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Lavender 15003309
Lavender 15003309
Lavender 15003309
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All content following this page was uploaded by Ethan Basch on 20 June 2014.
Ethan Basch is affiliated with the Natural Standard Research Collaboration. Ivo
Foppa is affiliated with Harvard University. Richard Liebowitz is affiliated with Duke
University. Jamie Nelson is affiliated with the University of Rhode Island. Michael
Smith is affiliated with the Canadian College of Naturopathic Medicine. David Sollars
is affiliated with the New England School of Acupuncture. Catherine Ulbricht is affili-
ated with Massachusetts General Hospital. All are members of Natural Standard Re-
search Collaboration (www.naturalstandard.com).
The information in this monograph is intended for informational purposes only, and
is meant to help users better understand health concerns. Information is based on re-
view of scientific research data, historical practice patterns, and clinical experience.
This information should not be interpreted as specific medical advice. Users should
consult with a qualified healthcare provider for specific questions regarding therapies,
diagnosis and/or health conditions, prior to making therapeutic decisions.
Copyright 2003 Natural Standard Inc. Reprinted with permission.
Journal of Herbal Pharmacotherapy, Vol. 4(2) 2004
http://www.haworthpress.com/web/JHP
Digital Object Identifier: 10.1300/J157v04n02_07 63
64 JOURNAL OF HERBAL PHARMACOTHERAPY
Brief Background
DOSING TOXICOLOGY
General
Standardization
Oral
Tea: One to two teaspoons of the herb taken as a tea (based on anecdote
and expert opinion). The tea can be made by steeping 2 U.S. teaspoons (10
grams) of leaves in 250 mL (1 cup) boiling water for 15 minutes.
Monograph from Natural Standard 67
PRECAUTIONS/CONTRAINDICATIONS
Allergy
Caution should be exercised in patients with known allergy/hyper-
sensitivity to lavender. Persons with allergy to lavender may experience
mild local skin reactions after topical use of lavender oil.14,16
Adverse Effects
General: In recommended doses, lavender is generally considered to be
well-tolerated, with minimal adverse effects.7,13,17
68 JOURNAL OF HERBAL PHARMACOTHERAPY
Precautions/Warnings/Contraindications
INTERACTIONS
Lavender/Drug Interactions
MECHANISM OF ACTION
Pharmacology
Lavender is comprised of over 100 constituents, including linalool,
perillyl alcohol, linalyl acetate, camphor, limonene, tannins, triterpenes,
coumarins, cineole, and flavonoids.
Linalool has been shown to reduce motor activity in mice due to a
70 JOURNAL OF HERBAL PHARMACOTHERAPY
HISTORY
The name lavender is derived from the Latin lavare, meaning to wash.
In ancient Greece, Persia and Rome, it was used as a perfume in baths and
laundry, and as an antiseptic. Ancient Egyptians created mummification
casts by soaking linen in oil of lavender containing asphalt, then wrapping
the bodies with these and drying them in the sun until the casts were hard.
Lavender has been renowned as a ‘healing agent’ in India and Tibet. In Ti-
betan Buddhist medicine, lavender is still used to treat insanity and psycho-
ses. Today, in Europe and the Americas, lavender is often used as an
anxiolytic and sleep aid.
EVIDENCE TABLE
Condition Study Design Author, N Statistically Quality of Magnitude ARR NNT Comments
Year Significant? Study of Benefit
0-2=poor
3-4=good
5=excellent
Anxiety Not randomized, Saeki, 10 Yes 1 Small NA NA Poor
controlled 2000 description of
methodology;
unclear
blinding or
randomization.
Anxiety Randomized, Dunn, 12 Yes 1 Small NA NA Initial benefit
controlled 1995 2 dissipated
after first
session.
Anxiety Not randomized, Motomura, 42 Yes 0 Large NA NA Small study,
controlled 1998 results unclear
due to lack of
randomization.
Anxiety Case series Itai, 2000 14 Yes NA Large NA NA No significant
difference
compared to
odorless smell.
Hypnotic Case series Hardy, 4 NA NA None NA NA Small series
1995 using
aromatherapy.
Perineal Double-blind, Dale, 63 No 3 None NA NA Subjective
relief randomized, 1994 5 outcome
following controlled measure,
childbirth incomplete
data, no
difference
found.
Tumor Case series Ripple, 18 NA 1 NA NA NA Uncontrolled
regression (phase I clinical 1998 trial using
trial) perillyl alcohol
(POH).
72 JOURNAL OF HERBAL PHARMACOTHERAPY
EVIDENCE DISCUSSION
Anxiety (Aromatherapy)
Summary: In general, the evidence supporting lavender aromatherapy as
an anxiolytic is weak. There are conflicting results from methodologically
flawed studies, with some showing lack of effect. However, overall, the
weight of the evidence suggests a small positive effect in relieving anxiety.
Further study through well-designed randomized trials would strengthen this
case. However, there are inherent difficulties involved with designing blind-
ing or placebo control for study of an olfactory therapy. These difficulties
must be overcome before compelling results can be generated.
Evidence: Saeki et al. attempted to demonstrate that lavender aromatherapy
via footbath produced anxiolytic effects compared to placebo.17 This “be-
fore and after” study, which consisted of 10 subjects, concluded that a hot
footbath with lavender oil is associated with small but significant changes
in autonomic activity. However, the incomplete description of methodol-
ogy and analysis make results difficult to interpret.
Dunn et al. conducted a randomized, single-blind study in 122 inten-
sive care unit patients, allocated to one of three groups: body massage
with grapeseed oil, body massage with lavender oil, or undisturbed
rest.7 Psychological endpoints were assessed using an arbitrary 4-point
scale, and physiological endpoints included blood pressure, heart rate,
and breaths-per-minute. Treatment ranged from one to three 30-minute
sessions, 24 hours apart. All patients received at least one session; 66
patients completed three sessions. After the first session, patients who
had received a massage with lavender oil had significantly less anxiety
than the group who rested. This difference was not maintained in the
following sessions. It is not clear to what extent the lack of dou-
ble-blinding, or the high dropout rate, affected results.
Motomura et al. conducted an experiment in which 42 students were di-
vided into three groups: Group 1 experienced a “stressful condition;” group
2 experienced a “stressful condition” with the addition of lavender odor;
group 3 experienced a “non-stressful condition.” Stress was evaluated
based on a Japanese version of Cox and Mackay’s stress/arousal adjective
checklist. The experiment found that scores in the lavender group were sig-
nificantly lower than the group who was stressed and did not receive laven-
der therapy.35 However, blinding and randomization were not clearly
described.
In a case series consisting of 14 female, chronic renal failure patients
on hemodialysis, Itai et al. evaluated the effect of lavender oil on mood
Monograph from Natural Standard 73
using the Hamilton rating scale for depression (HAMD) and the Hamil-
ton rating scale for Anxiety (HAMA).36 Compared to natural smell (base-
line), lavender was observed to decrease anxiety as evidenced by the
HAMA scale (P = 0.05). Lavender did not significantly alter patients’
HAMD scores from baseline. When lavender was compared to odorless
conditions, the difference in HAMA and HAMD scores was minimal.
Buckle compared therapeutic benefits of oils from two different spe-
cies of lavender (L. angustifolia and L. burnatti) applied by massage to 28
hospitalized patients.37 A semi-structured interview to collect qualitative,
subjective data was used several days after treatment. The study reported
that L. burnatti had significantly more relaxing effects than its counterpart.
However, further details of statistical analysis or methodology were in-
complete, thus raising question about the results.
Hypnotic/Sleep (Aromatherapy)
Spasmolytic (Oral)
Antibiotic (Topical)
Cancer (Oral)
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