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Integrative Cancer Therapies, Vol. 3, No. 2, 128-148 (2004)
DOI: 10.1177/1534735404265003
Safety and Efficacy of Herbal Sedatives in Cancer Care
Keith I. Block, MD
Block Center for Integrative Cancer Care, Evanston, Illinois, and the Program for Collaborative Research in the Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago
Charlotte Gyllenhaal, PhD
Block Center for Integrative Cancer Care, 1800 Sherman, Suite 515, Evanston, IL 60201. cgyllenhaal@blockmedical.com
Mark N. Mead, MS
Block Center for Integrative Cancer Care, Evanston, Illinois
Insomnia and other sleep disturbances are common in cancer patients. Insomnia is a multifactorial health concern that currently affects at least 1 in 3 cancer patients, and yet most insomnia sufferers do not consult their physician regarding pharmaceutical options for relief. Use of hypnotic drugs (primarily benzodiazepines) is associated with increasing tolerance, dependence, and adverse effects on the central nervous system. While hypnotic drug use declined substantially in the past decade, the use of herbal sedatives appeared to increase. Mostly self-prescribed by lay people, herbal sedatives hold widespread appeal, presumably because of their lower cost and higher margin of safety when compared to pharmaceuticals. Studies of better-known herbal sedatives, notably valerian and kava, showed moderate evidence for both safety and efficacy for valerian while revealing disturbing toxicity concerns for kava. Milder sedatives or anxiolytics in need of clinical study include German chamomile, lavender, hops, lemon balm, and passionflower; St. John’s wort may have anxiolytic effects with relevance to sleep. Herb-drug interactions are a possibility for some of these species, including St. John’s wort. Although sufficient evidence exists to recommend some of these agents for short-term relief of mild insomnia, long-term trials and observational studies are needed to establish the safety of prolonged use as well as overall efficacy in the context of cancer treatment and management.
Key Words: insomnia • sleep disorders • hypnotic • herbal sedatives • valerian • kava • lavender • chamomile • hops • lemon balm • passionflower
DOI: 10.1177/1534735404265003
Safety and Efficacy of Herbal Sedatives in Cancer Care
Keith I. Block, MD
Block Center for Integrative Cancer Care, Evanston, Illinois, and the Program for Collaborative Research in the Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago
Charlotte Gyllenhaal, PhD
Block Center for Integrative Cancer Care, 1800 Sherman, Suite 515, Evanston, IL 60201. cgyllenhaal@blockmedical.com
Mark N. Mead, MS
Block Center for Integrative Cancer Care, Evanston, Illinois
Insomnia and other sleep disturbances are common in cancer patients. Insomnia is a multifactorial health concern that currently affects at least 1 in 3 cancer patients, and yet most insomnia sufferers do not consult their physician regarding pharmaceutical options for relief. Use of hypnotic drugs (primarily benzodiazepines) is associated with increasing tolerance, dependence, and adverse effects on the central nervous system. While hypnotic drug use declined substantially in the past decade, the use of herbal sedatives appeared to increase. Mostly self-prescribed by lay people, herbal sedatives hold widespread appeal, presumably because of their lower cost and higher margin of safety when compared to pharmaceuticals. Studies of better-known herbal sedatives, notably valerian and kava, showed moderate evidence for both safety and efficacy for valerian while revealing disturbing toxicity concerns for kava. Milder sedatives or anxiolytics in need of clinical study include German chamomile, lavender, hops, lemon balm, and passionflower; St. John’s wort may have anxiolytic effects with relevance to sleep. Herb-drug interactions are a possibility for some of these species, including St. John’s wort. Although sufficient evidence exists to recommend some of these agents for short-term relief of mild insomnia, long-term trials and observational studies are needed to establish the safety of prolonged use as well as overall efficacy in the context of cancer treatment and management.
Key Words: insomnia • sleep disorders • hypnotic • herbal sedatives • valerian • kava • lavender • chamomile • hops • lemon balm • passionflower
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