Background: Anxiety disorders represent a growing global mental health concern, affecting millions worldwide and significantly impacting quality of life. Conventional treatments, including Selective Serotonin Reuptake Inhibitors (SSRIs) and benzodiazepines, present challenges such as adverse effects, dependency risks, and limited accessibility. As a result, there is increasing interest in natural anxiolytic agents such as Myristica fragrans (nutmeg) and Phyllanthus acidus (otaheite gooseberry), which exhibit neuroprotective and antioxidant properties. Methods: This study employs a comprehensive literature review methodology, systematically analyzing experimental and clinical studies from Scopus, PubMed, and Google Scholar. Using the Critical Appraisal Skills Programme (CASP), studies were selected based on rigorous inclusion criteria, emphasizing pharmacological mechanisms, efficacy in anxiety management, and safety profiles. The primary focus was on the modulation of serotonergic, GABAergic, and hypothalamic-pituitary-adrenal (HPA) axis pathways by nutmeg and otaheite gooseberry extracts. Findings: The review identified eight key studies demonstrating that myristicin from Myristica fragrans enhances serotonin levels through monoamine oxidase inhibition while modulating GABAergic activity, resulting in significant reductions in anxiety-related behaviors (p < 0.05). Flavonoids and vitamin C in Phyllanthus acidus exhibited neuroprotective effects by reducing oxidative stress and lowering cortisol levels by approximately 20%. A synergistic combination of these extracts showed greater efficacy in reducing anxiety symptoms compared to individual extracts alone. Conclusion: Nutmeg and otaheite gooseberry extracts present a promising natural alternative for anxiety management, with evidence supporting their effectiveness in neurotransmitter modulation and oxidative stress reduction. However, concerns regarding high-dose toxicity, particularly the neurotoxic effects of myristicin and gastrointestinal risks of flavonoids, necessitate further large-scale clinical trials. Novelty/Originality of this Article: This study is the first to provide a systematic evaluation of the combined effects of Myristica fragrans and Phyllanthus acidus as a potential functional lozenge for anxiety relief. The findings contribute to advancing research on natural anxiolytic therapies with improved safety and efficacy.
Fauzana et al. (Thu,) studied this question.
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