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25-30 Herbs.Indd Research American skullcap (Scutellaria laterifl ora): an ancient remedy for today’s anxiety? nxiety is ‘an unpleasant emotional state Abstract ranging from mild unease to intense fear’ Anxiety is a common but potentially serious disorder as it can lead to somatic and A(British Medical Association (BMA), 2002). social dysfunction. Orthodox anxiolytics are associated with unpleasant side-effects and Although anxiety is a normal response to stressful dependency. American skullcap (Scutellaria laterifl ora) is a popular herb in traditional situations it can be seen as a chronic manifestation medicine systems and the western materia medica for anxiety and related disorders. of a modern lifestyle that includes repeated daily Preliminary clinical and in vitro research provides encouraging support for its potential as a stressors (Pavlovich, 1999). It is a potentially serious safe, well-tolerated and effective alternative. disorder as it can precipitate a number of health problems and diffi culties in social and occupational functioning (Fricchione, 2004). Key points Physical symptoms of anxiety include pallor, Research has demonstrated the capacity of American skullcap’s fl avonoids to bind to sweating, hyperventilation, diarrhoea, irritable brain receptors implicated in modulation of anxiety bowel, fl ushing, dysphagia, palpitations, nausea, and In one year up to one in six UK adults in the UK may suffer from an unexplained muscle tension (BMA, 2002). Furthermore, Pitsavos psychological disorder, the most common being anxiety et al (2006) found strong evidence for a positive Anxiety and stress are common reasons for visits to herbal medicine practitioners association between severity of state anxiety in both An initial survey of UK and Ireland herbal medicine practitioners indicated American men and women and increased levels of plasma skullcap as their treatment of choice for anxiety and related disorders pro-infl ammatory cytokines, coagulation factors, Quality control of the raw herb and its commercial products is important. C-reactive protein and white blood cells. Alleviation Key words of these adverse eff ects on health is important. Anxiety, Stress, Herbal Medicine, Flavonoids Many orthodox anxiolytic treatments can have unwanted side eff ects. Benzodiazepines, for example, have been linked to muscle weakness, article discusses its clinical application, and reviews Christine Brock amnesia, headaches, vertigo, urinary retention, both scientifi c and anecdotal evidence in support of Research scholar, slurred speech and gastrointestinal disturbances. its traditional use for anxiety. School of Life Sciences, They may lead to tolerance and physical and University of Westminster psychological dependence, and are considered American skullcap (Scutellaria to be dangerous to use long–term (BNF, 2008). laterifl ora L) Julie Whitehouse The side eff ects of antipsychotics, sometimes Scutellaria laterifl ora is a perennial herb belonging Principal lecturer and course prescribed in the short–term for severe anxiety, to the Lamiaceae (mint) family and is one of 360 leader, include tremor, abnormal face and body movements known skullcap species worldwide (Malikov and School of Life Sciences, and restlessness (BNF, 2008). Beta-blockers may Yuldashev, 2002). It grows on wetlands and is University of Westminster be prescribed for relief of physical symptoms, indigenous to North America and Canada where such as tremors and palpitations, associated with it is widely distributed (USDA). It also grows on Ihab Tewfi k anxiety. However, side eff ects are similar to those riverbanks and marshes in northern Iran (Yaghmai, Course leader, of benzodiadepines and may additionally include 1988) and is grown commercially worldwide (Wills School of Life Sciences, bradycardia, vasoconstriction and heart failure (BNF, and Stuart, 2004). University of Westminster 2008). There is therefore a need for safe alternatives, It was an important North American without unwanted side eff ects. ethnobotanical medicine for use in anxiety, hysteria, To n y To we l l American skullcap (Scutellaria laterifl ora) (Figure phobias, panic attacks, tension, sleep disorders and Professor and course leader, 1) is one of the most commonly used herbs by stress (Felter and Lloyd, 1898; Joshee et al, 2002). It Department of Psychology, western medical herbalists, particularly for anxiety has also been used for centuries in both Persian and University of Westminster and related conditions (Bergner, 2002–2003). This Cherokee folk medicine for nervous disorders of the British Journal of Wellbeing • Vol 1 No 4 • July 2010 25 Research conditions, and infl ammation (Natural Medicines Comprehensive Database, 2008). Following reports of liver damage from use of S. laterifl ora products there was a decline in its popularity in the 1970s and 1980s (McCaleb, 2004). The cause of the hepatotoxicity was probably due to contamination with Germander (Teucrium) species (De Smet, 1999), which contains pyrrolizidine alkaloids (McCaleb, 2004). S. laterifl ora is not associated with hepatotoxicity. Since 2002 there has been a sharp increase in demand for S. laterifl ora, possibly due to it being favoured as an anxiolytic alternative to the previously popular Piper methysticum (kava kava), which, due to toxicity fears, is no longer widely prescribed by herbalists in Europe (Greenfi eld and Davis, 2004). Scutellaria baicalensis (Georgi) (Baikal skullcap) root is extensively prescribed in traditional Chinese and Japanese (kampo) medicines. In particular, this is used to treat infl ammatory diseases, and has been widely researched in relation to its effi cacy and pharmacological properties. Although S. laterifl ora is a popular herb in western herbal medicine and is contained in many herbal formulations (Joshee et al, 2002), particularly for anxiety and stress, relatively few scientifi c studies of this herb exist (Cole et al, 2008). S. laterifl ora is the practitioner’s choice for treating anxiety Results of a survey conducted by the authors among herbal medicine practitioners in the UK and Ireland indicate that S. laterifl ora is considered to be an eff ective intervention for anxiety and stress USDA NRCS WETLAND NRCS USDA INSTITUTE SCIENCE and is commonly prescribed for these conditions Plant life: Scutellaria laterifl ora L. and related co-morbidities. digestive tract (Khosh, 2000) and Native American The survey aimed to gather information on women traditionally used it for premenstrual tension the extent of, and indications for, current use (Indiana Medical History Museum, undated). The of S. laterifl ora. It also looked at perceptions herb is also used extensively and highly valued of its eff ectiveness and safety. Herbal medicine in traditional western herbal medicine. It was practitioners were selected from the membership mentioned in the fi rst American materia medica in list of the National Institute of Medical Herbalists 1785 but had been in longstanding use as a home (NIMH). All members with identifi able email remedy before then (Lloyd 1911; 109). addresses were contacted (n = 377) and responses In modern western herbal medicine it is used were received from 62 (a 16% response rate). most commonly for insomnia, nervous disorders and Results indicate primary use of S. laterifl ora for digestive disturbances (Greenfi eld and Davis 2004). relief of anxiety, stress or associated symptoms. Bergner (2002–2003) proposes its action is primarily More than eight respondents in ten (84%) said they as a trophorestorative on the central nervous system, would prescribe it for specifi c anxiety disorders allowing relaxation following nervous exhaustion. and 100% for anxiety-related co-morbidities. It is also used for barbiturate and tranquilliser Twenty fi ve respondents said it is their preferred withdrawal symptoms (Joshee et al, 2002), herb for anxiety (Figure 2). One respondent said fi bromyalgia, anorexia nervosa, post-stroke paralysis, his or her preferred anxiolytic was S. baicalensis. atherosclerosis, hyperlipidaemia, allergies, skin In common with many other Scutellaria species, 26 July 2010 • Vol 1 No 4 • British Journal of Wellbeing Research S. laterifl ora and S. baicalensis have similar about the perceived actions of S. laterifl ora used in phytochemical constituents, although in diff erent isolation. Nevertheless the practitioners appeared ratios and quantities. This may explain the diff ering confi dent about attributing specifi c actions and traditional uses among Scutellaria species. For responses to S. laterifl ora as distinct from other instance, S. baicalensis contains 800 times more herbs in a mixture in having the anxiolytic actions. scutellarin than S. laterifl ora (Cole et al, 2008). Furthermore, respondents prescribing it as a single Although S. baicalensis is most commonly used for herb reported positive feedback from their patients. infl ammation (Joshee et al, 2002) both S. laterifl ora Examples include reduced anxiety, fewer and and S. baicalensis have been found to inhibit less intense panic attacks, feeling of wellbeing, cyclooexgenases in vitro (Gafner et al, 2004; Jia feeling more positive, and more able to cope. et al, 2007). S. laterifl ora is reported to have been Interestingly, one practitioner prescribing the herb traditionally used for infl ammation. The Iroquai in combination reported a relapse in symptoms of tribe, for example, used it ‘to keep the throat clear’ anxiety in some patients whenever it was removed (Joshee et al, 2002). Conversely, S. balicalensis root from the mix. is reported to have been used as
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