInsomnia
SundayOritsetimenyinOtimenyin
Abstract
The world has advanced in technology, health care, nan­cial instruments and management, and other aspects of human endeavors. This advancement has impacted posi­tively and negatively on the human race. Human demands are insatiable; hence, they crave more and more feats. This has created a lot of unnecessary pressure on man: the quest to meet targets, to achieve set goals, and to measure up with peer groups and pals. These unimaginable pressures have impacted negatively on the human and sometimes animal race. Such pressures have led to anxiety, depression, and sometimes insomnia. These have become a great economic and social burden. The need to address these burdens has increased over the years. Affected subjects sort care from orthodox and traditional medical practitioners. Traditional medical practitioner uses herbs and other natural products/ methods to manage these conditions (anxiety, depression and/or insomnia). Herbs used for the management of anxi­ety, depression, and insomnia have been reported to be rich in alkaloids and phenolic compounds. Alkaloids with these activities often contain quercetin, rutin, apigenin, luteolin, and kaempferol. Extensive research has led to some of the ndings, and revealed that these alkaloids exhibit their actions by acting on GABA receptors, serotonin receptors, monoamine oxidase (MAO), and BDNF expression. These herbs also alter endocrine, immunological, and monoamine systems, such as NE, DA, MDA formation, IL-6, BDNF, and TNF- α levels. These mechanisms of action support their claims. The herbal remedy is worth trying if orthodox medicines fail.
Keywords
Anxiety · Depression · Insomnia · Herb · Alkaloids · Quercetin · Rutin · Apigenin · Luteolin · Isorhamnetin · Kaempferol
S. O. Otimenyin (*) Department of Pharmacology, Faculty of Pharmaceutical Sciences, University of Jos, Jos, Nigeria
1 Introduction
Psychiatric disorders appear to be common in recent times, which may be attributed to the changes in life style over the decades. There seems to have been an increased pressure on the human race to achieve and possess. Psychiatric disorders that are commonly seen include anxiety, depression, and insomnia [1]. Depressive disorders are said to be one of the most prevalent types of mental illness. Depressive disorders have a huge inuence on society, especially the plagued indi­vidual. These psychiatric disorders have been the major con­tributors to the incidence of suicide and ischemic heart disease. It was ranked the second leading cause of disability worldwide [2]. Depression, anxiety, and insomnia tend to occur concurrently in subjects. Their symptoms are almost similar. Major depression presents with many symptoms including insomnia and anxiety. It isalso observed that drugs used in managing these disease conditions have related mechanisms of action.
Anxiety is a common emotional disorder that is intimately associated with proper fear. Anxiety may serve as a mecha­nism to adapt to the environment psychologically. It presents as a common symptom of many medical disorders, especially psychiatric disorders. Most people who suffer from anxiety most likely present with sleep disorder [3]. Most patients with the most common sleep disorder subjectively complain of their inability to initiate and/or maintain sleep. They may com­plain of poor quantity and quality of sleep, and hangovers. Anxiety, depression, and insomnia do occur in the same space of time. They are common co-morbid psychiatric disorders in the complexity of mental health disorders [4]. The link between anxiety, insomnia, and major depressive disorders impairs immune and cardiovascular systems function [4]. These psychiatric disorders (anxiety, insomnia, and major depressive disorders) affect the subject’s work, daily life, qual­ity of life, sleep, and well-being. Being a common problem, the subjects and their relatives sought cures in orthodox and herbal medicine. The rst point of call in rural settings is the traditional healer (who uses herbs as their remedies).
© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023 A. K. Dhara, S. C. Mandal (eds.), Role of Herbal Medicines, https://doi.org/10.1007/978-981-99-7703-1_13
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Mental illnesses are often attributed to negative spiritual intervention in the human system or activities. There is the common belief that orthodox remedies cannot proffer solu­tion to the illness; hence, they turn to the spiritualist for help. These spiritualists use herbal medications in most instances. Research has documented the benets of these herbs to mental health, and in some areas, it is being encouraged. New drug leads for use in orthodox medicine are often obtained from herbs, hence the need to document these plants for future research and drugdiscovery. New drug dis­covery is hoped to resolve the present situation seen across the population (rapid increase in the number of people with mental illness is rapidly increasing across the world).
Herbal medicines are commonly used to alleviate or cure central nervous system disorders, these herbs affect multiple target sites, and they stimulate more than one receptor in most cases. Keeping in view that central nervous system dis­orders, such as anxiety, depression, and insomnia, are habitu­ally found together in a subject and share some similarities in their neurological basis, medicines for managing these disor­ders may have similar mechanisms of action. Drugs for man­aging these diseases might be interconnected with each other; they may act on the same group of receptors but elicit different effects in different regions of the brain.
2 Mechanisms ofHerbs Used
intheManagement ofAnxiety, Depression, andInsomnia
Herbal medicines used for the management of anxiety, depression, and insomnia act by altering the chemical states of the brain or by correcting hormonal imbalances.
Most of these herbs act by:
1. IncreasingCNSconcentrations of norepinephrine (NE),
5-hydroxytryptamine (5-HT), and dopamine (DA)
2. Enhancing the transmission of GABAergic and/or gluta-
matergic transmitters
3. Suppressing the reuptake of norepinephrine (NE),
5-hydroxytryptamine (5-HT), and dopamine (DA) in the brain
4. Inhibiting monoamine oxidases
5. Interferencing with the hypothalamic–pituitary–adrenal
(HPA) axis
6. Depressing the release corticotropin releasing factor
(CRF).
7. Down regulating the secretion of adrenocorticotropin
(ACTH) from the anterior pituitarygland
8. Attenuating the production and secretion of glucocorti-
coids from the adrenal cortex
9. Suppressing the elevation of corticosterone
concentration
10. Restoring the normal expression and function of GR
11. Decreasing brain-derived neurotrophic factor (BDNF)
12. Increasing the phosphorylation level of CREB (cAMP response element-binding protein) and the expression of BDNF in the frontal cortex and hippocampus
13. Inhibiting the p-SAPK/p-JNK signaling pathways induced by stress
14. Decreasing in expression levels of both mRNA and pro­tein of BDNF in the hippocampus
3 Medicinal Plants Used
fortheManagement ofDepression
Central nervous system (CNS) disorders are poorly under­stood and present with complicated disorders. The CNS functionality has not been fully decoded; this explains the mystery that underlines its disorders. This also explains why such diseases are linked to spiritual problems. Diseases of the CNS are numerous among which are depression, anxiety, and insomnia. Depression is a syn­drome characterized by some observable behaviors. The behaviors incapacitate the patients and render them unpro­ductive or harmful to themselves. It is characterized by profound sadness and the inhibition of psychic/CNS func­tions. It sometimes present with neuro-vegetative symp­toms. Depression has been reported to be the second leading cause of death (suicide) and disability [5]. It is foremost among CNS disorders and is a commonly diag­nosed disease across the world; about 1in 20 people suffer from depression yearly. The population of people of all ages suffering from depression is estimated to be about 280 million; of this number, 700,000 die from suicide every year [6]. More than 75% of people in low-income and middle- income countries receive some sort of treat­ment [7]. Depression often starts at a young age, but it cuts across all ages. Adolescents with depression present with a reduction in functional activities. Depression in adoles­cents often reoccurs. Reduction in productivity is one of the presentations of depression; to arrest this, research is ongoing with the aim of arriving at a break-through that is hoped to improve depression.
Across the globe, there is demand for effective man­agement of depression and the saving of loss of man hours and reduction of suicides attributed to depression. Depression is a heterogeneous disorder that is associated with psychological, behavioral, and physiological symp­toms. Observed symptoms of depression include mood changes, difculty in thinking, and loss of interest in the environment. The patient may experience physical symp­toms, such as sleep disorders, sexual problems, loss of stamina, and headaches.
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3.1 Symptoms ofDepression
Gateway symptoms
• Depressed mood
• Loss of interest in pleasure (anhedonia)
• Headache
• Weight loss, appetite change, and diminished interest in pleasurable activities– presenting as social withdrawal
• Insomnia and hypersomnia
• Increased somatic symptoms – fatigue, pain, and insomnia
• Psychomotor agitation or retardation (feeling of helpless/ hopeless)
• General body weakness and diminished energy
• Feelings of uselessness, worthlessness, or/and guilt
• Difculty taking decisions and paying attention to details
• Thoughts of death or/and suicide
Clinical depression shows physical, behavioral/attitude,
and emotional presentation. The diagnostic effect sort include:
Physical
1. Sleep disturbances– insomnia, oversleeping, and waking
up early
2. Changes in appetite or eating: much more or much less
3. Decreased energy and fatigue
4. Unexplained digestive problems, headaches, and some-
times stomachaches
Behavioral/Attitude
1. Loss of interest in pleasurable activities that were once
pleasurable, such as sex, hobbies outings, sports, etc
2. Amnesia, difculty making decisions, and concentrating
3. Looking unpresentable and neglecting responsibilities
Emotional
1. Sadist or at mood occurring for up to two or more weeks
2. Sober or crying for no just cause
3. Feeling helpless, worthless, hopeless, or guilty
4. Feeling anxious, agitated, or irritable
5. Suicide or death thoughts
These symptoms of depression occur when there is an
alternation in chemical concentration in the central nervous system. It affects all aspects of the function of the brain. There is an altered cognitive, biological, psychomotor, moti­vational, behavioral, and emotional process. Depression affects a patient’s quality of daily life and may be the cause of suicidal death [5, 8]. Subjects are diagnosed to be depressed if they exhibit the above-listed symptoms consis­tently for 2weeks in a roll, daily, and appear clinically dis­tressed or display impairment in occupational, social, and/or
other areas of daily activity. Drug-induced depression is due to the direct effect of the drug on the physiological capabili­ties of the patient. This state of drug-induced depression in an individual is different from a normal depressed individ­ual. Normal depressed individuals present with complex mood disorders with many subtypes, multiple etiologies, symptomatology ranging from mild to severe with or with­out psychotic features, and interactions with other psychiat­ric and somatic disorders. Normal depression is also accompanied by: a change in appetite, loss of weight, psy­chomotor retardation or agitation, hypersomnia or insomnia, loss of energy or fatigue, indecisiveness or diminished abil­ity to concentrate or think, feelings of worthlessness or excessive/inappropriate guilt, and recurrent thoughts of death and/or suicidal ideation or attempt [9, 10].
Severe depression is characterized by a depressed mood, lasting for at least 2years, with other symptoms like fatigue, feeling hopeless, poor concentration, insomnia or hypersom­nia, overeating or poor appetite, and low self-esteem [9] (Fig.1).
4 Denition ofDepression
Depression is a state of negative alteration of the whole body, mood, and thoughts. Stress is the main trigger of depression. Stress produces reactions toward stimulus (causes of stress), displayed in the form of physical, mental, and/or emotional responses. It occurs when the brain is down regulated, evident in a reduction in the levels of most neurotransmitters in the brain. This results in an alteration of the subject’s personality, evident in the eating and sleep­ing habits of the subject, the feeling about self, and percep­tion of things. The functionality of the whole body is affected (itis a “whole-body” illness). In depression, there are negative changes in the behavior, feelings, thinking abil­ities, and physical well-being of the affected patient. The subject sometimes experiences problems with decision­making, short-term memory, negative thoughts and think­ing, pessimism, poor self-esteem, excessive guilt and self-criticism, and self-destructive thoughts. Subjects may be sad for no reason, not enjoying activities that were found pleasurable before depression, lack motivation, and become more apathetic, feeling “slowed down” and fatigued all the time, irritable, sometimes feeling helpless and hopeless, and experiencing difculty in controlling temper [10]. Behavior is altered: Subjects prefer to be alone, avoid external inter­ference, are socially withdrawn, act out their anger with temper outbursts, are not interested in sexual activities, and neglect their personal appearance and basic hygiene. Depressed subjects experience chronic fatigue, more sleep­ing or problems with sleeping, may stay awake during sleeping hours, and/or awaken many times at night. Some
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arouse emotion
depression
https://t.me/medicina_free
S. O. Otimenyin
Fig. 1 Depression cycle
to nociception
Over-production of
stress hormone
More of REM sleep
Thoughts that
patients may sleep for more than the sleeping hours, sleep most of the day and wake up with fatigue, experience loss of appetite and diminished memory, weight loss/gain, suicidal or morbid thoughts, and digestive disorders [2, 5].
Depression cycle
Increased sensitivity
Depressive
thoughts
Symptoms of
Decreased CNS 5HT
levels
Distorted sleep
Inadequate sleep
and exhaustion
Unpleasant
experiences
Lack of motivation
Reduced
association and
activities. failure
over-activity, pressure of speech, and decreased need for sleep.
4.4 Stress andDepression
4.1 Types ofDepression
1. Major depression
2. Dysthymic disorder
3. Unspecied depression
4. Adjustment disorder, with depression
5. Bipolar depression
6. Minor depression
7. Psychoticdepression
8. Postpartumdepression
9. Seasonal affective disorder (SAD)
10. Unipolar depression
4.2 Unipolar Depression
This is a condition characterized by apathy, anhedonia (loss of interest or capacity for pleasure), changes in sleep and appetite, sadness, and sometimes suicidal thoughts.
4.3 Bipolar Aective Disorder
This typically consists of both manic and depressive epi­sodes separated by periods of normal mood. Manic episodes involve increased energy and elevated mood, resulting in
Stress has been shown to be the major cause of depression, especially if it is not well managed. Stress can be relieved by engaging in activities that enhance brain activity and relieve stress. Such activities include:
1. Exercising the body, brain, and mind
1. walking
2. riding bicycles
3. attending aerobic classes
4. practicing yoga
5. swimming
6. playing tennis
4.5 Depression andDiet
The brain needs nutrients to function normally. Such nutri­ents are found in food and some drinks. In addition, some agents may be harmful to the brain, interfering with the nor­mal functioning of the brain. If such are found in the diet, it may spell doom for the brain and the individual. Diet plays a major role in the management of stress and in maintaining the brain in good health. It is known that food rich in sugar stimulates or prolongs the response to stress, while high­cholesterol foods adversely affect blood chemistry. Some medicinal plants and edible vegetables are rich in the
Herbal Medicine fortheManagement ofAnxiety, Depression, andInsomnia
https://t.me/medicina_free
Table 1 Plants with antidepressant properties
Plant Indication /part used Constituents Mechanism of action Citrus Limon [14] Depression
Anxiety[14] Sedation Essential oil Aerial parts
Clitoria ternatea Depression Quercetin Mediated via nor-adrenaline,
Clitoria ternatea,
Linn
Coriandrum sativum
Crocus sativus Depression
Cuscuta planiora Depression Quercetin, rutin, apigenin, luteolin, and
Cyperus rotundus. Depression Iridoids, apigenin, and luteolin Eschscholzia
californica
Apium graveolens Depression 3, n-butylphthalide and sedanenolide Avena sativa Depression, anxiety, and nervous
Bacopa monniera Depression
Benincasa hispida Depression
Daucus carota Depression Quercetin, rutin, apigenin, and luteolin, Eschscholtzia
californica Foeniculum
vulgare Vetiveria
zizanioides Gossypium
herbaceum Helianthus annuus Depression
H.Tuberculatum Depression
Hyoscyamus niger Antidepressant anxiolytic Chlorogenic acid, quercetin, rutin, and
Bacopa monniera Anxiolytic effects, antidepressant
Jasminum sambac Antidepressant Isoquercetin, rutin, apigenin, and
Datura fastuosa Depression Scopolamine, atropine, hyoscyamine,
Cassia occidentalis Antidepressant Quercetin, rutin, apigenin, and luteolin
Depression Quercetin Increase noradrenaline and
Depression Quercetin, rutin, apigenin, and luteolin Interaction with the adrenergic,
Petal of Crocus sativus
Depression Anxiety Insomnia
exhaustion
Anxiety
Anxiety
Depression Quercetin, rutin, apigenin, and luteolin
Depression Alpha tocopherol, quercetin, rutin,
Depression Anxiety
Anxiety
Anxiety
activity, and anticonvulsant actionantioxidant
Apigenin (biavonoid) Increases motor activity
Inhibits GABAA receptor [15] Mediated via noradrenergic and serotoninergic mechanisms
serotonin, and acetylcholine [16]
serotonin levels
dopamine-ergic, and GABA-ergic system
Crocin 1, picrocrocin, safranal, rutin, apigenin
kaempferol
Reticuline, aporphine, N-methyllaurotetanine, californidine, and corydine
Quercetin, rutin, apigenin, luteolin, isorhamnetin, and kaempferol
Bacopasides I and II, Bacosides A and B, and bacopasaponin C
Quercetin Inhibits MAO-A, increases
Protopine and o-diphenol Inhibits monoamine oxidase
apigenin, and luteolin Quercetin, rutin, apigenin, and luteolin Activation of AC-cAMP pathway
Quercetin, rutin, apigenin, and ferulic acid
Sylimarin, myrecetin, naringenin, rutin, and quercetin
apigenin Quercetin, rutin, apigenin, luteolin,
isorhamnetin, and kaempferol
luteolin
and quercetin
Increase the levels of VGF, BDNF, CREB, and P-CREB
GABAA and serotonin receptors
dopamine, α1-adrenaline, serotonin, and GABA
(MAO-B)
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precursors needed by the brain for normal activity; such plants may be benecial in the management of CNS-related problems. Plants that have been reported to improve depres­sion (anti- depressants) are listed in Table1.
Stress is inevitable in life. Individuals must devise ways of managing stress either by relaxing or engaging in positive relationships. The relaxation response reverses the stress response in the human mind–body system.
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S. O. Otimenyin
4.6 Causes ofDepression
Depression is caused by chemical imbalances in the brain. It may run in families or may be caused by environmental fac­tors or individual factors such as low self-esteemand self indulgence (e.g.alcoholism).
Depression is a syndrome characterized by some observable behaviors. It is characterized by profound sad­ness and the inhibition of psychic functions, sometimes accompanied by neuro-vegetative symptoms. Several causative factors that have been identied to cause depres­sion, such as:
1. genetic factors
2. changes in brain neurotransmitter concentration
3. psychosocial problems
4. psychodynamic factors
5. changes blood hormone concentration
6. some physical illnesses
7. drugs/medication
8. inadequate food and minerals
9. diet/food
Depression is caused by an unfavorable change in envi­ronmental, biochemical, genetic, and psychological factors. A number of theories have been proposed as an explanation for the patho-physiological basis of depression.
4.7 Possible Causative Pathological Factors
ofDepression
1. Impaired sleep (circadian rhythms)
2. Alteration in neurotransmitter levels
3. dysregulated GABA
4. glutamate signaling
5. altered hypothalamus–pituitary axis activity
Adverse life events, such as economic hardship (which often exacerbates mental health problems, incapacitates citizens, reduces ofce man hours, and impoverishes peo­ple), unexpected outcomes to hard work, unstable environ­ments, and many more have recently been observed to be the main predisposition to depression. The central nervous system controls humans and animals through a complex net­work of neurons. Such central neurons receive signals/infor­mation from other parts of the body and the environment. Biological, psychological, social, and epigenetic factors have signaled these neurons to alert them of possiblethreat or sad events.
4.8 Drug Induced Depression
Medications/drugs that produce symptoms that mimic depression:
• Anabolic steroids
• Opioids
• Digitalis
• Metoclopramide
• Glucocorticoids
• H2 blockers
Some beta-blockersßß
• Anti-arrythmics
• Carbidopa/levodopa
• Anti-convulsants
• Clonidine
• Barbituates
• Benzodiazepenes
4.9 Management ofDepression
Depression has become a great burden in most countries, leading to loss of man hours and economic loss. Governments in those countries have in place agencies that formulate poli­cies for the prevention and control of depression and other related diseases. The factors that predispose to depression (one of which is economic hardship) are difcult to control as they affect all nations across the world. Economic and socio-health factors are global issues that cut across almost all countries and are difcult to control. This impacts the control of depression and related mental health issues and makes it more difcult to prevent depression and access effective treatments.
The role of the monoaminergic system in depression has been well studied. Most drugs are expected to elicit their effects on this system, by increasing monoamine and their metabolites as well as transporters and precursors in the brain. This is thought to be the main mechanism of action of herbal antidepressants. Only a handful of herbal medicines act on other pathways to control depression. Patients treated with herbal remedies often regain normal mood and behav­iors within a few weeks. The state of their brain may not be returned to the initial state before depression, but they can function normally and reintegrate into the work force and other societal systems.
Herbal medicines have played a major role in the control and management of depression in many countries [1113]. The major drawback in its use is the unresearched aspect of toxicity, as they are presumed to be safe [13]. It is a general
Herbal Medicine fortheManagement ofAnxiety, Depression, andInsomnia
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belief that herbal medicines are safer than orthodox medi­cines. More so orthodox medicine has not been well accepted despite the decades of use. Herbs form part of the human diet, and it is generally believed that it replaces what is lacking in the body. Taking herbs as medicines is seen as taking food rather than medicines, which makes it more acceptable.
4.10 Medicinal Plants andDepression
Medicinal plants have met human health needs for decades (even before the establishment of orthodox medicines), among such medicinal plants are the antidepressant medici­nal plants. Traditional healers have used plants and other naturally occurring substances to treat/manage depression. It forms part of their traditional practice, a sizable number of these plants have and are undergoing clinical trials while some (or their active principle) have found their way into orthodox medicine. In traditional medicine practice, multiple plants are often used for a particular disease condition, with each plant eliciting the same effect or different effects, but the effects are thought to be benecial in the management of the disease conditions concerned. Some of the plants are used extensively while others are more specic and were employed only for specic disease conditions.
4.11 Use ofHerb toManage Depression
Most herbal prescriptions do not have specied dosages. The quantity of herbal products in a cup, and the size of the cup may vary. The mechanism of action, point of action, and effects of other untargeted organs are not established in herbal medicine. It is reasonable to sound a note of warning regarding the use of herbal medicines. This implies that herbal preparation must be standardized before it is used in the human population. Flavonoids are found in plants as nat­ural polyphenols. They have been extensively investigated for their antidepressant properties, and a number of plants used for the management of depression have been conrmed to contain active avonoids (Table 2). Most grains, fruits, vegetables, tea, and alcohol are the rich source of avonoids. They are known for their effects on stress (preventing or reversing stress through a number of mechanisms) (Tables 2 and 3). Some avonoids have been shown to have antide­pressant potential and their use has established this fact. In this chapter, we have attempted to compile potential mole­cules with benecial anxiolytic, sedative, and/or antidepres­sant actions. It is hoped that this review will contribute to the development of safe and effective nutriceuticals that will reduce in incidence of anxiety, insomnia, and depression in humans.
Table 2 Plants used for the management of anxiety and insomnia
Plant name/Family Constituents Achillea moschata
L.Asteraceae Adiantum capillus-veneris
L.Adiantaceae Agrimonia eupatoria
L.Rosaceae Alchemilla group alpina
L.Asteraceae Alchemilla group vulgaris
L.Asteraceae Aloysia citrodora Paláu
(L’Hér.) Kuntze) Verbenaceae Angelica archangelica
L.Apiaceae Angelica sylvestris
L.Apiaceae Anthemis arvensis
L.Asteraceae Artemisia absinthium
L.Asteraceae Artemisia arborescens
L.Asteraceae
Artemisia vulgaris L.Asteraceae
Arum italicum miller Araceae Apigenin-6,8-C-pentoside-hexoside Apigenin Antioxidant and anxiety
Apigenin, luteolin, di-succinilcaffeoylquinic acid, and isorhamnetin-3-O-glucoside
Carvacrol, hexadecanoic acid, thymol, quercetin 3-O-glucoside, and isoadiantol
Apigenin, naringin, and gallic acid Apigenin and
Linalool, cis-3-hexenol, quercitrin, isoquercetin, and apigenin-8-C-glucoside
Flavonoids and apigenin Apigenin Anti-inammatory, anti-depressant, and
Limonene, linalool, avonoids (apigenin, petalite, and luteolin), thymol, and geranial
Flavonoids (quercetin and alkaloids) and coumarins (osthole and angelicin).
Flavonoids (apigenin-7-glucoside) Apigenin Anti-cancer, antioxidant, anxiety,
Torreyol and apigenin Apigenin Antioxidant, antimicrobial, anxiety, and
Naringenin and avonoid(quercetin and catechin)
Chrysoeriol, apigenin, and artemetine Apigenin Antioxidant, antimicrobial, cytotoxic,
Eupatilin, apigenin, jaceosidin, luteolin, and galangin
Active biomolecule(s) Pharmacological effects
Apigenin Anxiety, insomnia, and antibacterial
Quercetin Anxiety, anti-inammatory, and
naringin Apigenin and
quercetin
Flavonoids Antioxidant, antimicrobial, anxiety,
Quercetin
Quercetin Hypoglycemic, anti-oxidant, and anxiety
Apigenin
hypoglycemic activity Antioxidant, antimicrobial, anxiety, and
insomnia
anxiety
insomnia, anti-inammatory, and hypnotic Antioxidant, anxiety, insomnia, anti-
inammatory, and hypnotic
insomnia, anti-inammatory, and hypnotic
anti-inammatory
anxiety, insomnia, anti-inammatory, and hypnotic
Antioxidant, anxiety, insomnia, anti­inammatory, and hypnotic
(continued)
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Table 2
(continued)
Plant name/Family Constituents Arum palaeictum L. f.
Araceae Avena fatua L.Poaceae Beta-carotene nd avonoids Flavonoids Antioxidant and isomnia Avena sativa L.Poaceae Apigenin, quercetin, naringenin, and luteolin Apigenin and
Ballota nigra L.Solanaceae Flavonoids (apigenin, ladanein, luteolin),
Borago ofcinalis L.Boraginaceae
Calendula ofcinalis L.Asteraceae
Centranthus ruber (L.) DC.Valerianaceae
Chamaemelum nobilis all. Asteraceae
Citrus aurantium L.Rutaceae Kaempferol, rutin, hesperidin, naringenin,
Citrus Limon L.Rutaceae Pinene, limonene, rutin, hesperidin, luteolin,
Citrus x sinensis (L.) Osbeck Rutaceae
Clinopodium nepeta (L.) Kuntze (=Calamintha nepeta (L.) Savi) Lamiaceae
Conium maculatum L.Apiaceae Leaves Infusion [62] Corydalis cava (L.
Corydalis cava (L.) Schweigg. and Körte Papaveraceae
Crataegus laevigata (Poir.) DC.Rosaceae
Crataegus monogyna Jacq. Rosaceae
Crocus sativus L.Iridaceae Crocin, picrocrocin, crocetin, safranal,
Cydonia oblonga mill. Rosaceae
Cynodon dactylon (L.) Pers Poaceae
Dianthus seguieri Vill. Caryophyllaceae
Ecballium elaterium (L.) A.Rich Cucurbitaceae
diterpenes, betaines, pinene, linalool, and cadinol
Flavonoids (quercetin), gallic acid, kaempferol, and vitamin C
Quercetin, vitexin, apigenin, myricetin, and kampferol
Valtrate (valepotriates) and avonoids Valtrate Antioxidant, anxiolytic, insomnia,
Flavonoids (apigenin, luteolin, and quercetin) Apigenin And
quercetin, and synephrine
apigenin, diosmetin, and quercetin
Quercetin, rutin, kaempferol, apigenin, diosmetin, luteolin, and hesperidin
Catechins, luteolin, quercetin, apigenin, and myricetin
Flavonoids and coumarins Flavonoid Antioxidant, anti-inammatory, analgesic,
Quercetin, catechin, kaempferol, apigenin, diosmetin, luteolin, and hesperidin
Proanthocynidins, setin, quercetin, and lupeol
Quercetin, lupeol, apigenin, myricetin, and rutin
zeaxanthin, avonoids, kaempferol, nigricin, tectoridin, and quercetin
Quinic acid, quercetin, rutin, kaempferol, epicatechin, and pectin
Quercetin, rutin, kaempferol, catechin, myricetin, carotene, violaxanthin, and luteolin
Quercetin, rutin, and kaempferol Anticancer, antiviral, and antibacterial
Rutin, quercetin, luteolin, and apigenin Antimicrobial, antioxidant, and anticancer
Active biomolecule(s) Pharmacological effects
quercetin Apigenin Antioxidant, antimicrobial, anxiolytic,
Quercetin Antioxidant, anxiolytic, sedative-hypnotic
Quercetin Antioxidant, antimicrobial, anxiety,
quercetin
Quercetin Antioxidant, anxiolytic, insomnia,
Apigenin Antioxidant, antimicrobial, anxiolytic,
Quercetinand apigenin
Quercetin and apigenin
Crocin Antioxidant, antiviral, anti-inammatory,
Antioxidant, anxiety, anti-inammatory, and anti-thrombotic effect
insomnia, anti-inammatory, sedative­hypnotic antidepressant, anticholinesterase, and inhibit the development of cervix cancer
antidepressant, and carcinogenic
insomnia,, hypnotic
sedative-hypnotic antidepressant Antioxidant, and antitumor, anxiolytic,
insomnia, and sedative-hypnotic antidepressant
anti-inammatory, analgesic, and sedative-hypnotic antidepressant
insomnia, anti-inammatory, sedative­hypnotic antidepressant, anticancer, and anticonvulsant
Antioxidant, antimicrobial, anxiolytic, antidepressant, and anticancer
Antioxidant, antimicrobial, anxiolytic, insomnia, sedative-hypnotic antidepressant, and anti cancer
and anti cancer
Antimicrobial, anxiolytic, sedative-hypnotic
Lowers blood pressure, antioxidant, anxiolytic, sedative-hypnotic, and anticancer
Lowers blood pressure, antioxidant, anxiolytic, and sedative-hypnotic,
hypotensive, anticonvulsant, antiAlzheimer, antidepressant, anxiolytic, sedative-hypnotic, anti-inammatory, and cytotoxic
Antioxidant, anxiolytic, insomnia, anti-inammatory, sedative-hypnotic antidepressant, and diuretic
Antioxidant, antimicrobial, anxiolytic, anti-inammatory, sedative-hypnotic antidepressant, anticancer, and antipyretic
S. O. Otimenyin