Passion Flower(Passiflora incarnata L.)

Passion Flower(Passiflora incarnata L.)

Background

The dried aerial parts of Passiflora incarnata have historically been used as a sedative and hypnotic (for insomnia), and for "nervous" gastrointestinal complaints. However, there is no clear controlled clinical evidence supporting any therapeutic use in humans. Pre-clinical studies provide preliminary support for a benzodiazepine-like calming action.

Evidence for significant adverse effects is equally inconclusive, and is complicated by the variety of poorly classified, potentially active constituents in different Passiflora species.

Passion fruit ( P. edulis Sims ), a related species, is used as a food flavoring.

Synonyms

Apricot vine, banana passion fruit ( P. mollissima ), Calmanervin (combination product), Compoz (combination product), corona de cristo, EUP, Euphytose (combination product), Fleischfarbige, fleur de la passion, flor de passion, granadilla, grenadille, Jamaican honeysuckle ( P. laurifolia ), madre selva, maypops, Naturest, passiflora, passionflower, passion vine, Passionsblume, purple passion flower, Sedacalm, water lemon, wild passion flower.

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidenceGrade*Sedation (agitation, anxiety, insomnia)
Passion flower has a long history of use for symptoms of restlessness, anxiety, or agitation. There is preliminary evidence in support of these uses from animal research and from poor-quality human studies. Better research is needed before a firm conclusion can be drawn.

C

Congestive heart failure
An extract containing passionflower and hawthorn has been studied in people with congestive heart failure for the treatment of shortness of breath and difficulty exercising. People using this combination of herbs have experienced improvements in these symptoms. However, any positive effects may have resulted from hawthorn, which is more commonly used for congestive heart failure. High quality human research of passion flower alone and compared to prescription drugs used for this condition is needed before a recommendation can be made.

C

* Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).

Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Alcohol withdrawal, anti-seizure, anti-spasm, aphrodisiac, asthma, anti-bacterial, attention deficit hyperactivity disorder (ADHD), burns (skin), cancer, chronic pain, cough, drug addiction, Epstein- Barr virus, hemorrhoids, high blood pressure, insomnia, nerve pain, pain (general), menopausal symptoms (hot flashes), gastrointestinal discomfort ("nervous stomach"), tension, wrinkle prevention.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Standardization

Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients. While there is no widely accepted standardization for passion flower, the flavonoid components have been used for standardization in some commercial products.

Adults (18 years and older)

General : Safety and effectiveness have not been established for any dose. There are no standard or well-studied doses of passion flower. Different preparations and doses have been used traditionally.

Dried herb : 0.5 to 2 grams taken 3 to 4 times daily by mouth has been used.

Tincture (1:8) : 1 to 4 milliliters taken 3 to 4 times daily by mouth has been used.

Tea : Tea made from 4 to 8 grams of dried herb, taken daily has been used.

Infusion : 2.5 grams has been used 3 to 4 times daily.

Children (younger than 18 years)

There is not enough scientific data to recommend passion flower for use in children at any dose.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Hypersensitivity reaction with urticaria (hives) and skin blood vessel inflammation (vasculitis), as well as occupational asthma with runny nose, have been reported with the use of passion flower products.

Side Effects and Warnings

Passion flower is generally considered to be a safe herb, with few reported serious adverse events. In cases of side effects, the products being used have rarely been tested for contamination (which may have been the cause). There is a report of children in Costa Rica who died from eating passiflora fruit ( P. adenopoda ) due to cyanide poisoning, derived from a substance (cyanogenic B-glycoside) in the fruit. However, in other studies, these substances (cyanogenic alkaloids) have not been found in passiflora fruit.

Rapid heart rate and rhythm, nausea, and vomiting have been reported. Side effects may also include drowsiness/sedation and mental slowing. Use caution if you are driving or operating heavy machinery.

Passion flower may theoretically increase the risk of bleeding and alter blood tests that measure blood clotting (international normalized ratio or "INR").

There is a case report of liver failure and death of a patient taking a preparation of passion flower with kava. Patients should use caution with any kava-containing products, as kava has been associated with liver damage. The cause of the liver damage is less likely related to the presence of passion flower.

Pregnancy and Breastfeeding

There is not enough scientific evidence to recommend the safe use of passion flower in any dose during pregnancy or breastfeeding. During the 1930s, animal studies found uterine stimulant action in components of Passiflora .

Many tinctures contain high levels of alcohol, and should be avoided during pregnancy.

References

1. Bilia AR, Bergonzi MC, Gallori S, et al. Stability of the constituents of Calendula, milk-thistle and passionflower tinctures by LC-DAD and LC-MS. J Pharm Biomed Anal 2002;30(3):613-624.

2. Bourin M, Bougerol T, Guitton B, et al. A combination of plant extracts in the treatment of outpatients with adjustment disorder with anxious mood: controlled study versus placebo. Fundam Clin Pharmacol 1997;11(2):127-132.

3. Capasso A, Pinto A. Experimental investigations of the synergistic-sedative effect of and kava. Acta Therapeutica 1995;21:127-140.

4. Carlini EA. Plants and the central nervous system. Pharmacol Biochem Behav 2003;75(3):501-512.

5. Dattilio L, Suddaby B. Ventricular tachycardia in a neonate. Pediatr Nurs 2002;28(6):612-613.

6. de Melo NF, Guerra M. Variability of the 5S and 45S rDNA sites in Passiflora L. species with distinct base chromosome numbers. Ann Bot (Lond) 2003;92(2):309-316.

7. Dhawan K, Kumar S, Sharma A. Antiasthmatic activity of the methanol extract of leaves of Passiflora incarnata. Phytother Res 2003;17(7):821-822.

8. Dhawan K, Dhawan S, Chhabra S. Attenuation of benzodiazepine dependence in mice by a tri-substituted benzoflavone moiety of Passiflora incarnata Linneaus: a non-habit forming anxiolytic. J Pharm Pharm Sci 2003;6(2):215-222.

9. Dhawan K, Kumar S, Sharma A. Aphrodisiac activity of methanol extract of leaves of Passiflora incarnata Linn in mice. Phytother Res 2003;17(4):401-403.

10. Dhawan K, Sharma A. Antitussive activity of the methanol extract of Passiflora incarnata leaves. Fitoterapia 2002;73(5):397-399.

11. Dhawan K, Kumar S, Sharma A. Suppression of alcohol-cessation-oriented hyper-anxiety by the benzoflavone moiety of Passiflora incarnata Linneaus in mice. J Ethnopharmacol 2002;81(2):239-244.

12. Dhawan K, Kumar S, Sharma A. Comparative anxiolytic activity profile of various preparations of Passiflora incarnata linneaus: a comment on medicinal plants' standardization. J Altern Complement Med 2002;8(3):283-291.

13. Dhawan K, Kumar S, Sharma A. Reversal of cannabinoids (delta9-THC) by the benzoflavone moiety from methanol extract of Passiflora incarnata Linneaus in mice: a possible therapy for cannabinoid addiction. J Pharm Pharmacol 2002;54(6):875-881.

14. Giavina-Bianchi PF Jr., Castro FF, Machado ML, et al. Occupational respiratory allergic disease induced by and . Ann Allergy Asthma Immunol 1997;79(5):449-454.

15. Gow PJ, Connelly NJ, Hill RL, et al. Fatal fulminant hepatic failure induced by a natural therapy containing kava. Med J Aust. 2003 May 5;178(9):442-3. Comment in: Med J Aust 2003;178(9):421-422.

16. Kapadia GJ, Azuine MA, Tokuda H, et al. Inhibitory effect of herbal remedies on 12-o-tetradecanoylphorbol-13-acetate-promoted Epstein--Barr virus early antigen activation. Pharmacol Res 2002;45(3):213-220.

17. Krenn L. Passion Flower (Passiflora incarnata L.)--a reliable herbal sedative [Article in German]. Wien Med Wochenschr 2002;152 (15-16) :404-406.

18. Marchart E, Krenn L, Kopp B. Quantification of the flavonoid glycosides in Passiflora incarnata by capillary electrophoresis. Planta Med 2003;69(5):452-456.

19. Puricelli L, Dell'Aica I, Sartor L, et al. Preliminary evaluation of inhibition of matrix-metalloprotease MMP-2 and MMP-9 by Passiflora edulis and P foetida aqueous extracts. Fitoterapia 2003;74(3):302-304.

20. Seigler DS, Pauli GF, Nahrstedt A, et al. Cyanogenic allosides and glucosides from Passiflora edulis and Carica papaya. Phytochemistry 2002;60(8):873-882.

21. Smith GW, Chalmers TM, Nuki G. Vasculitis associated with herbal preparation containing extract. Br J Rheumatol 1993;32(1):87-88.

22. Speroni E, Minghetti A. Neuropharmacological activity of extracts from . Planta Med 1988;54(6):488-491.

23. Talcott ST, Percival SS, Pittet-Moore J, et al. Phytochemical composition and antioxidant stability of fortified yellow passion fruit (Passiflora edulis). J Agric Food Chem 2003;51(4):935-941.

24. Von Eiff M, Brunner H, Haegeli A, et al. Hawthorn/passion flower extract and improvement in physical exercise capacity of patients with dyspnoea class II of the NYHA functional classifications. Acta Therapeutica 1994;20:47-66.

January 01, 2004