Jou nal o Complemen a y The apies in Heal h
ISSN 2975-9323 |eISSN 2975-9552
Jou nal o Complemen a y The apies in Heal h 2026:4(1). doi:10.5281/zenodo.17715684 ins i u op c.com/jou nal-complemen a y- he apies
Re iew
Phy o he apy o Anxie y: A Na a i e Re iew o E icacy,
Mechanisms and Clinical Conside a ions.
Ema Simões Calçada1*, and Liliana Sampaio dos San os1,2 .
1 ABS – A lân ico Business School, Vila No a de Gaia, Po o, Po ugal;
2 IPB – Poly echnic Ins i u e o B agança, B agança, Po ugal.
* Co espondence: ema. [email protected]
Abs ac
Backg ound: Anxie y diso de s a e among he mos p e alen men al heal h condi ions wo ldwide,
and cu en pha macological ea men s, al hough e ec i e, a e o en associa ed wi h ad e se e -
ec s and incomple e symp om emission. These limi a ions ha e in ensi ied in e es in complemen-
a y and al e na i e he apeu ic app oaches, including he bal medicine.
Objec i e: This na a i e e iew examines he e idence suppo ing he use o medicinal plan s o
he managemen o anxie y, highligh ing hei mechanisms o ac ion, clinical e icacy and sa e y
conside a ions.
Me hods: A sea ch o he scien i ic li e a u e was conduc ed o iden i y s udies in es iga ing medic-
inal plan s adi ionally used o anxie y ea men . Pa icula a en ion was gi en o indings e-
la ed o phy ochemical ac i i y wi hin he cen al ne ous sys em, clinical ou comes and epo ed
ad e se e ec s.
Resul s: Se e al plan s, including Vale iana o icinalis, Passi lo a inca na a, Melissa o icinalis, Ma -
ica ia chamomilla L., Wi hania somni e a and La andula angus i olia, demons a e anxioly ic e -
ec s suppo ed by p eclinical and clinical e idence. Thei p ima y mechanisms in ol e modula ion
o GABAe gic neu o ansmission, alongside an ioxidan and an i-in lamma o y pa hways. Despi e
hese p omising esul s, he li e a u e shows conside able a iabili y in s udy design, o mula ion
s anda disa ion and sample size, limi ing he gene alisabili y o indings.
Conclusions: He bal medicine p esen s a aluable complemen a y app oach o anxie y manage-
men , o e ing po en ial he apeu ic bene i s wi h gene ally a ou able sa e y p o iles. Ne e heless,
u he high-quali y, s anda dised clinical ials a e necessa y o con i m e icacy, es ablish op imal
dosages and ensu e long- e m sa e y. In eg a ing he bal he apies in o b oade heal hca e ame-
wo ks equi es s eng hened egula ion, p o essional aining and in o med public use.
Keywo ds: Anxie y; He bal Medicine; Phy o he apy; Anxioly ic Plan s; GABAe gic Ac i i y; Com-
plemen a y The apies.
1. Backg ound
Anxie y is a psychological condi ion and one o he mos p e alen oday, a ec ing
millions o people wo ldwide and nega i ely in luencing hei quali y o li e (QoL). Ac-
co ding o Lobo 1, in Po ugal, one in e e y i e people su e s om some psychia ic dis-
o de , wi h anxie y diso de s being he mos p e alen . Globally, Fe nandes e al. 2, d aw-
ing on da a om he Wo ld Heal h O ganiza ion (WHO), epo ha he wo ldwide p e -
alence o anxie y diso de is 3.6%, e lec ing he dynamics o con empo a y socie y. Al -
hough se e al con en ional he apeu ic app oaches exis o he ea men o anxie y,
such as psycho he apy and pha macology 3, hese he apies a e no always e ec i e and
may also en ail undesi able side e ec s, o example, hose a ising om pha macological
Ci a ion: Calçada E.S., dos San os
L.S. Phy o he apy o Anxie y: A
Na a i e Re iew o E icacy, Mecha-
nisms and Clinical Conside a ions.
Jou nal o Complemen a y The apies
in Heal h. 2026;4(1) 10.5281/ze-
nodo.17715684
Academic Edi o : Jo ge Rod igues
Recei ed: 22 Oc obe 2025
Re iewed: 15 No embe 2025
Re ised: 21 No embe 2025
Accep ed: 22 No embe 2025
Published: 25 No embe 2025
Publishe ’s No e: IPTC s ays neu al
wi h ega d o ju isdic ional claims in
published maps and ins i u ional a -
ilia ions.
Copy igh : ©2026 by he au ho s.
Submi ed o open access publica-
ion unde he e ms and condi ions
o he C ea i e Commons A ibu ion
(CC BY) license (h ps://c ea i ecom-
mons.o g/licenses/by/4.0/).
Jou nal o Complemen a y The apies in Heal h 2026: 4(1). 2 o 10
Calçada E.S., dos San os L.S.
Phy o he apy o Anxie y: A Na a i e Re iew o E icacy, Mechanisms and Clinical Conside a ions.
doi:10.5281/zenodo.17715684
ea men . Gi en his scena io, in e es in complemen a y and in eg a i e app oaches has
been inc easing. Fo example, Chinese he bal medicine is one o he pilla s o T adi ional
Chinese Medicine (TCM) and uses medicinal he bs in o de o es o e ene ge ic and unc-
ional balance in he body. Tha is, i o ms pa o an ancien medical sys em and is cha -
ac e ised by he use o lea es, lowe s, ui s, oo s, plan ba ks and mine als o he apeu-
ic pu poses 4-6.
Thus, in iew o he inc easing demand o sa e and e ec i e he apeu ic al e na i es, and
gi en ha anxie y is a diso de wi h high p e alence bo h globally and na ionally, i is
unde s ood ha s udying he ole o he bal medicine in he ea men o anxie y is pe i-
nen . The e o e, his s udy e iews he e icacy, mechanisms and clinical conside a ions
ele an o he opic.
2. The case o T adi ional Chinese Medicine
TCM is a science wi h cen u ies o his o y and is g ounded in knowledge based on
accumula ed empi ical expe ience 6. I begins om he heo y ha disease is he conse-
quence o an imbalance o he i al o ce (Qi) h oughou he body 7. Qi is he main sub-
s ance o he uni e se and o he body 8; i is he “ oo ” o he human being 9 and, oge he
wi h he body, o ms a single en i y 10. Xue co esponds o blood, bu i is a unc ional
concep ha di e s om he unde s anding in con en ional medicine and is associa ed
wi h Qi 11. Yin-Yang e e s o he balance and ha mony o he body 12,13. The e o e, TCM is
g ounded in a holis ic iew o he human being, whe e he body is an in eg a ed whole,
p o iding a amewo k o p e en ion, diagnosis and ea men , based on a ious heo-
ies ela ed o na u e and he human body 9.
2.1. Diagnosis in TCM
Diagnosis is he essence o medicine and means o know o unde s and a pa ien ;
a e deducing and comp ehending knowledge abou he pa ien and hei disease, i s na-
u e and possible cou se a e disco e ed 14. To pe o m diagnosis, some basic aspec s mus
be aken in o accoun : obse ing (wàng); lis ening and smelling (wén); assessing he pa-
ien ’s his o y (wèn); palpa ing he pulse, ho ax and abdomen, a ious pa s o he body,
channels and poin s (qiè). A e hese ini ial obse a ions, and in o de o ob ain a conc e e
diagnosis, he e is a as ange o diagnos ic echniques ha may be used wi hin TCM:
e alua ing he ene gy low in each channel h ough palpa ion o he adial a e y in six
di e en posi ions; obse ing he ace, eyes and ongue; supe icially examining he ea ;
no ing he sound o he pa ien 's oice; palpa ing he body, pa icula ly he abdomen;
compa ing empe a u es in di e en pa s o he body; and obse ing he ein o he index
inge in small child en. I should also be no ed ha e e y hing ha can be obse ed wi h-
ou ins umen s o in asi e echniques, such as he pa ien ’s heal h his o y and main com-
plain s, mus be included in he diagnos ic p ocess 14-17.
2.2. He bal Medicine as a TCM T ea men Technique
He bal medicine is one o he main he apeu ic echniques in TCM, and due o g ow-
ing public awa eness, i is inc easingly sough as a he apeu ic al e na i e o complemen
o Wes e n medicine 18,19. Rega ding i s ole wi hin TCM, he bal medicine is ex emely
ele an when compa ed wi h acupunc u e (pe haps he mos well-known TCM he a-
peu ic echnique), since Chinese he balis s use only he bal medicine o ea hei pa ien s,
bu mos acupunc u is s ely on he bal medicine o combine wi h acupunc u e ea men s.
The e o e, he bal medicine ea s diseases based on ene ge ic pa e ns iden i ied h ough
diagnosis (e.g., spleen Qi de iciency), and he bal o mulas a e selec ed o co ec hese
pa e ns and es o e ha mony be ween Yin and Yang, Qi, Xue and he in e nal o gans. The
main objec i es o his he apeu ic echnique a e as ollows: p o en clinical e icacy; sa e y
o use; he apeu ic indi iduali y; p omo ion o heal h and disease p e en ion; holis ic ap-
p oach; sus ainabili y and en i onmen al espec ; in eg a ion wi h o he he apies.
Jou nal o Complemen a y The apies in Heal h 2026: 4(1). 3 o 10
Calçada E.S., dos San os L.S.
Phy o he apy o Anxie y: A Na a i e Re iew o E icacy, Mechanisms and Clinical Conside a ions.
doi:10.5281/zenodo.17715684
2.3. He bal P esc ip ion
Once he diagnosis has been made and he pa ien ’s condi ion unde s ood, he he bal
he apis p esc ibes he o mula mos sui ed o he symp oma ic pic u e, usually p esc ib-
ing combina ions o i e o i een he bs, as single-he b o mulas a e a e in Chinese med-
icine. Howe e , o p esc ibe he bal medicinal p oduc s i is necessa y o possess legal au-
ho isa ion and echnical-scien i ic compe ence, hus a oiding exposing he pa ien o
isks.
The e o e, he bal p esc ip ion may be explained as he p ocess o iden i ying and guiding
he use o medicines p oduced mainly om medicinal plan s, ensu ing sa e y, e icacy
and quali y in ea men . T ea men does no ely on a single consul a ion; pa ien s mus
e u n a leas e e y se en o i een days so ha hei condi ion can be eassessed and
dosages adjus ed i necessa y 8. He bal medicines may be used as complemen a y ea -
men o diseases, bu in some cases may eplace medica ions, p o ided ha p esc ip ions
a e made esponsibly and by a quali ied p o essional 20. Thus, he bal p esc ip ion in ol es
co ec iden i ica ion o he plan , p epa a ion/ex ac ype, s anda disa ion/quali y, mode
o use and sui abili y o each case.
2.4. Ca ego ies o Plan s
Al hough some plan s ha e mo e applica ions han o he s do, hey all play a ole,
since emo ing one plan o al e ing he dosage esul s in a di e en o mula wi h di e -
en ene ge ic cha ac e is ics. Fo example, in Chinese Medicine, he bs ha e di e en la-
ou s (pungen , swee , bi e , sal y, sou and bland) and a e also classi ied acco ding o
empe a u e (ho , cold, wa m, neu al, cool and in e media e), whe eby ho diseases
should be ea ed wi h cold he bs and cold diseases ea ed wi h ho he bs 21. The e a e 18
ca ego ies o plan s, including: ho and cold he bs ha elease he ex e io ; he bs ha d ain
i e (cold he bs); pu ga i es; he bs ha egula e wa e and d ain dampness; he bs ha
dispel wind and dampness; he bs ha ans o m phlegm and s op cough; a oma ic he bs
ha ans o m and dissol e dampness; he bs ha elie e ood s agna ion; he bs ha eg-
ula e Qi; he bs ha egula e Xue; he bs ha wa m he in e io and expel cold; onics; as-
ingen he bs and subs ances ha s abilise and calm he spi i ; he bs ha nou ish he
hea and calm he spi i ; a oma ic subs ances ha open he o i ices; subs ances ha ex-
inguish wind and s op emo s; he bs ha expel pa asi es; and subs ances o ex e nal
applica ion 22,23.
3. Legal and clinical conside a ions in he use o He bal medicine
3.1. Legisla ion on He bal Medicine
Rega ding he legisla i e amewo k go e ning he use o he bal medicine and he
p o ession o he bal he apis , ou main egula o y documen s should be highligh ed.
Law No. 45/2003 o 22 Augus 24, also known as he Basic Legal F amewo k o Non-Con-
en ional The apies, es ablishes he egula ion o he ac i i y and p o essional p ac ice o
non-con en ional he apies. Law No. 71/2012 o 22 Augus 25 egula es Law No. 45/2003
conce ning he p o essional p ac ice o non-con en ional he apies, including he bal med-
icine (A icle 2). Conce ning he p o ession o he bal he apis , O dinance No. 207-E/2014
o 8 Oc obe 26 de ines he cha ac e isa ion and unc ional con en o he p o ession. Fi-
nally, O dinance No. 172-B/2015 o 5 June 27 egula es he gene al equi emen s o he
deg ee p og amme leading o a Bachelo ’s deg ee in He bal Medicine.
3.2. Plan –D ug In e ac ions
Scien i ic publica ions in ecen yea s ha e add essed in e ac ions be ween phy o-
chemical compounds (he bal medicine), d ug-me abolising enzymes and physiological
unc ions. Based on plan s’ abili y o inhibi o induce ce ain me abolic enzymes and/o
anspo p o eins, he po en ial isks o in e ac ion be ween plan s and medicines can be
assessed 28. Rega ding hese in e ac ions, he s udy by ocused exclusi ely on his subjec
Jou nal o Complemen a y The apies in Heal h 2026: 4(1). 4 o 10
Calçada E.S., dos San os L.S.
Phy o he apy o Anxie y: A Na a i e Re iew o E icacy, Mechanisms and Clinical Conside a ions.
doi:10.5281/zenodo.17715684
and p esen s nume ous examples based on empi ical e idence. Some o hese examples
a e shown in he able below.
Table 1. Examples o plan –d ug in e ac ions acco ding o Faus ino 28.
Medicine
Plan
In e ac ion
Pa ace amol
Wu Wei Zi (F uc us Schisand ae
Chinensis).
Dec ease in side e ec s: gomisin A lignan may ha e a li e -p o ec-
i e e ec ; hype kalaemia when used wi h high doses o po assium-
spa ing diu e ics; educed e ec o sodium bica bona e, aluminium
hyd oxide, an ibio ics, ese pine, ca eine, opia es, scopolamine and
be bamine.
Gene al an-
aes he ics
Sheng Jiang (Rhizoma Zengibe is O -
icinalis Recens);
Gan Jiang (Rhizoma Zengibe is O ici-
nalis).
Reduc ion o side e ec s, dec easing nausea.
Aspi in
Gan Cao (Radix Glycy hiza U a-
lensis).
Reduc ion o side e ec s, dec easing gas oin es inal i i a ion.
Ca eine
Ma Huang (He ba Ephed ae)
Inc eases hea a e and blood p essu e.
Chemo he -
apy
Yun Zhi (Scle o ium Co iolus Ve si-
colo )
Reduc ion o side e ec s, s eng hening immune cell p oduc ion
and imp o ing dend i ic and cy o oxic T-cell umou in il a ion.
Ci Wu Jia (Radix Eleu he ococcus
Sen icosus)
Reduc ion o e ec s, dec easing immune sys em dep ession and
he apy oxici y.
Epineph ine
Ma Huang (He ba Ephed ae)
Po en ia es d ug e ec due o he plan ’s ephed ine con en .
Hepa in
Dan Shen (Radix sal iae mil io hizae)
Po en ia es d ug e ec by inc easing hepa in abso p ion.
In luenza
accine
Ren Shen (Radix panax ginseng)
Enhances accina ion e ec s.
Insulin
Hu Lu Ba (Semem igonella oenum-
g aecum )
Po en ia es d ug e ec s: plan educes glycaemia, u ina y suga ex-
c e ion, choles e ol and iglyce ides.
Fenelzine
Ma Huang (He ba Ephed ae)
Po en ia es e ec s o ephed ine, as enelzine inhibi s ephed ine me-
abolism, leading o accumula ion.
Ren Shen (Radix panax ginseng)
Inc eases side e ec s (insomnia, headache, emo ). Mechanism un-
known.
4. Anxie y
4.1. Anxie y Diso de s and Diagnosis
In he li e a u e add essing he opic, anxie y appea s as an emo ional s a e cha ac-
e ised by app ehension, wo y o unease in he ace o eal o imagined h ea . This s a e
in ol es mul iple componen s (emo ional, cogni i e, physiological and beha iou al),
which may be bene icial, p omo ing adap a ion, o pa hological when in ense, pe sis en
and disp opo iona e o he igge ing s imulus 1,29.
Thus, adap i e anxie y and pa hological anxie y a e dis inguished. The o me , heal hy,
can help mo i a e people o p epa e, p ac ise and ain; i may also encou age app op ia e
cau ion in po en ially dange ous si ua ions 30. Hence, i is desc ibed as he an icipa ion o
u u e h ea and being mo e equen ly associa ed wi h muscle ension and igilance in
p epa a ion o u u e dange and cau ious o a oidan beha iou s 31. As well, pa hologi-
cal anxie y, on he o he hand, is a u u e-o ien ed emo ion, ma ked by a sense o uncon-
ollabili y and unp edic abili y abou po en ial a e si e e en s 32. To de e mine whe he
anxie y is adap i e o pa hological, Cas illo e al. 33 sugges e alua ing he anxious eac-
ion, whe he i is sho -li ed, sel -limi ed and ela ed o he s imulus.
The e o e, anxie y is uni e sal, as e e yone has el anxious a some poin in hei li es,
and i may occu a di e en s ages o li e 34. As a diso de , i is diagnosed ega dless o
age o gende and is no always easy o comp ehend 35. Howe e , when i causes dys unc-
ion and su e ing in he indi idual, i becomes maladap i e and he e o e a psychia ic
Jou nal o Complemen a y The apies in Heal h 2026: 4(1). 5 o 10
Calçada E.S., dos San os L.S.
Phy o he apy o Anxie y: A Na a i e Re iew o E icacy, Mechanisms and Clinical Conside a ions.
doi:10.5281/zenodo.17715684
diso de 30. The diagnosis o any anxie y diso de is based on he cha ac e is ic signs and
symp oms lis ed in he DSM-V (Diagnos ic and S a is ical Manual o Men al Diso de s),
bu i may be suspec ed when: anxie y is highly dis essing; anxie y in e e es wi h unc-
ioning; anxie y does no esol e spon aneously wi hin a ew days; and o he causes ha e
no been iden i ied 30.
Acco ding o he APA 31, he di e en anxie y diso de s a e dis inguished mainly by he
s imuli o ci cums ances ha igge ea , anxie y o a oidance beha iou s, as well as he
ypes o hough s and belie s associa ed wi h hem. The DSM-V p esen s diagnos ic c i e-
ia, isk ac o s, p ognosis, unc ional consequences and di e en ial diagnosis o each
ype o anxie y diso de , conside ing as anxie y diso de s: sepa a ion anxie y diso de ;
selec i e mu ism; speci ic phobia; social anxie y diso de (social phobia); panic diso de ;
ago aphobia; gene alised anxie y diso de (GAD); subs ance/medica ion-induced anxie y
diso de ; anxie y diso de due o ano he medical condi ion; o he speci ied anxie y dis-
o de ; and unspeci ied anxie y diso de 31.
4.2. He bal Medicine in he T ea men o Anxie y
Conce ning he use o medicinal plan s o he ea men o anxie y, he s udies by
Assi e al. 36 and Geo g Jensen e al. 37 a e no ewo hy. The o me highligh s he high p e -
alence o popula use o plan s o anxie y ea men , bu also he need o educa ion o
p omo e a be e -in o med popula ion and egula ion ega ding plan use o his pu -
pose. Geo g Jensen e al. 37, in u n, epo ha in he Middle Eas and A ican egions he e
a e plan s wi h conside able po en ial o anxie y ea men , wi h an ioxidan , an i-in lam-
ma o y and neu o ansmi e -modula ing mechanisms, bu acknowledge ha empi ical
e idence is limi ed due o small and poo ly s anda dised s udies. In o he wo ds, al hough
medicinal plan s o cul u al impo ance a e widely used, scien i ic igou is lacking, and
as p e iously men ioned, wo o he se en pilla s o he bal medicine a e p ecisely p o en
clinical e icacy and sa e y o use. Mo eo e , hese indings highligh he impo ance o
p o essional he bal p esc ip ion, pe o med by a quali ied he apis based on he pa ien ’s
symp oms and equi ing legal acc edi a ion and echnical-scien i ic compe ence.
Medicinal Plan s o he T ea men o Anxie y
He bal medicine has a ac ed signi ican esea ch in e es as an al e na i e and/o
complemen a y app oach in he ea men o anxie y, using medicinal plan s wi h anxio-
ly ic, calming and elaxing p ope ies 38,39. Indeed, many pa ien s show no esponse o
con en ional pha macological ea men s o canno ole a e hei ad e se e ec s 40.
Rega ding anxioly ic plan s, he li e a u e shows ha he bal p oduc s such as Vale iana
o icinalis, Passi lo a inca na a, Melissa o icinalis and Pipe me hys icum a e e ec i e in e-
ducing anxie y symp oms, ac ing on neu ochemical mechanisms ha modula e he cen-
al ne ous sys em (CNS), such as inc easing he a ailabili y o GABA (gamma-amino-
bu y ic acid), a c ucial neu o ansmi e in anxie y egula ion 39,41.
Pipe me hys icum (Ka a-ka a) has been o icially ecognised and equen ly used in
clinical s udies, being a ibu ed an anxioly ic e ec ; howe e , i p esen s some long- e m
sa e y es ic ions 40,42. This plan ’s anxioly ic ac ion is a ibu ed o he pha macological
ac i i y o alpha-py ones, and i also exhibi s an icon ulsan , seda i e and anaes he ic
p ope ies. The d ied s em o hizome, when chewed, ac s as a local anaes he ic and s im-
ula es sali a p oduc ion, and no ad e se e ec s associa ed wi h i s use ha e been iden i-
ied o da e 43-45.
The s udy by Sa age e al. 46 indica es an anxioly ic e ec wi hou dependence o hepa o-
oxici y; al hough no conclusi e, he s udy highligh s he he apeu ic po en ial o Ka a-
ka a. These indings a e unsu p ising, as Ju ino e al. 47 no e ha i is one o he species
wi h he highes numbe o s udies in ol ing pa ien s wi h anxie y diso de s, demons a -
ing i s e icacy, which jus i ies i s use as an e ec i e and p omising he apy o anxie y.
On he o he hand, Vale iana o icinalis has seda i e, anxioly ic and an ioxidan e ec s
clinically demons a ed 39,40,42,43. Due o i s seda i e ac ion, i aids sleep, and beyond i s use
Jou nal o Complemen a y The apies in Heal h 2026: 4(1). 6 o 10
Calçada E.S., dos San os L.S.
Phy o he apy o Anxie y: A Na a i e Re iew o E icacy, Mechanisms and Clinical Conside a ions.
doi:10.5281/zenodo.17715684
in he ea men o GAD, i ac s on he CNS by inc easing GABA concen a ion 44,45.
Passi lo a inca na a (passion lowe ) is used in con olled o m o mild o mode a e in e -
mi en anxie y as a na u al anquillise 40-42. I has seda i e, calming, an idep essan , an-
xioly ic, hypno ic and an ispasmodic e ec s 44.
Melissa o icinalis (lemon balm) has a elaxing e ec , educing physical symp oms o en-
sion and s ess 39,40,48. This e ec is associa ed wi h i s ac ion on he GABAa sys em, ace yl-
cholines e ase inhibi ion (AChE) and me allop o einase-2 inhibi ion, wi h osma inic acid
being he main componen esponsible o i s anxioly ic e ec 49.
In addi ion o he plan s men ioned abo e, Lobo 1 adds he ollowing o anxie y
ea men : Hype icum pe o a um (S John’s Wo ); Humulus lupulus (hops); and Rau ol ia
se pen ina (Indian snake oo o De il Peppe ). The li e a u e also includes Wi hania som-
ni e a, La andula angus i olia (la ende ) and Ma ica ia chamomilla L. (chamomile).
Rega ding Wi hania somni e a, P a e e al. 50 ound ha i con ibu es o a signi ican
educ ion in anxie y and has g ea e e icacy han psycho he apy. Indeed, Wi hania som-
ni e a appea s in he li e a u e associa ed wi h anxie y ea men , educing s ess symp-
oms ha gi e ise o anxie y 51. The sys ema ic e iew ca ied ou by Campos 52 simila ly
shows ha his plan signi ican ly educes symp oms o anxie y and s ess, imp o ing
QoL and well-being.
Con e sely, he s udies by Kee e e al. 53 and Mao e al. 54 highligh Ma ica ia chamo-
milla as a he apeu ic al e na i e. In he o me , chamomile showed a posi i e e ec on
he ea men o anxie y and GAD, wi h good le els o ole ance among pa icipan s. This
s udy suppo s he use o chamomile in anxie y ea men , wi h e icacy compa able o
anxioly ic medica ions in some cases. As no ed by Aguia e al. 40, many pa ien s do no
ole a e o do no espond o side e ec s o con en ional pha macological ea men s,
making i impo an o explo e al e na i e he apies. Mao e al. 54 also ound ha pa ici-
pan s ea ed wi h chamomile expe ienced ewe elapses, ewe symp oms and longe
ime o elapse, wi h good ole abili y. These esul s show ha long- e m chamomile use
may be sa e and help main ain GAD, as also demons a ed by Rocha e al. 55, who epo
ha chamomile’s anxioly ic e ec de i es om seconda y me aboli es o he la onoid
class.
Ano he plan ha may be used in anxie y ea men is la ende . In he s udy by
Kaspe e al. 56, Silexan, a s anda dised ex ac o La andula angus i olia used o he apeu ic
pu poses, educed symp oms o subclinical anxie y and GAD, showing e icacy compa a-
ble o medica ions such as lo azepam and pa oxe ine. Fu he mo e, Silexan imp o ed
sleep, soma ic and dep essi e symp oms, and was well ole a ed, ep esen ing an e ec-
i e and sa e al e na i e wi h a mild ad e se-e ec p o ile. Simila ly, Molle e al. 57 ound
ha Silexan signi ican ly educed subclinical anxie y and imp o ed sleep and QoL, es ab-
lishing i sel as an e ec i e and sa e al e na i e o ea ing subclinical anxie y symp oms.
These indings show ha la ende may be an e ec i e he apeu ic op ion, as also con-
i med by And ade e al. 58 and Sil a e al. 59. In he i s s udy, he au ho s no e he e icacy
o la ende in anxie y ea men due o i s s ess- educing and anxioly ic e ec s. In he
second s udy, ocusing on la ende oil, a ious e ec s a e desc ibed: he psychological
e ec s o inhaling la ende oil occu h ough conscious pe cep ion, belie and expec a ion,
and he pha macological e ec s occu h ough modula ion o cyclic adenosine monophos-
pha e ac i i y ( educ ion o cyclic adenosine monophospha e ou comes wi h seda ion)
and inhibi ion o glu ama e binding (seda i e e ec s). Thus, he use o he oil is conside ed
sa e, excep o a e alle gic eac ions, and may be bene icial in pa ien s wi h anxie y and
educe he need o an ipsycho ic medica ions.
Simila ly, Donelli e al. 60 also concluded ha la ende is bene icial o anxie y ea men
and, being adminis able in mul iple o ms, inhala ion was ound o be he mos e ec i e
ou e, ollowed by massage and capsules. These esul s con e ge wi h hose epo ed by
Kang e al. 61, in which la ende was shown o educe symp oms o pe cei ed anxie y,
pa icula ly when inhaled (a oma he apy).
Jou nal o Complemen a y The apies in Heal h 2026: 4(1). 7 o 10
Calçada E.S., dos San os L.S.
Phy o he apy o Anxie y: A Na a i e Re iew o E icacy, Mechanisms and Clinical Conside a ions.
doi:10.5281/zenodo.17715684
5. Conclusion
This na a i e li e a u e e iew indica es ha he bal medicine ep esen s a comple-
men a y o al e na i e he apeu ic s a egy wi h signi ican po en ial o he managemen
o anxie y, o e ing clinically ele an bene i s and, in many cases, ewe ad e se e ec s
compa ed wi h con en ional pha macological ea men s. Se e al medicinal plan s (such
as Vale iana o icinalis, Passi lo a inca na a, Melissa o icinalis, Ma ica ia chamomilla L., Wi h-
ania somni e a and La andula angus i olia) ha e demons a ed e icacy in educing anxie y
symp oms, ac ing h ough di e se neu ochemical mechanisms wi hin he cen al ne ous
sys em, pa icula ly ia modula ion o GABAe gic ac i i y.
Despi e hese p omising indings, he li e a u e highligh s he need o cau ion. Long-
e m sa e y p o iles, po en ial he b–d ug in e ac ions and he lack o s anda disa ion in
o mula ions and dosages emain impo an limi a ions, unde sco ing he necessi y o
u he obus and well-designed clinical s udies. In his con ex , he ole o quali ied
he bal he apis s is essen ial o ensu e esponsible p esc ip ion p ac ices, compliance wi h
exis ing legisla ion and he p o ision o ea men s ha p io i ise e icacy, sa e y and qual-
i y.
The e o e, he bal medicine cons i u es a iable he apeu ic op ion o he ea men
o anxie y and holds conside able po en ial o in eg a ion in o complemen a y and in e-
g a i e heal hca e models. Howe e , achie ing his in eg a ion equi es con inued scien-
i ic esea ch, s eng hened egula o y amewo ks, app op ia e p o essional aining and
g ea e public educa ion ega ding he sa e and in o med use o medicinal plan s.
.
C edi au ho s a emen : Concep ualiza ion: E.S.C. and L.S.S.; In es iga ion: E.S.C. and L.S.S.; W i -
ing, e iewing and edi ing: E.S.C. and L.S.S. All au ho s ha e ead and ag eed o he published
e sion o he manusc ip .
Funding: This esea ch did no ecei e any speci ic g an om unding agencies in he public,
comme cial, o no - o -p o i sec o s.
Con lic o In e es : The au ho s decla e ha he e a e no con lic s o in e es .
Ins i u ional Re iew Boa d S a emen : No applicable.
In o med Consen S a emen : No applicable.
Da a A ailabili y S a emen : The o iginal con ibu ions p esen ed in his s udy a e included in
he a icle. Fu he inqui ies can be di ec ed o he co esponding au ho .
Re e ences
1. Lobo EMdS. T ans o nos psiquiá icos: ansiedade. 2014.
2. Fe nandes MA, Ribei o HKP, San os JDM, Mon ei o CFdS, Cos a RdS, Soa es RFS. P e alence o anxie y diso de s as a cause
o wo ke s’ absence. Re is a B asilei a de En e magem. 2018;71.
3. Pin o ARdCR. T a amen o a macológico da ansiedade. 2014.
4. Aguia R, Gehlen S, Oli ei a R, Rod igues JM. Recen ad ances in Chinese phy opha macology o emale in e ili y: A sys em-
a ic e iew o high-quali y andomized con olled ials. Pha macological Resea ch - Mode n Chinese Medicine. 2024;13:100539.
doi: h ps://doi.o g/10.1016/j.p mcm.2024.100539
Jou nal o Complemen a y The apies in Heal h 2026: 4(1). 8 o 10
Calçada E.S., dos San os L.S.
Phy o he apy o Anxie y: A Na a i e Re iew o E icacy, Mechanisms and Clinical Conside a ions.
doi:10.5281/zenodo.17715684
5. Ca diga C, Cons an ino A, Fonseca C, Sil a D, Teixei a I, Rod igues JM. Chinese phy opha macology o gas i is - A sys ema ic
e iew o high-quali y andomized con olled ials. Pha macological Resea ch - Mode n Chinese Medicine. 2025;15:100631.
doi: h ps://doi.o g/10.1016/j.p mcm.2025.100631
6. Rod igues JM, San os C, Ribei o V, Al a enga A, San os RV. Chinese Phy opha macology in de ma ology - A Sys ema ic Re-
iew. Pha macological Resea ch - Mode n Chinese Medicine. 2023;7:100255. doi: h ps://doi.o g/10.1016/j.p mcm.2023.100255
7. Mills ine D. Medicina adicional chinesa Manuais MSD edição pa a p o issionais: Manual MSD; 2023 [upda ed 2023/12. A ail-
able om: h ps://www.msdmanuals.com/p /p o issional/ ópicos-especiais/medicina-in eg a i a-complemen a -e-al e na-
i a/medicina- adicional-chinesa
8. Yao W, Yang H, Ding G. Mechanisms o Qi-blood ci cula ion and Qi de iciency synd ome in iew o blood and in e s i ial luid
ci cula ion. Jou nal o adi ional Chinese medicine = Chung i sa chih ying wen pan. 2013;33(4):538-44. doi:
h ps://doi.o g/10.1016/s0254-6272(13)60162-4
9. Yuan CS. T adi ional Chinese Medicine: Taylo & F ancis; 2011. 9781841848433.
10. Liu L, Liu Z. Essen ials o Chinese Medicine: Volume 1: Sp inge London; 2009. 9781848825901.
11. Ximenes CSF. Medicina T adicional Chinesa: Fundamen os em Medicina E al Chinesa e Fo mulação no Sínd oma de Es ag-
nação do Qi: Uni e sidade do Po o (Po ugal); 2014.
12. Legge D. Yin and yang su aces: an e olu iona y pe spec i e. J Acupunc Me idian S ud. 2014;7(6):281-90. doi:
h ps://doi.o g/10.1016/j.jams.2014.07.003
13. Maciocia G. The Founda ions o Chinese Medicine: A Comp ehensi e Tex o Acupunc u is s and He balis s: Else ie Chu ch-
ill Li ings one; 2005. 9780443074899.
14. Maciocia G. Diagnosis in Chinese Medicine: A Comp ehensi e Guide: Else ie ; 2018. 9780702044144.
15. G e en HJ. [Chinese medicine as ege a i e sys ems biology. Pa II: he s uc u e o TCM diagnosis]. HNO. 2011;59(12):1165-
75. doi: h ps://doi.o g/10.1007/s00106-011-2413-x
16. G e en HJ. Chinese medicine as a model o sys em biology: Diagnosis as he ounda ion o acupoin selec ion. Cu en Re-
sea ch in Acupunc u e: Sp inge ; 2013. p. 621-57.
17. McDonald J, Penne J. Zang Fu Synd omes: Di e en ial Diagnosis and T ea men : Lone Wol P ess; 1994. 9780965052900.
18. Wang WJ, Zhang T. In eg a ion o adi ional Chinese medicine and Wes e n medicine in he e a o p ecision medicine. J In eg
Med. 2017;15(1):1-7. doi: h ps://doi.o g/10.1016/S2095-4964(17)60314-5
19. Keji C, Hao XU. The in eg a ion o adi ional Chinese medicine and Wes e n medicine. Eu opean Re iew. 2003;11(2):225-35.
doi: h ps://doi.o g/10.1017/s106279870300022x
20. Mazzei JVF. Pe gun as equen es sob e i o e apia e plan as medicinais. Plan as medicinais e i o e apia: adição e ciência.
2023.
21. Yang S-z. The di ine a me 's ma e ia medica: a ansla ion o he Shen Nong Ben Cao Jing: Blue Poppy En e p ises, Inc.; 1998.
0936185961.
22. Maciocia S. The P ac ice o Chinese Medicine: The T ea men o Diseases wi h Acupunc u e and Chinese He bs: Else ie Heal h
Sciences; 2021. 9780702079207.
23. Jingshen Acupunc u e and Chinese Medicine. Chinese He bal Medicine 2024 [A ailable om: h ps://chinesemedicinesa-
lon.blogspo .com/sea ch?q= i amin+D
24. Assembleia da República Po uguesa. Lei n.º 45/2003. Diá io da República: I-A sé ie, n.º 1932003.
25. Assembleia da República Po uguesa. Lei n.º 71/2013. Diá io da República: I sé ie, nº 168. 2013.
26. Minis é ios da Saúde e da Educação e Ciência. Po a ia n.º 207-E/2014. Diá io da República: I sé ie, nº 194. 2014.
27. Minis é ios da Saúde e da Educação e Ciência. Po a ia n.º 172-B/2015. Diá io da República: I sé ie, nº 109. 2015.
28. Faus ino S. In e ações Medicamen osas en e Fi o e apia Chinesa e Fá macos G au de Conhecimen o dos Especialis as de Me-
dicina T adicional Chinesa na Região de Lisboa. Re is a da UI_IP San a ém. 2016:19.
Jou nal o Complemen a y The apies in Heal h 2026: 4(1). 9 o 10
Calçada E.S., dos San os L.S.
Phy o he apy o Anxie y: A Na a i e Re iew o E icacy, Mechanisms and Clinical Conside a ions.
doi:10.5281/zenodo.17715684
29. Guedes ALP. Ansiedade, s ess e bu nou : de inição concep ual e ope acional, in e - elações e impac o na saúde: Uni e sidade
da Bei a In e io (Po ugal); 2020.
30. Ba nhill J. Visão ge al dos ans o nos de ansiedade Manuais MSD edição pa a p o issionais: Manual MSD; 2023 [upda ed
2023/08. A ailable om: h ps://www.msdmanuals.com/p /p o issional/ ans o nos-psiquiá icos/ansiedade-e- ans o nos- el-
acionados-a-es esso es/ isão-ge al-dos- ans o nos-de-ansiedade
31. APA. Diagnos ic and s a is ical manual o men al diso de s, 2013.
32. Ba low DH. Manual Clínico dos T ans o nos Psicológicos: T a amen o Passo a Passo: A med Edi o a; 2022. 9786558820987.
33. Cas illo ARGL, Recondo R, Asbah FR, Man o GG. T ans o nos de ansiedade. B azilian Jou nal o Psychia y. 2000;22.
34. Bap is a A, Ca alho M, Lo y F. O medo, a ansiedade e as suas pe u bações. Psicologia. 2014;19(1/2):267-77. doi:
h ps://doi.o g/10.17575/ psicol. 19i1/2.407
35. Sala i N, Hosseinian-Fa A, Jalali R, Vaisi-Raygani A, Rasoulpoo S, Mohammadi M, e al. P e alence o s ess, anxie y, dep es-
sion among he gene al popula ion du ing he COVID-19 pandemic: a sys ema ic e iew and me a-analysis. Global Heal h.
2020;16(1):57. doi: h ps://doi.o g/10.1186/s12992-020-00589-w
36. Assi M, Nasse S, Almoussawi R, Hamed F, Boukha y R, Wa a J. A C oss-sec ional S udy on U iliza ion o He bal Medica ions
o Anxie y in he Lebanese Popula ion: Usage Pa e ns and Implica ions o Ha monizing Men al Heal h. The Open Public
Heal h Jou nal. 2024;17(1). doi: h ps://doi.o g/10.2174/0118749445342434241021111304
37. Geo g Jensen M, Goode M, Hein ich M. He bal medicines and bo anicals o managing insomnia, s ess, anxie y, and dep es-
sion: A c i ical e iew o he eme ging e idence ocusing on he Middle Eas and A ica. Pha maNu i ion. 2024;29:100399. doi:
h ps://doi.o g/10.1016/j.phanu.2024.100399
38. Menezes ESC, Deune MC. T ans o no de ansiedade: a amen o po meio de i o e ápicos. Re is a JRG de Es udos Acadêmicos.
2024;7(14):e141189. doi: h ps://doi.o g/10.55892/j g. 7i14.1189
39. Rod igues ARdSP. Fi o e apia no auxilio ao con ole e a amen o da ansiedade – uma e isão in eg a i a de li e a u a. Re is a
de Casos e Consul o ia. 2022;13(1).
40. Aguia FdO, Lima AA, Lima LA, Faus ino CG, Rod igues ABL, Fa ias ALF, e al. P incipais Fi o e Ápicos U ilizados No T a a-
men o Do T ans o no De Ansiedade. Lumen E Vi us. 2025;16(46):1777-92. doi: h ps://doi.o g/10.56238/le 16n46-015
41. Co a BA, Ga cia RMA. Os bene ícios do uso das plan as medicinais e i o e ápicos no a amen o da ansiedade em uni e si á-
ios no B asil. Re is a Fi os. 2024;18.
42. Mo ei a ASVdF. Fi o e apia aplicada à ansiedade: uma al e na i a aos medicamen os de sín ese. 2014.
43. Ca alho LG, Lei e SdC, Cos a DdAF. P incipais i o e ápicos e demais medicamen os u ilizados no a amen o de ansiedade e
dep essão. Re is a de Casos e Consul o ia. 2021;12(1):e25178.
44. Fe ei a CKM. Uso de plan as medicinais no a amen o de ans o nos de ansiedade: uma e isão de li e a u a in eg a i a.
45. Passos HdS. O uso de medicamen os i o e ápicos no a amen o da ansiedade. 2023.
46. Sa age KM, S ough CK, By ne GJ, Scholey A, Bousman C, Mu phy J, e al. Ka a o he ea men o gene alised anxie y diso de
(K-GAD): s udy p o ocol o a andomised con olled ial. T ials. 2015;16(1):493. doi: h ps://doi.o g/10.1186/s13063-015-0986-
5
47. Ju ino E, Souza J, Ma iz S, edi o s. Ka a-ka a e seus bene ícios no a amen o da ansiedade: uma e isão in eg a i a. Anais III
CONBRACIS; 2018; Campina G ande: Realize Edi o a.
48. Paz LL, Oli ei a KNdL, Lima IMdO, San os MdS, De Alenca AC, Sil a MGC, e al. Plan as medicinais que ajudam no con ole
da ansiedade. B azilian Jou nal o Implan ology and Heal h Sciences. 2023;5(5):2909-25. doi: h ps://doi.o g/10.36557/2674-
8169.2023 5n5p2909-2925
49. Awad R, Muhammad A, Du s T, T udeau VL, A nason JT. Bioassay-guided ac iona ion o lemon balm (Melissa o icinalis
L.) using an in i o measu e o GABA ansaminase ac i i y. Phy o he apy esea ch : PTR. 2009;23(8):1075-81. doi:
h ps://doi.o g/10.1002/p .2712
