Herbal supplements have long been used to help calm the mind and body — but how well do they actually work when it comes to anxiety?
Welcome back to Weekly Education Talks with Rivia Mind. In Part 1 of this three-part series, we explored the evidence behind herbal supplements for depression. Now, in Part 2, we’re turning our focus to anxiety — a condition that affects nearly one in three adults at some point in their lives.1
From well-known herbs like St. John’s wort and passionflower to lesser-discussed options like kava, a growing number of plant-based supplements are being considered for their calming effects. But just like with depression, the question remains: how strong is the science behind them?
In this article, we’ll take a closer look at what the research says about herbal support for anxiety, including:
- Which supplements show the most promise — and which fall short
- How they may work in the brain and body
- What side effects or safety considerations to keep in mind
- And when to involve a healthcare provider
If you or someone you support is looking for alternative or supplemental options for managing anxiety, this guide offers a clear-eyed, evidence-based overview of where things stand — and what to consider next.
St. John’s Wort for Anxiety: Inconclusive Evidence and Mixed Results
Given its well-documented benefits for mild to moderate depression, it might seem logical to assume that St. John’s wort could also help with anxiety. But the research tells a more complicated story.
Studies exploring St. John’s wort for anxiety have shown inconsistent outcomes. In one small trial of 13 patients with Generalized Anxiety Disorder (GAD), participants experienced significant symptom improvement, comparable to results seen with SSRIs. However, a larger study with 60 participants found no meaningful difference between those taking St. John’s wort and those receiving a placebo.
Where St. John’s wort has shown more promise is in combination therapies. Several randomized controlled trials have examined its use alongside valerian root, particularly in patients who experience both depression and anxiety. These studies found a significant reduction in anxiety symptoms when the two herbs were taken together. Importantly, the improvements in anxiety were more strongly linked to valerian, while the dose of St. John’s wort remained consistent across groups.
Typical Dosage
Clinical research is currently too limited to determine a standardized or recommended dose of St. John’s wort for treating anxiety.
Important Considerations
- Birth control pills
- Certain immunosuppressants (e.g., cyclosporine)
- Heart medications (e.g., digoxin)
- Pain medications (e.g., oxycodone)
- HIV medications (e.g., indinavir)
- Chemotherapy drugs (e.g., irinotecan)
- Blood thinners (e.g., warfarin)
The Bottom Line:
Although St. John’s wort is well-supported for treating mild depression, its effectiveness for anxiety disorders is unclear. Results across studies have been mixed, and when positive effects are observed, they often appear to be due to co-administered treatments like valerian. Until stronger evidence emerges, it’s best to approach St. John’s wort for anxiety with caution and consult a healthcare provider to explore more reliable options.
Passionflower for Anxiety: A Natural Anxiolytic with Renewed Interest
Passionflower has a long history of use as a calming remedy for restlessness, nervousness, and tension. Though its popularity declined in the early 2000s, interest in this plant-based option has grown again in recent years. It is now recognized as a medicinal agent in several countries, including the United States, Germany, France, Switzerland, Egypt, and India.
Over the past 15 years, a small number of human trials have investigated passionflower’s potential to treat anxiety disorders. One of the most notable was a double-blind, placebo-controlled study comparing oxazepam (a benzodiazepine) with passionflower in 36 patients diagnosed with Generalized Anxiety Disorder (GAD). The two treatments produced similar reductions in anxiety symptoms. Interestingly, participants taking passionflower reported better job performance, while those on oxazepam experienced faster symptom relief.
Still, passionflower presents some challenges when it comes to scientific validation. The plant contains thousands of phytochemicals, making it difficult to isolate which components are responsible for its calming effects. This complexity also means there’s a risk of ingesting ineffective or even potentially harmful compounds depending on how the supplement is processed.
Typical Dosage
Passionflower supplements are commonly sold in doses ranging from 250 to 900 mg per serving. However, due to limited clinical data, there’s no clearly established standard for what constitutes an effective or appropriate dose.
Important Considerations
Passionflower may affect how certain medications work in the body, especially those that impact the central nervous system or are processed through specific cellular pathways. Caution and a discussion with a healthcare professional are advised when considering combining it with prescription or over-the-counter drugs.
The Bottom Line:
Passionflower shows early promise as a plant-based option for anxiety, with one study suggesting its effects may be comparable to prescription medication. It may be especially appealing for people who are sensitive to sedation or looking for a more functional alternative. That said, the research is still limited, and the chemical complexity of the plant raises important safety questions.
Kava for Anxiety: Relief with Important Caveats
Kava, a traditional preparation made from the root of the Piper methysticum plant, has long been used for its calming effects. Unlike some herbal remedies, kava appears to reduce anxiety without causing sedation, making it an appealing option for people seeking relief without feeling impaired.
Its effects are believed to come from several mechanisms:
- Modulation of GABA-A receptors, which help calm nervous system activity
- Inhibition of sodium and calcium ion channels
- Blocking the reuptake of neurotransmitters like norepinephrine and dopamine
Together, these actions help reduce overactivity in the brain and body, contributing to a sense of calm without drowsiness.
To date, eight randomized controlled trials have studied kava for anxiety. Five of those studies — about 63% — found significant reductions in anxiety symptoms. Kava has shown the most promise as a stand-alone treatment for Generalized Anxiety Disorder (GAD) and related conditions, and it may also offer symptom relief for individuals tapering off benzodiazepines.
Typical Dosage
Up to 400 mg per day is generally considered safe and well tolerated.
Important Considerations
In 2002, the FDA issued a consumer advisory regarding potential cases of severe liver damage associated with kava use, including hepatitis and cirrhosis. As a result, kava has been banned in places like Canada and the United Kingdom.
However, more recent research suggests that these serious side effects are rare and may be linked to specific factors, such as:
- Use of low-quality or improperly prepared kava
- Prolonged use (more than six months)
- Combining kava with other medications that affect the liver
Because of these risks, kava should only be used with medical supervision, especially if there’s any history of liver disease or concurrent medication use.
The Bottom Line:
Kava shows strong potential as an effective treatment for anxiety, particularly for GAD or during benzodiazepine withdrawal. It offers non-sedating relief and is generally well tolerated at doses under 400 mg per day. Still, due to concerns about liver toxicity, it’s essential to work with a healthcare provider if you’re considering kava — and to use only high-quality products from reputable sources.
Chamomile, Lavender, and Lemon Balm — Early Evidence, Ongoing Research
While some options have been the focus of more extensive research, several other plant-based supplements have shown early promise in managing symptoms of anxiety. These alternatives are not as well studied, but may offer benefits for some individuals seeking gentle or adjunctive support.
Chamomile
Short-term use of chamomile may help reduce anxiety symptoms, according to limited clinical data. However, caution is advised for individuals taking anticoagulants (blood thinners), as chamomile can increase the risk of bleeding.
Lavender
Lavender has been studied in both oral supplement form and aromatherapy. Preliminary research suggests it may reduce anxiety levels. That said, oral lavender supplements have been associated with some side effects, including:
- Constipation
- Headaches
- Lowered blood pressure
- Increased appetite
Lavender may also intensify the sedative effects of other medications or supplements.
Lemon Balm
Lemon balm has shown some potential in reducing anxiety in early studies and is generally well tolerated. Side effects, when they occur, tend to be mild and may include nausea or abdominal discomfort. It’s considered safe for short-term use.
The Bottom Line:
Chamomile, lavender, and lemon balm are herbal supplements with encouraging early results in anxiety treatment. However, they haven’t yet been studied at the same scale as other herbal remedies.
Finding Calm in the Evidence: The Role of Herbs in Anxiety Care
When it comes to managing anxiety, herbal supplements offer both possibility and complexity. While options like passionflower, kava, and lavender show real potential, the quality and consistency of research vary — and not all products are created equal.
Some herbs may offer relief for people with mild to moderate anxiety or those looking to complement conventional treatment. Others, like St. John’s wort, have produced mixed or inconclusive results in anxiety-specific studies. And even the more promising options often come with important safety considerations, from medication interactions to the need for high-quality sourcing.
Ultimately, herbal supplements are not one-size-fits-all solutions. What works for one person may not work for another, and without clear dosing standards or strong regulatory oversight, it’s essential to approach these remedies with care.
If you’re considering an herbal supplement for anxiety, the most important step you can take is to talk with a trusted healthcare provider. Together, you can weigh the potential benefits, identify any risks based on your personal health history, and determine whether a particular approach fits into your broader care plan.
This article is Part 2 in our three-part series on herbal support for mental health. If you missed Part 1 on depression, you can read it here. Next, we’ll explore how herbal remedies may — or may not — help with insomnia.
Dealing with anxiety? Reach out today to see how we can support your mental health journey.
Sources:
- University of California, Davis. Anxiety disorders will affect nearly 1 in 3 adults: Here’s what you need to know. Published 2023. Accessed 2025.
- National Center for Complementary and Integrative Health. St. John’s Wort and Depression: In Depth. Updated 2017. Accessed 2025.
References:
Lakhan, S. E., & Vieira, K. F. (2010). Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutrition joumal, 9, 42. https://doi.org/10.1186/1475-2891-9-42
Liu, L., Liu, C. Wang, Y. Wang, P., Li, Y.., & Li, B. (2015). Herbal Medicine for Anxiety, Depression and Insomnia. Current neuropharmacology, 13(4), 481-493. https://doi.org/10.2174/1570159×1304150831122734
Liu, Y. R., Jiang, Y. L.. Huang, R. Q.. Yang, J. Y., Xiao, B. K., & Dong, J. X. (2014). Hypericum perforatum L. preparations for menopause: a meta-analysis of efficacy and safety. Climacteric: the journal of the International Menopause Society, 17(4), 325-335. https://doi.org/10.3109/13697137.2013.861814
Mischoulon D. (2018). Popular Herbal and Natural Remedies Used in Psychiatry. Focus (American Psychiatric Publishing), 16(1), 2-11. https://doi.org/10.1176/appi.focus.20170041
