Passionflower

Passionflower is deemed to be mildly cooling in the understanding of Western herbal energetics. This cooling action reduces heat, excitation and overstimulation in the cells (3). Whilst passionflower is less obviously sour than other medicinal herbs , it does have a notable sour taste. This cooling action is often seen in plants that have a sour taste profile. Herbs like sorrel (Rumex acetosa) and lemon balm (Melissa officinalis) also fit in this category of non-fruiting sour relaxants whose actions may be well applied for this type of nervous excitability.

In Ayurveda, passionflower is thought to decrease pitta and kapha. It also moves obstructed vata. It is said that when used in excess, it may increase vata, so it is likely best to use with caution for individuals with a high vata constitution (4).

Similar to Ayurveda, traditional Chinese medicine (TCM) has its own unique system of understanding health balance and disease. TCM understands passionflower to be of a calming nature, relieving anxiety and soothing the spirit. It also tonifies Heart yin (put simply, yin translates as a restorative energy that allows the body and mind to slow down, rest and relax), whilst also clearing internal wind. Internal wind may be indicated by the presence of spasms, pain and seizures arising from hyperactive Liver yang (yang refers to active energy, heat, movement and power) (5).

In the energetics of the eclectics, passionflower is understood to be best adapted to debility and nervous irritability. It is specifically indicated for irritation of the brain and nervous system with atony. This herb is appropriate for those whose sleep is affected by overwork, worry and exhaustion. In addition, convulsions, hysteria and oppressed breathing may be present (6).

Nervous system

Passionflower has a marked sedative effect on the central nervous system. It is often used by herbalists to treat anxiety, restlessness and other mental health conditions. It has been shown to improve symptoms in people with attention deficit disorder (ADD) as well as in alleviating withdrawal symptoms in people recovering from conventional and recreational drug addictions (12,13,14).

Passionflower is an excellent remedy for insomnia. It works most effectively when taken in the evening to support the transition into sleep. It is well known to induce a restful sleep without a feeling of grogginess the next day that can often accompany sedatives (15,16).

Furthermore, passionflower can be applied to spasmodic conditions, such as the spasmodic muscular convulsions seen in epilepsy (1,15). It is also referenced for use in Parkinson’s disease (16). The antispasmodic actions also indicate its use in the treatment of neuralgia and pain from shingles (16).

As a sedative, passionflower can be used in the acute treatment of mania and also for panic attacks, but it is also safe to use for chronic anxiety. Passionflower is a more gentle sedative than other herbs like valerian and hops (2).

Digestive system

Passionflower may be applied in spasmodic conditions of the digestive system, particularly where these are linked to stress and tension such as with irritable bowel syndrome (IBS). This herb is antispasmodic, meaning that it can easily relax tension held in the digestive tract such as in flatulence and intestinal spasm. This spasmodic state can also be seen in conditions such as reflux, colic and dysentery (1,16).

Cardiovascular system 

Passionflower additionally acts as an antihypertensive to reduce high blood pressure and prevent tachycardia, particularly where the cause is stress. Traditionally, it has been applied to reduce palpitations. This mechanism is likely due to its effect on the nervous system in reducing the stress response, as opposed to a specific cardiac mechanism (1,3).

Respiratory system

Passionflower can be useful in the treatment of spasmodic asthma and whooping cough (2,16). As a herb with powerful antispasmodic actions, passionflower can be applied where these conditions leave a patient with persistent tension in the lungs and diaphragm that leads to spasmodic coughing (2,16).

Passionflower in the treatment of generalized anxiety: A pilot double-blind randomised controlled trial with oxazepam

A double-blind randomised control trial was carried out to compare the efficacy of Passiflora incarnata extract with oxazepam (an anti-anxiety and insomnia pharmaceutical medication) in the treatment of generalised anxiety disorder.

The study was carried out on outpatients with a generalised anxiety diagnosis. Patients were randomly allocated — with 18 participants receiving the passionflower extract at 45 drops per day, 18 in the placebo tablet group, and 18 to receive oxazepam at 30 mg per day plus placebo drops over a four week trial period.

The results show that passionflower  extract and oxazepam are equally as effective in the treatment of generalised anxiety disorder. However, subjects taking oxazepam displayed significantly more problems relating to impairment of job performance. The study concludes that Passionflower is effective for the management of generalized anxiety disorder. Passionflower holds the advantage over oxazepam with its low incidence of impairment of job performance and side effects (16).

Passiflora incarnata in neuropsychiatric disorders—A systematic review

A systematic review was carried out on nine different clinical trials where passionflower is used in the treatment of psychiatric disorders. The review includes a number of studies where passionflower was used in clinical trials to assess its efficacy for anxiety. Some of these studies focused on preoperative and pre-spinal anaesthesia anxiety and also for anxiety related to dental procedures.

The results across each study showed that passionflower was safe and effective for reducing anxiety. This includes the case of conscious sedation in adult patients. Passionflower was found to significantly contribute to reducing pre-procedural anxiety. A very low incidence of side effects was reported, however, a study where passionflower was used in preoperative anxiety found that psychomotor functions were impaired 30 minutes after extubation (17).

The same review discusses the results of a study where the effects of passionflower were compared to midazolam for bilateral extraction of the mandibular third molars. The anxiolytic action of both substances used in the study was similar. Among the subjects in the midazolam group, 20% reported significant memory loss, while none of the patients receiving passionflower reported such an experience. The midaxolam group reported a higher incidence of drowsiness (17).

The review concludes with a theme of strong evidence to support that passionflower is able to alleviate some symptoms of neuropsychiatric origin. The anxiolytic effect of passionflower is comparable to the drugs oxazepam or midazolam. However, passionflower holds the advantage of having little to no adverse reactions, such as including memory loss or collapse of psychometric functions as often seen with its pharmaceutical equivalents. Consequently, passionflower offers a safe and effective medicine to reduce stress reactivity, insomnia, anxiety, and depression-like behaviours (17).

Randomised, double-blind, placebo-controlled, clinical study of Passiflora incarnata in participants with stress and sleep problems

This randomised, double blind, placebo controlled clinical study was carried out to evaluate the effect of a passionflower extract on participants with stress and sleep issues. Participants were randomly divided into two groups, one (32 people) to receive 600 mg of passionflower at bedtime and the other (33 people) placebo group to receive placebo capsules. The study was carried out over a 30 day time period, with assessments carried out on day 1, 15 and 30.

Results showed a significant reduction on the Perceived Stress Scale (PSS) in the passionflower group vs placebo, an increase in total sleep time in the passionflower group as well as a notable increase in overall psychological health in the passionflower group. There were no adverse effects reported, suggesting passionflower is an effective remedy in reducing stress levels and supporting sleep (18). 

Passiflora incarnata in the treatment of attention-deficit hyperactivity disorder in children and adolescents

In an eight-week, double-blind, randomised clinical trial the effectiveness of passionflower in treatment of ADHD was carried out on a group of 34 children aged between the ages of 6 to13 years old. Subjects in the treatment group were given 0.04 mg passionflower tablets twice daily whilst the control received methylphenidate (an ADHD medication) at 1 mg twice daily. Both treatment groups demonstrated significant clinical benefits over the period of treatment as assessed by both parents and teachers. The study concludes that “passionflower may be a novel therapeutic agent for the treatment of ADHD” (12).

Research into passionflower’s effects on psychiatric disorders is promising, however larger scale clinical trials and studies are required to add more weight to the evidence base.

In Grieves’ A Modern Herbal written originally in 1931, the traditional uses of passionflower are understood to be due to a combined effect as a nervous system depressant. She described this mechanism to be specifically affecting descending motor pathways (7).

Historical records show that the Aztecs used passionflower for its medicinal benefits, including for the treatment of urinary tract disorders, bone fractures, and skin contusions. 

Traditionally, Native Americans used passionflower as a sedative (8).

Nicolas Monardes, a Spanish doctor working in Peru, was the first European to bring passionflower to Europe after learningof  its medicinal uses from the Indigenous peoples of South America in 1569. Subsequently, passionflower became widely cultivated and used in European folk medicine (9).

North American physicians prescribed passionflower for its effects on spasmodic conditions, such as seizures and epilepsy. In the early 20th century, European physicians were understood to have used passionflower to treat anxiety and mild sleep disorders (10).

Passionflower is a key remedy for reducing anxiety. This herb can be used to support multiple symptoms of anxiety. A typical indication for passionflower is where anxiety is accompanied by racing and repetitive thoughts. Symptoms may also present with agitation, restlessness, spasms, neuralgic pain, headaches, palpitations and feelings of panic. Passionflower can be applied to help with any of these symptoms as it facilitates a feeling of calm and relaxation (1).

Passionflower works directly on the central nervous system, alleviating overactivity. Passionflower brings peace to the nervous system and allows one to function from a place of calm, regaining a sense of confidence and control (2).

The grounding effects of passionflower are especially helpful where these types of presentations are accompanied by sleep disturbances, such as insomnia. It is a gentle relaxant and a mild hypnotic (2).

Passionflower is also sometimes used to alleviate nervous irritability that can accompany weaning off from pharmaceutical sedatives or anxiety medications. Recovery from alcohol and drug addictions may also be supported by passionflower via the same mechanism. For this application, it may be combined with other nervine sedative herbs, such as hops (Humulus lupulus) and valerian (Valeriana officinalis) (1). Furthermore, where digestive symptoms arise from stress and tension, passionflower may be used as a stomach relaxant and for symptoms of indigestion, particularly (2).

The name passionflower refers to the ‘passion of christ’. It was thought to symbolise events in the last hours of the life of Jesus Christ. Symbolically the corona or flower was thought to represent the crown of thorns, the styles represent the nails used in the crucifixion, the stamens represent the five wounds, and the five sepals and five petals represent 10 of the Apostles — all but Judas (7).

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