Therapeutic efficacy and safety of chamomile for state anxiety, generalized anxiety disorder, insomnia, and sleep quality: A systematic review and meta‐analysis of randomized trials and quasi‐randomized trials

• Published in: Phytotherapy research 2019-06, Vol.33 (6), p.1604-1615
• Main Authors: Hieu, Truong Hong, Dibas, Mahmoud, Surya Dila, Kadek Agus, Sherif, Nourin Ali, Hashmi, Muhammad Usman, Mahmoud, Mostafa, Trang, Nguyen Thi Thuy, Abdullah, Lava, Nghia, Thai Le Ba, Y, Mai Nhu, Hirayama, Kenji, Huy, Nguyen Tien
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anxiety; Anxiety - drug therapy; Anxiety - epidemiology; Anxiety Disorders - drug therapy; Anxiety Disorders - epidemiology; chamomile; Chamomile - adverse effects; Chamomile - chemistry; Effectiveness; Female; GAD; generalized anxiety disorders; Humans; Insomnia; Male; Meta-analysis; Middle Aged; Plant Extracts - therapeutic use; Randomization; Randomized Controlled Trials as Topic - statistics & numerical data; Safety; Sleep; Sleep - drug effects; Sleep disorders; Sleep Initiation and Maintenance Disorders - drug therapy; Sleep Initiation and Maintenance Disorders - epidemiology; sleep quality; state anxiety; Systematic review; Treatment Outcome
• ISSN: 0951-418X; 1099-1573
• DOI: 10.1002/ptr.6349

This systematic review and meta‐analysis aimed to study the efficacy and safety of chamomile for the treatment of state anxiety, generalized anxiety disorders (GADs), sleep quality, and insomnia in human. Eleven databases including PubMed, Science Direct, Cochrane Central, and Scopus were searched to retrieve relevant randomized control trials (RCTs), and 12 RCTs were included. Random effect meta‐analysis was performed by meta package of R statistical software version 3.4.3 and RevMan version 5.3. Our meta‐analysis of three RCTs did not show any difference in case of anxiety (standardized mean difference = −0.15, 95% CI [−0.46, 0.16], P = 0.4214). Moreover, there is only one RCT that evaluated the effect of chamomile on insomnia and it found no significant change in insomnia severity index (P > 0.05). By using HAM‐A scale, there was a significant improvement in GAD after 2 and 4 weeks of treatment (mean difference = −1.43, 95% CI [−2.47, −0.39], P = 0.007), (MD = −1.79, 95% CI [−3.14, −0.43], P = 0.0097), respectively. Noteworthy, our meta‐analysis showed a significant improvement in sleep quality after chamomile administration (standardized mean difference = −0.73, 95% CI [−1.23, −0.23], P