An Evidence-Based Approach: M. Officinalis and S. Officinalis for Alzheimer's

Article excerpt

History of Use

Two common herbs of the Labiatae family, Melissa officinalis and Salvia officinalis, have long histories of medicinal use, M. officinalis, or lemon balm, appears in the ancient "Materia Medica" and was much favored by the early English herbalists. "The London Dispensary" (1696) reported that an essence of this plant, drunk in wine, would "strengthen the brain." According to John Gerard's "Herbal" (1633), this plant "comforts the heart, and driveth away all melancholy." A more contemporary voice, Mrs. M. Grieve, wrote in her "Modern Herbal" (1931) that one John Hussey of Sydenham, England, lived to the age of 116 after drinking lemon balm tea for 50 years.

S. officinalis, or common sage, was said by Gerard to be "singular good for the head and braine; it quickneth the senses and memory." Mrs. Grieve described it as "a valuable agent in the delirium of fevers and in the nervous excitement frequently accompanying brain and nervous diseases."

Rationale for Use

A group of researchers from the Medicinal Plant Research Centre, University of Newcastle upon Tyne (England), have identified nicotinic receptor-binding activity in extracts of these plants. They explained, "Brain nicotinic acetylcholine receptors are a family of ligand-gated ion channels, and high-affinity nicotine binding is associated with receptors composed of [[alpha].sub.4][[beta].sub.2] subunits.

The pathogenesis of Alzheimer's disease (AD) includes loss of receptors of this subtype from regions of the brain concerned with cognition and memory ... and the discovery of increasing numbers of agonists and antagonists for this receptor have focused attention on the possibility of nicotinic therapy for AD" (J. Ethnopharmacol. 69[2]:105-14, 2000).

The Randomized Trials

As part of a national project in Iran, Shahin Akhondzadeh, Ph.D., of Tehran University of Medical Sciences, reported on two randomized trials of these herbal extracts in Alzheimer's patients. In an e-mail from Tehran, Dr. Akhondzadeh explained to this newspaper, "Although FDA-approved drugs are in hand for the management of Alzheimer's disease, the outcomes are not fully promising and there is a place for alternative medicine and, in particular, phytotherapy."

He further said that traditional use of these plants has been associated with soothing, carminative, anxiolytic, sedative, and hypnotic effects.

* The M. officinalis study. Eligible patients had a diagnosis of probable Alzheimer's disease and a score of 12 or greater on the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog) and 2 or less on the Clinical Dementia Rating scale (CDR), signifying mild to moderate disease. They were randomized to receive 60 drops of M. officinalis per day or placebo.

A total of 35 patients completed the study. By the end point at week 16, statistically significant differences were seen on both efficacy measures between the active-treatment group and the placebo group: On the ADAS-cog, in which scores range from 0 to 70 with 70 being most severe, changes from baseline were -6. …

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