Passion Flower is a traditional herbal medicine used for the temporary relief of mild anxiety and to aid sleep. There is also evidence to suggest benefits for nerve pain and reducing symptoms of opioid withdrawal.
Complementary and Alternative Medications (CAM)
The genus Passiflora L. comprises about 520 species of plants in the family Passifloraceae. Passiflora incarnata and P. alata, also commonly known as Passionflower, are two species of a perennial climbing vine with beautiful exotic flowers and delicious fruit that grow worldwide in subtropical climates. They are native to the United States, from Virginia to Florida and as far west as Texas.
Passionflower (Passiflora incarnata) is considered the most bioactive of the species in the family Passifloraceae and is the species most investigated and referred to here. Purple passionflower (P. edulis), the source of passion fruit, is often confused with P. incarnata.
Passion Flower is believed to have many pharmaceutical properties with multiple clinical applications. It is listed in the national pharmacopeias of Egypt, France, Germany and Switzerland, United States and also mongraphed in the British Herbal Compendium.
In Germany, Passionflower is used as a component in sedatives (combined with valerian root and lemon balm), a pediatric sedative tea (Species nervinae pro infantibus: with lemon balm, lavender flower, and St John’s Wort) and cardiotonic formulations (with hawthorn). It is also a German homeopathic medicine for pain, insomnia, and neurasthenia.
A 2016 study in mice suggests that Passiflora incarnata might be useful for treating neuropathic pain. The antinociceptive (pain-relieving) and behavioural findings are thought to stem from underlying opioidergic and GABAergic mechanisms. The study is preliminary and the findings cannot be reliably applied to human application yet without further research.
In 2001, a study reported on a controlled trial of P. incarnata in the treatment of opiate withdrawal when provided with clonidine, that evaluated withdrawal symptoms such as anxiety, nausea and tremor. Clonidine is commonly used to treat opiate withdrawal but tends to reduce mostly the physical symptoms and not the psychological symptoms of withdrawal. This trial compared clonidine and Passiflora with clonidine and placebo in 65 males undergoing detoxification. 15 subjects in each of the two groups completed the 14 day trial. Subjects were evaluated on days 0, 1, 2, 3, 4, 7 and 14 for ratings of severity of 16 withdrawal symptoms.. On day 14, all withdrawal symptoms were reported significantly lower in the clonidine and Passiflora group, including the mental withdrawal symptoms, when compared to the clonidine and placebo group.
Enhanced sleep with Passiflora has been demonstrated in animals and human studies. The effectiveness of P. incarnata tea on sleep quality was measured in a study of 41 healthy young adults, using sleep diaries validated by polysomnography (PSG – slleep study) plus an anxiety assessment. Subjects with a history of sleep disorder were excluded. Participants were provided 1 cup of either Passionflower or placebo tea (Parsley) for one week, followed by a 1 week ‘washout’ period, and then crossed over (given the opposite tea to the first week). Sleep quality was significantly better for those who drank Passionflower tea. While this study is encouraging, th
e quality and design of the study lacks authority.
Stress and Anxiety
Multiple animal and human studies performed over the last ten years have demonstrated the effectiveness of Passion Flower extract for anxiety comparable to benzodiazepines. Compared to the benzodiazepines, Passion Flower may not have as rapid onset, but it appears to be less likely to impair memory and no withdrawal syndromes from Passion Flower have been reported.
In my search of the internet for articles on Passion Flower I stumbled on one that recommended the use of Passion Flower tea as a calmative agent for dogs. See below for more information.
Passion Flower – Safety
Passionflower extract is classified as “generally regarded as safe” (GRAS) by the Food and Drug Administration. Mild adverse effects were reported in one study, including dizziness, drowsiness and confusion. There are no confirmed reports of serious adverse effects or toxicity and no known contraindications aside from allergy to Passion Flower. Unlike the benzodiazepines used for anxiety, Passion Flower does not appear to impair memory.
Oral administration of extracts of P. incarnata given for 15 days have also shown hypoglycemic and hypolipidemic effects, suggesting the possibility of additive or synergistic effects when Passiflora is given to someone who is taking anti-diabetic or lipid-lowering medications. A randomized controlled study of 60 patients undergoing spinal anesthesia showed that oral P. incarnata extract had no effect on hemodynamics such as blood pressure during their operations. Pregnant women are advised to avoid high doses.
While preliminary animal and human evidence for the clinical benefits listed above exist for P. incarnata, the quality of evidence is poor and robust studies are lacking. Therefore definite conclusions regarding benefits should not be drawn. Caution should be taken when interpreting the results of these studies as their results may have not yet been replicated. Random controlled trials are needed with larger samples that compare the effectiveness of Passiflora with placebo and other medications (e.g. Kava, prescription anxiolytics and hypnotics). That being said, the safety profile is very acceptable and argues the potential for trial in cases resistant to alternative modes of treatment.
Dried herb: 2 g, three to four times daily.
Tea Infusion: 2 g in 150 ml water, three to four times daily.
Fluid extract 1:1 (g/ml): 2 ml, three to four times daily. Can be taken in liquid phyto-cap form, 2 capsules,
three to four times daily.
Tincture 1:5 (g/ml): 10 ml, three to four times daily.
Passion Flower – Neurobiology
Passionflower extracts consist of fresh or dried aerial parts of P. incarnata or P. alata, collected during the flowering and fruiting period. Extracts contain 0.825% apigenin and luteolin glycosides, vitexin, isovitexin and their C- glycosides, kaempferol, quercetin, and rutin; indole alkaloids (0.01%), mainly harman, harmaline, harmine; coumarin derivatives; cyanogenic glycosides (gynocardin); amino acids (including GABA); fatty acids (linoleic and linolenic); gum; maltol; phytosterols (stigmasterol); sugars (sucrose); and a trace of volatile oil.
Mechanisms of Action
Passion Flower is believed to exert its anti-anxiety effects via the same GABA receptors that the benzodiazepine class of drugs work on, but only extracts from P. incarnata leaves have been shown to produce anxiolytic effects. Numerous pharmacological effects of Passiflora incarnata are mediated via modulation of the GABA system including affinity to GABA(A) and GABA(B) receptors, and effects on GABA uptake. Although the active ingredients have not been conclusively identified, most data suggests flavonoids and GABA account for the clinical effects.
In 2007, researchers at the US Army Graduate Program studied the effects of chrysin, a Passiflora extract related to the modulation of the benzodiazepine receptor and the GABA(A) receptor. Chrysin significantly decreased anxiety to the same degree as midazolam (a potent benzodiazepine). Another study of GABA-mediated anxiolytic activity of P. incarnata conducted at the University of Florida concluded that the P. incarnata extract exerted an anxiolytic effect that was comparable to diazepam (Valium).
Passion Flower – Overviews
- Passionflower (Passiflora) – An overview of the research and clinical indications
- Assessment report on Passiflora incarnata L. – 2014
- Passiflora incarnata L. – ethnopharmacology, clinical application, safety and evaluation of clinical trials – 2013
Passion Flower – Neuropathic Pain
- Passiflora incarnata attenuation of neuropathic allodynia and vulvodynia apropos GABA-ergic and opioidergic antinociceptive and behavioural mechanisms – 2016
Passion Flower – Opioid Withdrawal
- Passionflower in the treatment of opiates withdrawal – a double-blind randomized controlled trial – 2001
Passion Flower – Sleep
- A double-blind, placebo-controlled investigation of the effects of Passiflora incarnata (passionflower) herbal tea on subjective sleep quality. – PubMed – NCBI
Passion Flower – Stress
- Passiflora incarnata L. Improves Spatial Memory, Reduces Stress, and Affects Neurotransmission in Rats. – PubMed – NCBI
- Passiflora incarnata L. (Passionflower) extracts elicit GABA currents in hippocampal neurons in vitro, and show anxiogenic and anticonvulsant effects – 2010
Passion Flower – Stress for Dogs
Emphasis on Education
Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.
For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.
Should you wish more information regarding any of the subjects listed – or not listed – here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.
For more information, please contact Accurate Clinic.
Supplements recommended by Dr. Ehlenberger may be purchased commercially online or at Accurate Clinic.
Please read about our statement regarding the sale of products recommended by Dr. Ehlenberger.
Accurate Supplement Prices