Lavender & Depression

An estimated 3.8% of the global population experience depression, including 5% of adults (4% among men and 6% among women), and 5.7% of adults older than 60 years. Approximately 280 million people in the world have depression and depression is about 50% more common among women than among men.

Natural medicine is a moderately strong area for the treatment of mild to moderate depression.  Research on several botanicals including lavender essential oil, St. John’s wort, saffron, curcumin and research on nutraceuticals including folate, B12, and high-EPA fish oils are on the regular menu of options in a natural medicine strategy.

Lavender essential oil has emerged as a more common treatment for anxiety and/or depression in the last ten years with over a half dozen studies showing efficacy.  There have been over 50 randomized controlled trials and at least 17 non-randomized trials showing favorable effects for anxiety disorders.  There are at least 17 studies on lavender showing significant effects for depression.

The current study was published in April 2024. The trial was conducted between October 2020 and April 2023 in various psychiatric or neurological practices in Germany and Poland.  Patients with mild to moderate major depressive disorders (MDD) were eligible.  Two thirds of the patients were female and about half had mild depression and about half had moderate episodes.  More than half had recurrent depression with the average duration of their current depressive episode being 3.4 months.

Participants were randomly assigned to take on 80 mg capsule of a lavender essential oil (“Silexan”) or sertraline or a placebo.  Patients were instructed to take two capsules daily: one capsule of their treatment (Silexan, placebo or sertraline) and one placebo capsule.

The primary outcome was the intraindividual change from baseline to eight weeks in the Montgomery Asberg Depression Rating Scale (MADRS) total score.  Secondary outcome measures included the self-rated Revised Beck Depression Inventory (BDI-II), the nine item self-rated depression module of the Patient Health Quesionnaire-9 (PHQ-9); the Clinical Global Impressions (CGI) scale, an observer rated measure of mental illness severity and the Sheehan  Disability Scale (SDS).

Results:

After eight weeks, the average MADRS total scores decreased significantly in the Silexan and sertraline groups compared with placebo.  The Silexan and sertraline groups also had higher response and remission rates compared to placebo, although these differences were not significant.   After eight weeks, 53.5% of the Silexan group, 54% of the sertraline group and 41.5% of the placebo groups were considered responders (a MADRS score decrease by at least 50% from baseline).  Remissions (a total MADRS score of less than 10 at the end of the study) were 44.4% in the Silexan group, 45.2% of the sertraline group and 32.6% of the placebo group.

For the secondary outcomes, the Silexan group had notable symptom relief according to the BDI-II and PHQ-9 scores, although these were not statistically significant.  By week 8, more individuals in the Silexan and sertraline groups were rated as not depressed or significantly improved on the CGI scale compared to the placebo group, but again these results were not significant.  The Silexan group, but not the sertraline group showed significant improvements in functional impairments that were related to their MDD.

Adverse Effects:

The most common adverse event for Silexan were belching, burping and nasal passage inflammation.  The most common adverse event for sertraline was headache, nausea and diarrhea.

Conclusion and commentary:

This study confirms efficacy of Silexan, an 80 mg lavender essential oil capsule, in reducing symptoms of mild to moderate MDD, with reductions better than placebo and comparable with sertraline.

I have been using 80 mg lavender essential oil capsules ever since the first published study for anxiety disorder in 2010.  My most common uses have been for general anxiety disorder and mixed anxiety-depression disorders.   I have not typically used it for solo mild to moderate depression.  With the results of this study, I will certainly add it to my list of options for these individuals.

Reference: Kasper V, Holler H, et al.  Lavender oil preparation Silexan is effective in mild to moderate major depression: A randomized, placebo and reference controlled trial.  Eur Arch Psychiatry Clin Neurosci. 2024; April