Efficacy of herbal therapy with melissa and valerian to treat benzodiazepine dependence in patients with primary insomnia

Introduction. The use of benzodiazepines in patients with insomnia is common practice, and it is not unusual to detect a degree of therapeutic inertia that can prolong the consumption of these agents for months or even years. Although they have clear short-term benefits, prolonged use often leads to a degree of neuroadaptation; it is therefore important to reduce the symptoms of abstinence during withdrawal in order to achieve greater success in the discontinuation of treatment. The use of herbal therapy can help to achieve these aims. The objective of the present study was to evaluate the efficacy of a combination of Valerian and Melissa on the reduction of symptoms of withdrawal and the effect of this combination on sleep parameters. Subjects and methods This was a randomised, controlled, unblinded experimental study performed in the Estevill Sleep Clinic on a sample of 50 patients with primary insomnia and on treatment with 1 mg of lorazepam for between 6 months and 2 years prior to recruitment. Patients were assigned in a 1-to-1 ratio to the intervention group (IG), which received a combination of 120 mg of extract of Valerian and 80 mg of extract of Melissa, or to the control group (CG). Outpatient follow-up visits and weekly patient diaries were used to evaluate the parameters related with the quality of sleep and rest and the severity of symptoms most commonly associated with drug withdrawal. Results. After a follow-up of 90 days, fewer subjects in the group receiving herbal therapy reported anxiety (IG, 59%; CG, 77%), irritability (IG, 54%; CG, 84%), restlessness (IG, 52%; CG, 62%), or mood disorders (IG, 43%; CG, 64%), and a smaller proportion of this group suffered moderate or severe forms of these symptoms. In addition, the IG presented a shorter time to onset of sleep and fewer episodes of waking compared with the CG, as well as a greater mean duration of sleep after withdrawal. Although a larger proportion of patients in the IG reported a better quality of sleep and of derived rest, the differences observed did not reach statistical significance. Conclusions. Despite the limitations of the study, the results suggest that herbal therapy gives rise to a subjective improvement in the quality of certain sleep parameters and a reduction in the onset and severity of symptoms associated with benzodiazepine withdrawal in patients with primary insomnia. This treatment could constitute an effective option in the management of benzodiazepine withdrawal (AU)