Questioning Everything Propaganda
Anxiety disorders affect millions worldwide, prompting many to seek relief beyond traditional prescription medications. Over-the-counter (OTC) herbal remedies have gained popularity for their perceived natural approach and accessibility. Drawing from a comprehensive overview on GoodRx, this article examines several herbal and natural supplements touted for anxiety management, evaluating their potential benefits, scientific backing, and risks. Additionally, we delve into Phenibut, a pharmaceutical-grade compound widely used in Eastern Europe but absent from U.S. markets, exploring its efficacy, regional studies, and the speculative reasons behind its lack of FDA approval—including possible commercial influences that may stifle ethical research.
The GoodRx compilation highlights 14 OTC options, primarily herbal or nutrient-based, that people often turn to for anxiety relief. While some show promising evidence from studies, most require more robust research to confirm efficacy and safety. Below, we consider key remedies, focusing on their mechanisms, evidence, and caveats.
Derived from the amino acid tryptophan, 5-HTP serves as a precursor to serotonin, a neurotransmitter linked to mood regulation. Small-scale studies suggest it may alleviate anxiety symptoms, either alone or in combination with other compounds. However, larger trials are needed to validate these findings. Benefits include potential mood enhancement, but risks like serotonin syndrome arise when mixed with antidepressants or other serotonin-boosting drugs. Always consult a healthcare provider before use.
This essential mineral plays a role in over 300 bodily functions, including nerve signaling. Deficiencies are common in older adults or those with gastrointestinal issues, and supplementation has shown promise in reducing anxiety in some studies. For instance, it may help calm the nervous system. Side effects from excess include digestive upset or irregular heartbeat, so monitoring intake is crucial.
Extracted from cannabis, CBD interacts with the endocannabinoid system to modulate neurotransmitters. A review of eight studies indicated improvements in anxiety, particularly social anxiety, with doses ranging from 6 mg to 400 mg. Yet, results are inconsistent. Potential liver damage and drug interactions are concerns, and while legal in many forms, it's not FDA-endorsed for anxiety. Use under medical supervision is advised.
Sourced from Pacific Island roots, kava contains kavalactones that promote relaxation. Research demonstrates short-term anxiety reduction (up to 8 weeks), but long-term efficacy wanes. It's effective for mild symptoms but linked to liver toxicity in high doses or poor-quality products. Quality control is vital, and professional guidance is recommended.
Used since ancient times, this herb from Valeriana officinalis may enhance GABA activity for a sedative effect. Evidence is mixed—some studies support anxiety relief, others do not. It could aid sleep-related anxiety but risks liver damage or withdrawal symptoms upon abrupt cessation.
An Ayurvedic staple (Ocimum tenuiflorum), holy basil is praised for lowering stress hormones like cortisol. Studies indicate mood improvements and anxiety reduction, making it a gentle option for daily stress. Long-term data is limited, so dosing should be discussed with a professional.
Another Ayurvedic herb (Withania somnifera), ashwagandha acts as an adaptogen, potentially reducing cortisol and improving sleep. Clinical trials show benefits for anxiety and stress, with better sleep quality as a bonus. While generally safe, more extensive studies on long-term use are warranted.
Available as tea or extract, chamomile (German or Roman varieties) contains apigenin, which binds to GABA receptors for a calming effect. A meta-analysis of 10 studies found it effective in nine for anxiety, mimicking benzodiazepines without addiction risks. Allergic reactions are possible for those sensitive to ragweed, and it interacts with blood thinners.
From Passiflora incarnata, this plant boosts GABA levels. Studies compare it favorably to prescription anxiolytics like oxazepam, with benefits for anxiety, pain, and insomnia. Side effects are minimal, but further research is needed for widespread endorsement.
Extracted from Melissa officinalis, lemon balm acts as a mild sedative. Evidence supports its use for anxiety and depression symptom relief, though high-quality studies are sparse.
Vitamins like B6 and B12 support nervous system health. High-dose B6 may ease anxiety in deficient individuals, but overall evidence is inconclusive. Supplementation addresses potential deficiencies but isn't a standalone cure.
This sleep-regulating hormone shows efficacy for short-term anxiety, especially pre-surgery, rivaling benzodiazepines. It's safe for up to three months but not ideal for chronic use without more data.
Found in tea, this amino acid promotes relaxation without drowsiness. A small study noted stress reduction after four weeks, but broader evidence is limited.
From fish oil, these fats support brain health. Doses around 2 grams daily have strong evidence for anxiety reduction, making them a dietary staple for mental wellness.
Overall, these remedies offer accessible options with varying degrees of scientific support. They may complement lifestyle changes like exercise and therapy but aren't substitutes for professional treatment. Side effects and interactions underscore the need for medical consultation, especially for those on medications.
Shifting to pharmaceutical-grade options, Phenibut (β-phenyl-γ-aminobutyric acid) stands out as a compound developed in the Soviet Union during the 1960s. Primarily used in Russia and other Eastern European countries like Latvia, Estonia, Belarus, Kazakhstan, and Ukraine, it's prescribed for anxiety, tension, fear, insomnia, and as a nootropic to enhance cognitive function. In clinical settings, it's administered for psychosomatic or neurotic conditions, often pre- or post-operatively to reduce stress.
Studies from the region highlight its efficacy. A systematic review of clinical trials and case reports found Phenibut safe and well-tolerated at therapeutic doses (typically 250-1000 mg daily), with minor adverse effects like mild sedation or gastrointestinal discomfort. It acts on GABA-B receptors and voltage-dependent calcium channels, producing anxiolytic effects comparable to benzodiazepines but with added nootropic benefits like improved focus. Research also suggests neuroprotective potential, such as in traumatic brain injury models, where it mitigated mitochondrial damage. In Eastern Europe, it's integrated into standard care for anxiety disorders, with positive outcomes in reducing symptoms without the severe addiction profile of some Western alternatives.
Despite this, Phenibut remains unapproved by the FDA in the United States. The agency has repeatedly stated it's not a dietary ingredient, rendering supplements containing it adulterated. Key concerns include high abuse potential, rapid tolerance development, severe withdrawal symptoms (e.g., anxiety, hallucinations, insomnia), and overdose risks like depressed consciousness. U.S. poison control data shows rising exposures, often from online purchases, leading to hospitalizations. It's legal to possess but not to market as a supplement or drug, with FDA crackdowns on sellers since 2019.
Speculation abounds on why Phenibut hasn't gained traction in the U.S. beyond safety issues. One theory points to commercial pushback from pharmaceutical giants. As an unpatentable, decades-old compound, it lacks profit incentive for costly FDA trials. Big Pharma may prioritize patented anxiolytics like SSRIs or benzodiazepines, which generate billions in revenue. Lobbying could indirectly curb approvals of cheaper alternatives, as seen in historical cases where off-patent drugs face regulatory hurdles. This raises ethical implications: limited funding for independent studies in the U.S. stifles objective research, potentially denying patients effective options. Without FDA backing, ethical trials are harder to conduct, perpetuating a cycle where lack of data justifies non-approval, while commercial interests favor high-margin innovations over proven but unprofitable ones.
Herbal remedies provide a spectrum of options for anxiety, from well-studied choices like omega-3s and chamomile to emerging ones like ashwagandha, but they demand caution and professional oversight. Phenibut's success in Eastern Europe underscores regional disparities in drug approval, highlighting how safety, abuse risks, and possibly commercial dynamics shape access. As anxiety treatments evolve, balancing natural and pharmaceutical approaches—while advocating for unbiased research—could offer more comprehensive solutions. Consult healthcare experts for personalized advice, and stay informed on regulatory updates.
Sourcing:
https://www.goodrx.com/conditions/generalized-anxiety-disorder/otc-remedies-anxiety
Primary sources for the Phenibut sections in the previous article primarily come from Russian/Soviet-era research, clinical use documentation, and a few key English-language reviews that summarize or translate those findings. Since Phenibut was developed and introduced in the Soviet Union in the 1960s, much of the foundational evidence originates from Russian-language publications, with limited translation into English. Below is a curated list of the most direct and authoritative primary or near-primary sources, focusing on efficacy, Eastern European use, studies, and regulatory context.
Lapin I. Phenibut (β-phenyl-γ-aminobutyric acid HCl): a tranquilizer and nootropic drug.
CNS Drug Reviews. 2001;7(4):471-481.
This is one of the most cited English-language reviews summarizing Soviet/Russian clinical experience. It describes Phenibut's discovery in the 1960s, its introduction into Russian clinical practice, and its use to relieve tension, anxiety, fear, and improve sleep in psychosomatic or neurotic patients, as well as pre- or post-operative medication. It compares it to piracetam and diazepam, noting anxiolytic and nootropic effects via GABA-mimetic action (primarily GABA-B receptors).
Available via PubMed: https://pubmed.ncbi.nlm.nih.gov/11830761/ (full text often accessible through academic libraries or PMC: https://pmc.ncbi.nlm.nih.gov/articles/PMC6494145/).
Kupats E, et al. Safety and Tolerability of the Anxiolytic and Nootropic Drug Phenibut: A Systematic Review of Clinical Trials and Case Reports.
Pharmacopsychiatry. 2020;53(5):201-208.
This systematic review analyzes 11 clinical trials (583 patients) from Eastern European contexts, concluding that at therapeutic doses (typically 0.25–2 g/day), Phenibut is safe and well-tolerated with minor adverse effects (e.g., somnolence in ~1.89% of cases). It contrasts this with higher-risk outcomes from online-purchased, high-dose use. The review highlights discrepancies between controlled clinical use in Eastern Europe (low adverse events) and Western misuse cases.
PubMed: https://pubmed.ncbi.nlm.nih.gov/32340063/.
Russian Prescribing Information (Инструкция по применению Фенибут)
Official product monographs from Russian manufacturers (e.g., via Vidal.ru or RLSnet.ru) describe Phenibut (tablets 250 mg) as indicated for anxiety, asthenia, insomnia, fear/tension relief, alcohol withdrawal, and vestibular disorders. Dosing is typically 250–500 mg 2–3 times daily for adults, with use in children from age 3 in some cases. These are based on longstanding Russian pharmacopoeia and post-marketing data.
Examples:
Early Soviet studies (often in Russian journals like Farmakol Toksikol or Eksp Klin Farmakol) established its anxiolytic profile, but many are not digitized in English. The Lapin review (above) cites foundational works, including:
Phenibut's inclusion in cosmonaut medical kits (e.g., during Apollo-Soyuz in 1975) is documented in historical accounts and Wikipedia summaries drawing from Russian sources.
No direct "primary" FDA document approves or details Phenibut, as it is unapproved. FDA has issued warnings on dietary supplements containing it:
The scarcity of large-scale, independent Western trials stems from its unpatentable status (old compound) and safety concerns (tolerance, withdrawal). Commercial dynamics may play a role—patentable alternatives (e.g., SSRIs, benzodiazepines) receive more funding—but this remains speculative, as no direct evidence of lobbying against it exists in public records. Ethical research hurdles arise from its Schedule-like risks in many countries and lack of incentive for costly FDA-level trials.
For deeper access, search PubMed or Russian databases (e.g., eLIBRARY.ru) using terms like "фенибут" (Phenibut in Cyrillic). Always consult healthcare professionals, as Phenibut carries dependence risks despite its established use in Russia and select Eastern European countries.