Herbal Remedy Research Standards

There are special considerations to take into account when looking at scientific studies that investigate the effectiveness of herbal remedies for OCD, anxiety disorders, or any other mental health condition. Sometimes, study results sound impressive because basic research standards were compromised. First, studies using herbs which are not in a standardized form may have varying activity levels of chemical components. Studies must take into account the accurate identity of the plant as well as whether the active constituents come from the leaf, root, seed, or stem of the plant. Studies evaluating the effectiveness of medications should also include a placebo treatment group that receives a “sugar pill” that is inactive and could not possibly account for any reduction in symptoms. By using a placebo treatment, it is possible to tell if the actual drug had an effect or not. Lastly, it is important that neither the researchers nor the study participants know who is receiving what treatment until the study is over to avoid bias. A medical study in which neither the patient nor the physicians know who is using the medication or supplement and who is receiving a placebo is called a double-blind study.

Alternative Medicine and Herbs for OCD

Nutritional supplements are available for OCD and anxiety. But you should inform yourself about the evidence-based benefits and potential side effects before you decide to take one. Most herbal remedies are available at drugstores without a prescription. However, it’s important to talk to your doctor before taking any supplement. In addition to having side effects, many of these nutritional supplements can interfere (enhance or decrease) the actions of prescription medications.

St. John’s Wort

St. John’s Wort (Hypericum perforatum) is best know as an herbal anti-depressive, although its effectiveness in treating depression and other forms of mental illness is controversial. St. John’s Wort has been widely used (and in some cases, licensed) in Europe for decades to treat mood and anxiety disorders. An analysis has found that hypericum—the chemical that’s thought to be the key ingredient in St. John’s Wort—appears to affect the serotonin system. Disruptions in the serotonin system are thought to be important in the development of symptoms of OCD. A case study (one patient) suggested that St. John’s Wort was effective in reducing symptoms. A second study (12 people with OCD) found that it produced a significant reduction in symptoms that were similar to what would be expected with treatment with a selective serotonin reuptake inhibitor (SSRI) antidepressant medication. Neither study properly accounted for the placebo effect. In both cases, the people participating in the research studies were told upfront that they were going to be receiving St. John’s Wort in the hopes of reducing their OCD symptoms. Simply knowing that they were receiving a potentially beneficial treatment could have been enough to cause people to feel better. At least one randomized-controlled trial looked at whether St. John’s Wort was effective in reducing OCD symptoms. In the study, 60 people randomly received either St. John’s Wort or placebo. The reduction in symptoms among those who took St. John’s Wort was no different than it was in those who took a placebo. Results like this question the effectiveness of St. John’s Wort as an OCD treatment.

Milk Thistle

Milk thistle (Silybum marianum) is an herbal remedy that has long been used in Iran. In 2010, a double-blind, placebo-controlled study compared the effects of milk thistle to the antidepressant Prozac (fluoxetine) in treating OCD (600 milligrams of milk thistle vs 30 milligrams of Prozac daily). It was found that there was no significant difference between milk thistle and Prozac for OCD symptoms.

N-Acetylcysteine

N-Acetylcysteine is an amino acid that moderates glutamine in the brain. N-acetylcysteine helps produce glutathione, an important antioxidant. A single study of a single person found that N-acetylcysteine improved the actions of the SSRI Luvox (fluvoxamine), resulting in a significant decrease in OCD symptoms.

5-HTP and Inositol

Since the dysregulation of serotonergic and glutamatergic pathways in the brain appears to occur with OCD, other herbs that work in this pathway have also been considered for their possible benefits. Some of these include 5-hydroxytryptophan (5-HTP) and ​inositol.

Kava (Piper Methysticum)

Kava is an herbal medication found in clinical trials to reduce anxiety, nervous tension, restlessness, and mild depression. It has been used for hundreds of years in Polynesia, the Micronesia Islands, and Hawaii. The key constituent in Kava is kavalactone, which stimulates production of both serotonin and gamma amino butyric acid (GABA) in the body which produce a calming effect to the body. It’s best to take Kava from a water-based extract at less than 250 mgs per day. Kava is not recommended during lactation or pregnancy.

Side Effects

Although many consumers believe that herbals are safer and have fewer adverse effects than prescription medications, treatments like St. John’s Wort are not regulated as closely as conventional medications are and they may cause unpleasant or even dangerous side effects in some people. Herbal treatments can also interfere with prescription medications that you may already be taking. For example, if you are currently taking an SSRI to treat OCD, it is essential that you consult your treating physician before taking St. John’s Wort as it could affect your body’s ability to metabolize it. This could lead to a problem known as serotonin syndrome.

Other Complementary Therapies

Don’t forget that there are other alternatives for treating the symtoms of OCD. Beyond supplements, lifestyle interventions such as mindfulness meditation, acupuncture, and yoga may be effective as well. Unfortunately, there have been few clinical trials looking at these interventions for people with OCD and those that have been done are of fairly poor quality. Yet, unlike prescription drugs and herbal medications, lifestyle interventions rarely have significant side effects and may also help reduce stress.