Anxiety is the most common mental health disorder in the U.S. While general anxiety disorder is the most common form of anxiety, there are numerous others, including panic disorder, phobic related disorders, obsessive-compulsive disorder, and post-traumatic stress disorder. In a 2020 survey, 62% of respondents reported some degree of anxiety. An estimated 31% of all adults in the U.S. will experience anxiety disorder at some point in life. At any one time, an estimated 19.1% of adults in the U.S. have had an anxiety disorder. Anxiety disorders are more prevalent in women than in men, affecting about 23% of U.S. female adults and 14% of male adults, with women being more than twice as likely as men to have generalized anxiety disorder. It is even more prevalent in female adolescents than male adolescents aged 13-18 with 38% female vs 26.1% male.
Approximately 12 million women in the U.S. experience clinical depression each year, with 1 in 8 women developing a clinical depression during their lifetime. Depression occurs most frequently in women aged 25 to 44. Women experience depression at roughly twice the rate of men, and girls aged 14-18 years have consistently higher rates of depression than boys in this age group.
Psychotherapy and prescription medications are the mainstays of conventional treatment. While prescription pharmaceuticals can be a lifeline for some, there are high rates of side effects and drug resistance, and that is assuming they are working. They of course don’t always work and there is too often a trial-and-error random approach to selection.
Herbal medicines, on the other hand, have a low rate of side effects, and while the research is not as robust, there are excellent results in the published literature for general anxiety disorder, PTSD, obsessive-compulsive disorder, and depression disorders.
Lemon balm (Melissa officinalis) has been used to function as an anxiolytic and anti-depressant, with a long history of historical uses and some modern research. While individual studies are available, to date, there have been no systematic reviews or meta-analyses. The authors of the current study conduct a systematic review and meta-analysis to evaluate the effects of lemon balm on anxiety and depression in clinical trials.
In this review and meta-analysis, only randomized controlled trials (RCTs) that assessed lemon balm on anxiety or depression as a main outcome were included.
In the end, there were 10 RCTs for analysis that met all considerations for non-duplication and Cochrane guidelines. These 10 articles included 632 participants for the qualitative synthesis and 6 included 435 participants for the meta-analysis. Depression was analyzed with 369 patients, and anxiety with 527 patients. Of the 632 patients, 105 had depression, 263 had anxiety, and 264 had both. All but one of the studies used oral route for delivery. Four studies used an extract, one used an essence, and five used a dried powder, and the dosages were not the same. The length of the studies ranged from a single dose to 56 days.
Four of 10 studies were not included in the meta-analysis due to lack of data and one due to too many differences with the other study designs.
For the meta-analysis, five studies showed a significant mean anxiety score reduction in the lemon balm group compared to placebo. In the acute anxiety subgroup with three studies, there was a significant difference between lemon balm and placebo. However, there was no significant difference in the chronic anxiety subgroup analysis with two studies. In the meta-analysis for depression, three studies demonstrated significant reduction in mean depression score in the lemon balm group compared to placebo and the subgroup with two studies for acute depression revealed a significant decrease in the mean depression score. The subgroup with one study for chronic depression also exhibited a significant decrease in mean depression score for the lemon balm group compared to placebo.
Side effects reported for lemon balm included headache, EEG changes, reduced alertness, sleep disturbances, and withdrawal symptoms.
Commentary: I appreciate knowing of this systematic review and meta-analysis of such a simple and safe herb such as lemon balm. In these times of increasing mental health issues including depression and anxiety, the need for more therapies, safe therapies, effective therapies, and affordable therapies is imperative. Lemon balm is easy to obtain and easy to take in capsule, tincture, or even tea form for those with less need for specific dosages. Dosages to consider would be 300 to 500 mg three times daily of powdered and encapsulated lemon balm for chronic depression and/or anxiety. A lower dose tea would be ¼ to 1 tsp of dried lemon balm herb in hot water (equivalent to 1 capsule 1-3 times daily). A higher dose can be taken for acute anxiety. Cautions should be employed if thyroid disorder and/or on thyroid medication or coumadin medication.
I was drawn to this article due to the immense current need, as well as the robust amount of it growing in my garden and spreading to other areas it likes to grow. The plant and the land know we need her.
Ghazizadeh J, Sadigh-Eteghad S, Marx W, et al. The effects of lemon balm (Melissa officinalis L.) on depression and anxiety in clinical trials: A systematic review and meta-analysis. Phytother Res. December 2021;35(12):6690-6705.