Plantas medicinais no tratamento de ansiedade e depressão: Uma revisão

Há uma grande diversidade de plantas no Brasil, e muitas delas, ao serem estudadas, apresentam elevado teor nutricional, presença de antioxidante, entre outras propriedades, podendo ter um potencial farmacológico significativo e consequentemente gerando aplicações em diversas áreas como saúde, cosmética e culinária. As plantas medicinais são usadas por grande parte da população mundial, como um recurso medicinal alternativo para o tratamento de diversas doenças, visto que em muitas comunidades, representam um recurso mais acessível em diversos sentidos em relação aos medicamentos alopáticos. Destaca-se a utilização das plantas medicinais para fins terapêuticos, em que muitas atividades biológicas conferidas às plantas foram demonstradas, dentre elas a ação no sistema nervoso central, sendo utilizadas para o tratamento e/ou prevenção de transtornos psicossociais como ansiedade e depressão. Sendo assim, o presente estudo tem como objetivo realizar uma revisão bibliográfica sobre as plantas medicinais mais utilizadas no tratamento da ansiedade e depressão. Verificou-se que nos tratamentos, as plantas medicinais e os fitoterápicos são vistos como uma alternativa viável para o tratamento dos quadros de ansiedade e depressão, visto que possuem menos efeitos colaterais. Sendo assim, a presente pesquisa revisou as espécies: Hypericum perforatum L.; Passiflora incarnata L.; Melissa Officinalis L.; Chamomilla recutita L.; Piper methysticum G.; Erythrina verna; Humulus lupulus L. e Crataegus oxyacantha L. Foi possível apresentar a efetividade de todas as espécies citadas, com as descrições encontradas em estudos da literatura.

An Attempt to Estimate the Noises in Homeopathic Pathogenetic Trials by Employing the Jaccard Similarity Index and Noise Index

Background The critical task of researchers conducting double-blinded, randomized, placebo-controlled homeopathic pathogenetic trials is to segregate the signals from the noises. The noises are signs and symptoms due to factors other than the trial drug; signals are signs and symptoms due to the trial drug. Unfortunately, the existing tools (criteria for a causal association of symptoms only with the tested medicine, qualitative pathogenetic index, quantitative pathogenetic index, pathogenic index) have limitations in analyzing the symptoms of the placebo group as a comparator, resulting in inadequate segregation of the noises. Hence, the Jaccard similarity index and the Noise index are proposed for analyzing the symptoms of the placebo group as a comparator. Methods The Jaccard similarity index is the ratio of the number of common elements among the placebo and intervention groups to the aggregated number of elements in these groups. The Noise index is the ratio of common elements among the placebo and intervention group to the total elements of the intervention group. Homeopathic pathogenetic trials of Plumbum metallicum, Piper methysticum and Hepatitis C nosode were selected for experimenting with the computation of the Jaccard similarity index and the Noise index. Results Jaccard similarity index calculations show that 8% of Plumbum metallicum's elements, 10.7% of Piper methysticum's elements, and 19.3% of Hepatitis C nosode's elements were similar to the placebo group when elements of both the groups (intervention and placebo) were aggregated. Noise index calculations show that 10.7% of Plumbum metallicum's elements, 13.9% of Piper methysticum's elements and 25.7% of Hepatitis C nosode's elements were similar to those of the placebo group. Conclusion The Jaccard similarity index and the Noise index might be considered an additional approach for analyzing the symptoms of the placebo group as a comparator, resulting in better noise segregation in homeopathic pathogenetic trials.

Characterization of different forms of kava (Piper methysticum) products by UPLC-MS/MS

There are several forms of kava (Piper methysticum) products available for human consumption, and many factors are known to influence their chemical compositions and therefore their pharmacological properties. Because of the increased popularity of kava intake, a rigorous characterization of their content diversity is prerequisite, particularly due to its known potential to cause hepatotoxicity. To understand the composition diversity of kavalactones and flavokavains in commercial kava products, we developed a UPLC-MS/MS-based analytical method for the quantification of six kavalactones (kavain, dihydrokavain, methysticin, dihydromethysticin, yangonin and desmethoxyyangonin) and two flavokavains (flavokavains A and B) and analyzed their contents in 28 different kava products in the form of capsules, tinctures, traditional aqueous suspensions and dried powders. Our results demonstrated a great variation in terms of the total and relative abundance of the analyzed kavalactones and flavokavains among the analyzed kava preparations. More importantly, the kavalactone abundance in the product label could differ up to 90% from our experimental measurements. Therefore, more rigorous and comprehensive quality control of kava products is required with respect to the content of individual kavalactones and flavokavains. Accurate content information is essential to understand the pharmacological properties and safety of different kava products.

Piper methysticum G. Forst (Piperaceae) in the central nervous system: phytochemistry, pharmacology and mechanism of action

Due to the continuous increase in incidents of diseases and disorders in the central nervous system as neurodegenerative disease, the growth of studies that seek to use herbal medicines has been observed, since these are more easily produced and more economically viable, in addition to having side effects to a lesser extent when compared to existing synthetic drugs. In this way, a wide variety of plants have been analyzed for their medicinal purposes and this review presents papers published from 1970 to 2021 that describe the chemical composition pharmacological activities and elucidates mechanisms of action in the central nervous system (CNS) of the species Piper methysticum (Kava-kava). The Kava-kava has a class of compounds that include tannins, alkaloids, benzoic acid, cinnamic acid, sugars, bornyl-cinnamate, stigmasterol, flavocavaines, mucilages, pyrones, tetrahydroiangonins, phytochemicals that are responsible for the pharmacological activities of this plant being thus more studied as anxiolytic, sedative and neuroprotection. Some action mechanisms that describe the performance of kava in the CNS were also addressed, Being the main ones related to blocking of sodium and calcium ion channels, modulation of the erythroid 2 pathway, to receptors such as γ-aminobutyric acid, glutamatergics, glycine and cannabinoid, as well as monoamine oxidase and acetylcholinesterase enzymes, in addition to neurotransmitters such as dopamine, serotonin and norepinephrine. Therefore, this study aims to open new paths for more in-depth pharmacological studies on Kava-kava, and its use in the central nervous system.

Biological Activity, Hepatotoxicity, and Structure-Activity Relationship of Kavalactones and Flavokavins, the Two Main Bioactive Components in Kava (Piper methysticum)

Kava (Piper methysticum Forst) is a popular and favorable edible medicinal herb which was traditionally used to prepare a nonfermented beverage with relaxant beneficial for both social and recreational purposes. Numerous studies conducted on kava have confirmed the presence of kavalactones and flavokawains, two major groups of bioactive ingredients, in this miraculous natural plant. Expectedly, both kavalactone and flavokawain components exhibited potent antianxiety and anticancer activities, and their structure-activity relationships were also revealed. However, dozens of clinical data revealed the hepatotoxicity effect which is indirectly or directly associated with kava consumption, and most of the evidence currently seems to point the compounds of flavokawains in kava were responsible. Therefore, our aim is to conduct a systematic review of kavalactones and flavokawains in kava including their biological activities, structure-activity relationships, and toxicities, and as a result of our systematic investigations, suggestions on kava and its compounds are supplied for future research.

Kava – 20 Jahre Kampf gegen regulatorische Windmühlenflügel

ZusammenfassungArzneimittel auf der Basis von Extrakten aus den Wurzeln der Kavapflanze (Piper methysticum) waren in Deutschland bis zum Widerruf der Zulassungen am 14. Juni 2002 sehr beliebte Mittel gegen nervöse Angst-, Spannungs- und Unruhezustände. Kava ist eine der am besten untersuchten Arzneipflanzen, sowohl aus pharmakologischer Sicht als auch durch klinische Evidenz und Jahrhunderte traditioneller Erfahrung der sicheren Anwendung im Südpazifik. Noch bleibt Hoffnung, dass die behördliche Entscheidung revidiert werden kann.

Avaliação físico-química e microbiológica de fitoterápicos utilizados em uma farmácia municipal de manipulação

O medicamento fitoterápico possui como insumo, plantas medicinais ou seus derivados. Apesar de inúmeros benefícios, o uso indiscriminado e falhas durante a produção podem expor o consumidor final a efeitos nocivos à sua saúde. Nesse sentido, o estudo avaliou a qualidade físico-química e microbiológica de insumos vegetais utilizados em uma farmácia de manipulação municipal na região sudoeste do Paraná. Foram analisadas amostras de extratos secos de: Cymbopogon citratus, Baccharis trimera., Aesculus hippocastanum, Equisetum arvense, Echinodorus grandiflorus, Curcuma longa, Ginkgo biloba, Piper methysticum, Melissa officinalis e Passiflora incarnata. Para a avaliação físico-química, foram realizados os testes, segundo a Farmacopeia Brasileira (2019): características organolépticas, umidade, granulometria, pH, densidade, solubilidade e constituintes secundários, dentre os quais flavonoides, saponinas e taninos. Para a análise microbiológica, determinou-se a presença de microrganismos totais, bolores, leveduras, Salmonella sp e Shiguella sp, segundo Barbosa (2014). A avaliação organoléptica revelou que todas as amostras se apresentaram com aspecto de pó fino e homogêneo, com odor e cor característicos de cada espécie. Os extratos secos apresentaram resultados de teor de umidade, granulométricos, pH e densidade dentro dos valores de referência farmacopéicos. Com relação a solubilidade, a amostra de E. arvense se revelou praticamente insolúvel ao solvente utilizado. Todas as amostras testaram positivo para a presença de flavonoides. As amostras de G. biloba, P. methysticum e P. incarnata não apresentaram saponinas. Nenhuma amostra apresentou contaminação por bactérias totais, Salmonella sp e Shiguella sp. Portanto, os resultados obtidos nesta pesquisa atendem aos parâmetros da legislação vigente, comprovando a qualidade dos extratos estudados.

Current perspectives in herbal and conventional drug interactions based on clinical manifestations

Background Herbs are an important source of pharmaceuticals. Herbs are traditionally used by millions of peoples for medicine, food and drink in developed and developing nations considering that they are safe. But, interaction of herbs with other medicines may cause serious adverse effects or reduces their efficacy. The demand for “alternative” medicines has been increased significantly, which include medicine derived from plant or herbal origin. The objective of this review article mainly focuses on drug interactions of commonly used herbs along with possible mechanisms. The method adopted for this review is searching of herb-drug interactions in online database. Main text Herb-drug interaction leads to pharmacological modification. The drug use along with herbs may show pharmacodynamic and pharmacokinetic interactions. Pharmacokinetic interaction causes alteration in absorption, distribution, metabolism and elimination. Similarly, pharmacodynamic interaction causes additive or synergistic or antagonist effect on the drugs or vice versa. Researchers had demonstrated that herbs show the toxicities and drug interactions like other pharmacologically active compounds. There is lack of knowledge amongst physician, pharmacist and consumers related to pharmacological action and mechanism of herb-drug interaction. This review article focuses on the herb-drug interaction of danshen (Salvia miltiorrhiza), Echinacea (Echinacea purpurea), garlic (Allium sativum), ginkgo (Ginkgo biloba), goldenseal (Hydrastis canadensis), green tea (Camellia sinensis), kava (Piper methysticum), liquorice (Glycyrrhiza glabra), milk thistle (Silybum marianum) and St. John’s wort (Hypericum perforatum) along with probable mechanisms and clinical manifestation based on case studies reported in literature. Conclusion Herb-drug interactions may lead to serious side effects. Physician, pharmacist and patients must be more cautious while prescribing and or consuming these herbs.

UTILIZAÇÃO DA PIPER METHYSTICUM (L.) E PASSIFLORA INCARNATA (L.) NO TRATAMENTO DE TRANSTORNO DE ANSIEDADE GENERALIZADA

As medidas de controle recomendadas no contexto da pandemia do COVID-19 tem afetado a população em muitos calibres das condições de vida e de saúde e, entre elas, de forma significativa o componente de saúde mental como a ansiedade e a depressão. Objetivo: Revisar, através da literatura científica, a eficácia, interações farmacológicas e benefícios do uso dos fitoterápicos kava-kava (Piper methysticum L.) e maracujá (Passiflora incarnata L.) como alternativas terapêuticas para o tratamento do Transtorno de Ansiedade Generalizada (TAG), agravados em tempos de pandemia. Métodos: Trata-se de uma revisão bibliográfica sistemática qualitativa, na qual utilizou-se os sites eletrônicos SciELO, PubMed, Google acadêmico, ANVISA e OMS para a busca de dados. Resultados: Observou-se que os principais benefícios da utilização de fitoterápicos diz respeito ao custo reduzido, à facilidade de acesso e ao baixo índice de efeitos colaterais e reações adversas. Encontrou-se um número considerável de informações que demonstraram a utilização e a procura de fitoterápicos à base de P. Incarnata para tratar as psicopatologias como o TAG, durante o isolamento social e a quarentena. Não foram encontrados números significativos de estudos capazes de comprovar a utilização da P. Methysticum durante a pandemia da COVID-19. Considerações finais: Sugere-se que as espécies P. Incarnata e P. Methysticumão eficazes para o tratamento do TAG por possuir alto valor medicinal com propriedades farmacológicas ansiolíticas, anticonvulsivantes e sedativas.