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Lemon Balm for insomnia

Traditional use

Various cultures utilise Lemon Balm as a sedative for anxiety and insomnia and to lift depression.1, 2 It is traditionally known as a herb for mental disorders.3 It also considered to enhance cognitive capacities, as such it has been used for dementia,1 and to relieve various other afflictions including heart conditions, digestive complaints and skin conditions.4 In recent research, this herb has been shown to improve depression,5, 6 reduce anxiety,2, 5, 7-9 and assist with sleeping disorders. 2, 3, 5, 7, 10 One randomised controlled trial (RCT) demonstrated efficacy and safety on the cognitive function and agitation of patients with Alzheimer’s disease when compared to placebo.2

The research

General insomnia

In a RCT, Soltanpour et al (2019) found that Lemon Balm leaf powder significantly improves sleep quality by 54% in patients who had previously undergone coronary artery bypass grafting.2

In another RCT by Heydari et al (2019), it was shown that Lemon Balm significantly reduces anxiety and sleep disorder in adolescent girls with premenstrual syndrome in comparison with placebo.3

Another RCT by Shirazi et al (2021) found that Lemon Balm improves the quality of life in postmenopausal women with sleep disturbance. The improvement was significantly greater than citalopram and placebo. The greatest impact was seen in vasomotor symptoms, which is considered a major cause of sleep disturbance during menopause.10

In an open-label, uncontrolled trial by Cases et al (2011), 19 out of 20 volunteers responded positively for insomnia with Lemon Balm extract. Seventeen patients achieved full remission of insomnia symptoms. The remaining three achieved significant symptom improvement and partial remission.7

Sleep onset insomnia

In a RCT, Haybar et al (2018) found that Lemon Balm significantly decreased sleep onset insomnia by 31.94%, while placebo achieved a non-significant reduction of 7.5%.5 In the open-label, uncontrolled trial by Cases et al (2011), initial insomnia reduced by 53% in adults with anxiety disorder and sleep disturbances.7

How does it work?

Lemon Balm leaf extracts standardised to contain more than 5% hydroxycinnamic acid (HA) are known to address anxiety and insomnia.7 A prominent HA in Lemon Balm is rosmarinic acid,  which is an inhibitor of Gama-aminobutyric acid transaminase (GABA-T). GABA-T is an enzyme which reduces GABA levels in the brain. It is thought that GABA activity modulates anxiety. Hence, when this enzyme is inhibited, higher GABA levels in the brain may reduce anxiety.5, 7

Lemon Balm is probably serotonergic and noradrenergic. Mice studies have shown that the antidepressant effect of Lemon Balm aqueous (water) extract as well as the essential oil, may occur through enhancing noradrenergic neurotransmission and through a serotonergic action.6, 11

One of these studies observed that the antidepressant activity of Lemon Balm is close to that of imipramine, a tricyclic antidepressant with selective effects on noradrenergic transmission. It also observed that at a different dosage, Lemon Balm acts like the selective serotonin reuptake inhibitor fluoxetine.11 (A water extract is, simply put, a tea or infusion. What a good motive to try Lemon Balm tea! Or how about a few drops of essential oil in your bath?)

A human RCT also demonstrated that the antidepressant effect of Lemon Balm is comparable to fluoxetine.12 Another RCT investigating Lemon Balm for premenstrual syndrome (PMS) proposed that it may attenuate PMS symptoms via GABAergic action that influences serotonin and noradrenaline.13

Safety

Lemon Balm is traditionally considered a safe drug and current human trials assessing safety have not reported adverse events. Although, to get the most out of herbal treatment it is essential to get qualified guidance with the treatment. It is important to get a good quality herbal supplement, produced with well-sourced herbs, at the right dosage and for the correct duration.

It is equally critical to get a professional opinion about interactions with other medicines. If you would like to ask a naturopath about taking this herb click here. If you are looking for a good quality Lemon Balm supplement, consider this one.

Best wishes!

References

  1. Braun L, Cohen M. Herbs and Natural Supplements, Volume 1: An Evidence-Based Guide: Elsevier Health Sciences; 2015.
  2. Soltanpour A, Alijaniha F, Naseri M, Kazemnejad A, Heidari MR. Effects of Melissa officinalis on anxiety and sleep quality in patients undergoing coronary artery bypass surgery: A double-blind randomized placebo controlled trial. European Journal of Integrative Medicine. 2019;28:27-32.
  3. Heydari N, Dehghani M, Emamghoreishi M, Akbarzadeh M. Effect of Melissa officinalis capsule on the mental health of female adolescents with premenstrual syndrome: a clinical trial study. Int J Adolesc Med Health. 2019;31(3).
  4. Culpeper N. 1. The Complete Herbal / To which is now added, upwards of one hundred additional herbs, with a display of their medicinal and occult qualities physically applied to the cure of all disorders incident to mankind: to which are now first annexed, the English physician enlarged, and key to Physic 2015 [cited 2021 2 October]. Available from: vbk://0-Te58-fYAjNVRmIPX6qdVTdOO-A207q469exMR50Yk.
  5. Haybar H, Javid AZ, Haghighizadeh MH, Valizadeh E, Mohaghegh SM, Mohammadzadeh A. The effects of Melissa officinalis supplementation on depression, anxiety, stress, and sleep disorder in patients with chronic stable angina. Clinical nutrition ESPEN. 2018;26:47-52.
  6. Lin S-H, Chou M-L, Chen W-C, Lai Y-S, Lu K-H, Hao C-W, et al. A medicinal herb, Melissa officinalis L. ameliorates depressive-like behavior of rats in the forced swimming test via regulating the serotonergic neurotransmitter. J Ethnopharmacol. 2015;175:266-72.
  7. Cases J, Ibarra A, Feuillère N, Roller M, Sukkar SG. Pilot trial of Melissa officinalis L. leaf extract in the treatment of volunteers suffering from mild-to-moderate anxiety disorders and sleep disturbances. Med J Nutrition Metab. 2011;4(3):211-8.
  8. Kennedy DO, Little W, Scholey AB. Attenuation of laboratory-induced stress in humans after acute administration of Melissa officinalis (Lemon Balm). Psychosom Med. 2004;66(4):607-13.
  9. Ghazizadeh J, Hamedeyazdan S, Torbati M, Farajdokht F, Fakhari A, Mahmoudi J, et al. Melissa officinalis L. hydro-alcoholic extract inhibits anxiety and depression through prevention of central oxidative stress and apoptosis. Exp Physiol. 2020;105(4):707-20.
  10. Shirazi M, Jalalian MN, Abed M, Ghaemi M. The Effectiveness of Melissa Officinalis L. versus Citalopram on Quality of Life of Menopausal Women with Sleep Disorder: A Randomized Double-Blind Clinical Trial. Revista Brasileira de Ginecologia e Obstetrícia. 2021;43:126-30.
  11. Emamghoreishi M, Talebianpour M. Antidepressant effect of Melissa officinalis in the forced swimming test. DARU Journal of Pharmaceutical Sciences. 2015;17(1):42-7.
  12. Araj-Khodaei M, Noorbala AA, Yarani R, Emadi F, Emaratkar E, Faghihzadeh S, et al. A double-blind, randomized pilot study for comparison of Melissa officinalis L. and Lavandula angustifolia Mill. with Fluoxetine for the treatment of depression. BMC Complement Med Ther. 2020;20(1):207-.
  13. Akbarzadeh M, Dehghani M, Moshfeghy Z, Emamghoreishi M, Tavakoli P, Zare N. Effect of Melissa officinalis Capsule on the Intensity of Premenstrual Syndrome Symptoms in High School Girl Students. Nurs Midwifery Stud. 2015;4:24-8.