Passionflower

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    Last Updated: November 15, 2023

    Passionflower is a woody, flowering vine used as a calming supplement for both anxiety and sleeping disorders. There are many different forms of the supplement, including tea, liquids, capsules, and tablets. It is generally well-tolerated with limited side effects.

    What is passionflower?

    Passionflower (Passiflora incarnata) is a flowering, woody vine traditionally used as a calming and sedative agent. The flower petals, leaves, and stems of the plant are typically used in supplements.[7] People around the world have used it as a treatment for pain, insomnia, anxiety, and opioid dependence.[8] The supplement comes in several formulations, including teas, capsules, tablets, and liquids. In addition to its uses as a supplement, passionflower is also a FDA-approved food additive for flavoring purposes.[9]

    The Passiflora genus has many different species. Passiflora incarnata should not be confused with Passiflora edulis; even though the latter has shown numerous effects in animal studies, very limited information is available regarding its use in humans.[10]

    What are passionflower’s main benefits?

    Passionflower has been traditionally used for anxiety and insomnia, due to its calming and sedating effects.[8] However, there is limited clinical data to support the use of passionflower for these purposes, and larger clinical trials should be conducted.

    One study compared the effect of 45 drops/day of a branded passionflower extract (prepared from the standardized extract of leaves, flower and fruit of Passiflora Incarnata and containing 11–15 mg per 100 ml of total flavonoids as hyperoside[11]) to oxazepam (a benzodiazepine used to treat symptoms of anxiety and insomnia) in reducing symptoms of generalized anxiety disorder. Results showed that passionflower decreased symptoms of anxiety, with a lower incidence of job performance impairment and dizziness than oxazepam.[5] Two other studies compared passionflower to placebo in the anxiety-inducing situation of preoperative procedures. Both 500 mg of the same standardized passionflower extract used in the previous study and 750 mg of a Passiflora incarnata syrup resulted in a decrease in anxiety, compared to placebo, without causing sedation.[1][2] Moreover, another study showed a decrease in anxiety symptoms and an increase in sedation when participants received either passionflower or midazolam before a dental procedure. Participants given passionflower also experienced limited memory loss associated with the procedure, in contrast to midazolam, which may cause temporary memory loss; however, this is not necessarily a positive, as some people may prefer not to remember medical procedures.[12] Additionally, one study showed that passionflower may be a helpful add-on therapy to sertraline (a selective serotonin reuptake inhibitor, or SSRI) for anxiety.[13] While these studies did show a reduction in anxiety levels, and an increase in sedation, associated with passionflower, more studies should be conducted to validate these results.

    One study found that sleep quality was improved when drinking 2 grams of passionflower tea a day compared to placebo. However, the study did not find any differences in sleep onset, number of awakenings, feelings of refreshment upon awakening, or anxiety symptoms between the passionflower and placebo groups.[3] It is worth noting that the passionflower dose used in this study was smaller than that used in other studies looking at anxiety outcomes. Furthermore, this study had a small sample size, was short in duration, and although the outcomes were measured through sleep diaries and polysomnography (PSG), the bulk of participants only provided sleep diaries; only ten people underwent PSG. Therefore, larger and longer studies should be conducted to better understand the impact of passionflower use on insomnia.

    What are passionflower’s main drawbacks?

    Passionflower is generally well-tolerated, but there are some side effects that have been found in clinical trials. Some common side effects of passionflower supplementation include dizziness, confusion, drowsiness, nausea, and vomiting.[14][15] In rare but serious cases, passionflower has been shown to increase uterine contraction, causing the induction of labor;[16] it should therefore not be used in pregnancy.[17] Additionally, there has been one case report of increased heart rate, palpitations, and chest pain after taking passionflower supplements.[18]

    It is worth noting that clinical trials often look at passionflower in combination with other remedies, making it harder to determine its benefits as well as its side effects.

    How does passionflower work?

    Passionflower appears to act on the gamma-aminobutyric acid (GABA) pathway system. By increasing levels of GABA, brain cell activity is decreased, leading to calming and sedating effects.[19]

    Passionflower also contains flavonoids[8] that have anti-inflammatory and antioxidant properties, as well as indole alkaloids. The latter may be responsible for the antidepressant and anxiolytic effects of passionflower, although more research is needed to clarify their role.[20]

    What are other names for Passionflower

    Note that Passionflower is also known as:
    • Apricot vine
    • Passiflora
    • Passiflora incarnata
    • Maypop
    • Mburucuya
    • Passion flower

    Dosage information

    The most effective dose and frequency for passionflower have yet to be established. Manufacturers frequently do not specify the purity and concentration of passionflower supplements, contributing to uncertainty regarding recommended strength, frequency, and dosing. There are currently no generally accepted dosage guidelines for passionflower. However, a range of dosing has been used in different clinical studies and may be used for reference. Dosing for capsules and tablets ranges from 500–1200 mg per day.[1][2][3] For liquid extracts, dosages typically range from 30–60 drops diluted in water per day.[4][5][6]

    Additionally, one study using passionflower in the form of tea used a daily dosage of 2 grams of dried passionflower leaves steeped in hot water.[3] However, it's worth noting that the author acknowledged this as a relatively low dosage, and to achieve more significant benefits, the tea should have been consumed three times a day. This was not feasible due to the risk of daytime sedation.

    Frequently asked questions

    What is passionflower?

    Passionflower (Passiflora incarnata) is a flowering, woody vine traditionally used as a calming and sedative agent. The flower petals, leaves, and stems of the plant are typically used in supplements.[7] People around the world have used it as a treatment for pain, insomnia, anxiety, and opioid dependence.[8] The supplement comes in several formulations, including teas, capsules, tablets, and liquids. In addition to its uses as a supplement, passionflower is also a FDA-approved food additive for flavoring purposes.[9]

    The Passiflora genus has many different species. Passiflora incarnata should not be confused with Passiflora edulis; even though the latter has shown numerous effects in animal studies, very limited information is available regarding its use in humans.[10]

    What are passionflower’s main benefits?

    Passionflower has been traditionally used for anxiety and insomnia, due to its calming and sedating effects.[8] However, there is limited clinical data to support the use of passionflower for these purposes, and larger clinical trials should be conducted.

    One study compared the effect of 45 drops/day of a branded passionflower extract (prepared from the standardized extract of leaves, flower and fruit of Passiflora Incarnata and containing 11–15 mg per 100 ml of total flavonoids as hyperoside[11]) to oxazepam (a benzodiazepine used to treat symptoms of anxiety and insomnia) in reducing symptoms of generalized anxiety disorder. Results showed that passionflower decreased symptoms of anxiety, with a lower incidence of job performance impairment and dizziness than oxazepam.[5] Two other studies compared passionflower to placebo in the anxiety-inducing situation of preoperative procedures. Both 500 mg of the same standardized passionflower extract used in the previous study and 750 mg of a Passiflora incarnata syrup resulted in a decrease in anxiety, compared to placebo, without causing sedation.[1][2] Moreover, another study showed a decrease in anxiety symptoms and an increase in sedation when participants received either passionflower or midazolam before a dental procedure. Participants given passionflower also experienced limited memory loss associated with the procedure, in contrast to midazolam, which may cause temporary memory loss; however, this is not necessarily a positive, as some people may prefer not to remember medical procedures.[12] Additionally, one study showed that passionflower may be a helpful add-on therapy to sertraline (a selective serotonin reuptake inhibitor, or SSRI) for anxiety.[13] While these studies did show a reduction in anxiety levels, and an increase in sedation, associated with passionflower, more studies should be conducted to validate these results.

    One study found that sleep quality was improved when drinking 2 grams of passionflower tea a day compared to placebo. However, the study did not find any differences in sleep onset, number of awakenings, feelings of refreshment upon awakening, or anxiety symptoms between the passionflower and placebo groups.[3] It is worth noting that the passionflower dose used in this study was smaller than that used in other studies looking at anxiety outcomes. Furthermore, this study had a small sample size, was short in duration, and although the outcomes were measured through sleep diaries and polysomnography (PSG), the bulk of participants only provided sleep diaries; only ten people underwent PSG. Therefore, larger and longer studies should be conducted to better understand the impact of passionflower use on insomnia.

    What are some other possible benefits of passionflower?
    Quick answer:

    Passionflower has shown some efficacy in reducing anxiety with some sedating effects, but it has also been shown to help treat opiate withdrawal symptoms, attention deficit hyperactivity disorder (ADHD), and menopausal symptoms.

    In one study including individuals diagnosed with opioid use disorder, 60 drops of passionflower extract were taken in combination with clonidine to determine the effect on withdrawal symptoms compared to clonidine alone. Results showed that physical withdrawal symptoms were decreased in both the passionflower and placebo groups. Both groups also saw a reduction in mental withdrawal symptoms, but the passionflower group showed a more rapid onset of action and more significant symptom reduction than the to placebo group.[6] These results could impact the treatment of opioid withdrawal; they show that passionflower could potentially be added to prescription therapy to reduce opioid withdrawal symptoms, although larger studies are needed to confirm these effects.

    Furthermore, one randomized controlled trial (RCT) showed that daily supplementation with tablets of a standardized extract of Passiflora incarnata, given at a dosage of 0.04 mg of passionflower extract per kg of bodyweight (0.04 mg/kg), was as effective as methylphenidate in treating ADHD in children. Moreover, children taking passionflower had a lower incidence of decreased appetite and anxiety/nervousness than those in the methylphenidate group. However, the occurrence of other side effects did not significantly differ between the two groups.[21] However, since this study was relatively small, had a short follow-up period, lacked a placebo control group, and was limited to children and adolescents, larger-scale studies are needed to determine passionflower’s true efficacy for ADHD.

    In one study, 10 drops three times a day plus 30 drops at bedtime of a standardized extract of passionflower leaves, flower and fruit was shown to decrease menopausal symptoms such as insomnia, depression, anger, and headache. However, this study presents several limitations including the absence of a control group, a small sample size, and the use of outdated tests to measure menopausal symptoms.[4]

    What are passionflower’s main drawbacks?

    Passionflower is generally well-tolerated, but there are some side effects that have been found in clinical trials. Some common side effects of passionflower supplementation include dizziness, confusion, drowsiness, nausea, and vomiting.[14][15] In rare but serious cases, passionflower has been shown to increase uterine contraction, causing the induction of labor;[16] it should therefore not be used in pregnancy.[17] Additionally, there has been one case report of increased heart rate, palpitations, and chest pain after taking passionflower supplements.[18]

    It is worth noting that clinical trials often look at passionflower in combination with other remedies, making it harder to determine its benefits as well as its side effects.

    How does passionflower work?

    Passionflower appears to act on the gamma-aminobutyric acid (GABA) pathway system. By increasing levels of GABA, brain cell activity is decreased, leading to calming and sedating effects.[19]

    Passionflower also contains flavonoids[8] that have anti-inflammatory and antioxidant properties, as well as indole alkaloids. The latter may be responsible for the antidepressant and anxiolytic effects of passionflower, although more research is needed to clarify their role.[20]

    Update History

    References

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    2. ^Aslanargun P, Cuvas O, Dikmen B, Aslan E, Yuksel MUPassiflora incarnata Linneaus as an anxiolytic before spinal anesthesia.J Anesth.(2012-Feb)
    3. ^Ngan A, Conduit RA double-blind, placebo-controlled investigation of the effects of Passiflora incarnata (passionflower) herbal tea on subjective sleep quality.Phytother Res.(2011-Aug)
    4. ^Fahami F, Asali Z, Aslani A, Fathizadeh NA comparative study on the effects of Hypericum Perforatum and passion flower on the menopausal symptoms of women referring to Isfahan city health care centers.Iran J Nurs Midwifery Res.(2010)
    5. ^Akhondzadeh S, Naghavi HR, Vazirian M, Shayeganpour A, Rashidi H, Khani MPassionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam.J Clin Pharm Ther.(2001-Oct)
    6. ^Akhondzadeh S, Kashani L, Mobaseri M, Hosseini SH, Nikzad S, Khani MPassionflower in the treatment of opiates withdrawal: a double-blind randomized controlled trial.J Clin Pharm Ther.(2001-Oct)
    7. ^Dhawan K, Kumar S, Sharma AAnxiolytic activity of aerial and underground parts of Passiflora incarnata.Fitoterapia.(2001-Dec)
    8. ^Miroddi M, Calapai G, Navarra M, Minciullo PL, Gangemi SPassiflora incarnata L.: ethnopharmacology, clinical application, safety and evaluation of clinical trials.J Ethnopharmacol.(2013-Dec-12)
    9. ^Food and Drug AdministrationNatural flavoring substances and natural substances used in conjunction with flavorsU. S. Department of Health and Human Services.(2023)
    10. ^He X, Luan F, Yang Y, Wang Z, Zhao Z, Fang J, Wang M, Zuo M, Li Y: An Insight Into Current Researches on Phytochemistry and Pharmacology.Front Pharmacol.(2020)
    11. ^Nassiri-Asl M, Shariati-Rad S, Zamansoltani FAnticonvulsant effects of aerial parts of Passiflora incarnata extract in mice: involvement of benzodiazepine and opioid receptors.BMC Complement Altern Med.(2007-Aug-08)
    12. ^Dantas LP, de Oliveira-Ribeiro A, de Almeida-Souza LM, Groppo FCEffects of passiflora incarnata and midazolam for control of anxiety in patients undergoing dental extraction.Med Oral Patol Oral Cir Bucal.(2017-Jan-01)
    13. ^Nojoumi M, Ghaeli P, Salimi S, Sharifi A, Raisi FEffects of Passion Flower Extract, as an Add-On Treatment to Sertraline, on Reaction Time in Patients ‎with Generalized Anxiety Disorder: A Double-Blind Placebo-Controlled Study.Iran J Psychiatry.(2016-Jul)
    14. ^Baek JH, Nierenberg AA, Kinrys GClinical applications of herbal medicines for anxiety and insomnia; targeting patients with bipolar disorder.Aust N Z J Psychiatry.(2014-Aug)
    15. ^Rodriguez-Fragoso L, Reyes-Esparza J, Burchiel SW, Herrera-Ruiz D, Torres ERisks and benefits of commonly used herbal medicines in Mexico.Toxicol Appl Pharmacol.(2008-Feb-15)
    16. ^Farnsworth NR, Bingel AS, Cordell GA, Crane FA, Fong HHPotential value of plants as sources of new antifertility agents I.J Pharm Sci.(1975-Apr)
    17. ^Health Information: PassionflowerBethseda,MD: National Centre for Complementary and Integrative Health, National Institutes of Health.(August 2020)
    18. ^Fisher AA, Purcell P, Le Couteur DGToxicity of Passiflora incarnata L.J Toxicol Clin Toxicol.(2000)
    19. ^Appel K, Rose T, Fiebich B, Kammler T, Hoffmann C, Weiss GModulation of the γ-aminobutyric acid (GABA) system by Passiflora incarnata L.Phytother Res.(2011-Jun)
    20. ^Hamid HA, Ramli AN, Yusoff MMIndole Alkaloids from Plants as Potential Leads for Antidepressant Drugs: A Mini Review.Front Pharmacol.(2017)
    21. ^Akhondzadeh et alPassiflora incarnata in the treatment of attention-deficit hyperactivity disorder in children and adolescents(2005)
    22. ^Andre Luis Dias Araujo Mazzari, Mariella Guimarães Lacerda, Flora Aparecida Milton, João Augusto Mulin Montechiari Machado, Simone Batista Pires Sinoti, Anne-Soulene Toullec, Patricia Marquez Rodrigues, Francisco de Assis Rocha Neves, Luiz Alberto Simeoni, Dâmaris Silveira, Jose Maria PrietoIn vitro effects of European and Latin-American medicinal plants in CYP3A4 gene expression, glutathione levels, and P-glycoprotein activityFront Pharmacol.(2022 Oct 5)
    23. ^Schäfer AM, Gilgen PM, Spirgi C, Potterat O, Meyer Zu Schwabedissen HEConstituents of Passiflora incarnata, but Not of Valeriana officinalis, Interact with the Organic Anion Transporting Polypeptides (OATP)2B1 and OATP1A2.Planta Med.(2022 Feb)
    24. ^Boll et alPassiflora incarnata treatment during gestation and lactation: toxicological and antioxidant evaluation in wistar damsBrazilian Journal of Pharmaceutical Sciences.(2014-04)
    25. ^Zeynep Ozturk, Cigdem Colak KalayciPregnancy outcomes in psychiatric patients treated with passiflora incarnataComplement Ther Med.(2018 Feb)