Comparing the effects of saffron, lippia, and saffron-lippia combination on anxiety among candidates for coronary angiography

Document Type : Original Research Article

Authors

1 Faculty of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran

2 Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran

Abstract

Objective: Coronary artery disease (CAD) is among the most prevalent diseases in the world, and its severity is usually assessed through coronary angiography (CA). Anxiety is the most prevalent problem before angiography. The aim of this study was to evaluate Crocus sativus (saffron) and Lippia citriodora Kunth (lippia) extracts and saffron-lippia extract combination on anxiety among the candidates for CA.
Materials and Methods: This double-blind randomized placebo-controlled trial in four month was conducted on 120 angiography candidates in Valiasr hospital, Birjand, Iran. The random allocation was doing through block randomization to saffron, lippia, saffron-lippia, and placebo groups; four hours before angiography, participants in these groups respectively received a single dose of saffron extract capsule (40 mg), lippia extract capsule (40 mg), saffron-lippia extract capsule (20 mg saffron and 20 mg lippia), and lactulose capsule (40 mg). Participants’ anxiety was assessed before, thirty minutes after, and three hours after the intervention via Spielberger State-Trait Anxiety Inventory.
Results: The mean scores of state, trait, and total anxiety in the saffron group reduced significantly (p <0.05), while the mean scores in the other groups did not change significantly, except for the mean score of trait anxiety in the saffron-lippia group which decreased significantly (p=0.05). Therefore, after the intervention, the mean scores of state, trait, and total anxiety in the saffron group were significantly lower than the other groups (all, p <0.05).
Conclusion: This study suggests that the oral use of a single-dose of 40 mg saffron extract is effective in alleviating anxiety among the candidates for CA.

Keywords


Ai J, Dekermendjian K, Wang X, Nielsen M,
Witt M-R. 1997. 6-Methylflavone, a
benzodiazepine receptor ligand with
antagonistic properties on rat brain and
human recombinant GABAA receptors in
vitro. Drug development res, 41: 99-106.
Bakhtiari Z. 2010. Attitude of patients about
herbs in Isfahan. J Herbal Drug, 1: 47-50.
Bangratz M, Abdellah SA, Berlin A, Blondeau
C, Guilbot A, Dubourdeaux M, Lemoine P.
2018. A preliminary assessment of a
combination of rhodiola and saffron in the
management of mild–moderate depression.
Neuropsychiatric dis treatment, 14: 1821
Basiri-Moghadam M, Hamzei A, Moslem A-R,
Pasban-Noghabi S, Ghorbani N, Ghenaati J.
2016. Comparison of the anxiolytic effects
of saffron (Crocus sativus. L) and diazepam
before herniorrhaphy surgery: a double
blind randomized clinical trial. Zahedan J
Res Med, 18: e6248.
Bayani A. 2008. The relationship between the
religious orientation and anxiety and
depression of university students. J fund
mental health, 10: 209-214
Bostan HB, Mehri S, Hosseinzadeh H. 2017.
Toxicology effects of saffron and its
constituents: a review. Iran j basic med sci,
20: 110.
Dehghan-nayeri N, Adib-Hajbaghery M. 2011.
Effects of progressive relaxation on anxiety
and quality of life in female students: a nonrandomized controlled trial. Complement
therap med, 19: 194-200.
Edition HPoIMt. 2006. heart deseases. 148-
149.
Eidi M, Kavgani AI, Shahabzadeh S,
Sasaninezhad Z, Ghahramani R, Nomani
MH. 2014. Effect of Lippia Citriodora on
anxiety behaviour in adult male rats. Med J
Tabriz Uni Med Sciences Health Service,
36: 68-73.
Etemad L, Oskouei Shirvan Z, VahdatiMashhadian N, Adel Moallem S, Zafari R,
Hosseinzadeh H. 2016. Acute, subacute, and
cell toxicity of the aqueous extract of Lippia
citriodora, Jundishapur J Nat Pharm, 11:
e32546.
Fukui H, Toyoshima K, Komaki R. 2011.
Psychological and neuroendocrinological
effects of odor of saffron (Crocus sativus).
Phytomedicine, 18: 726-730.
Hanifi N, Bahraminejad N, Mirzaei K, Ahmadi
F, Khani M, Taran L. 2012. The effect of
orientation program on stress, anxiety and
depression of patients undergoing coronary
angiography. Iran j nurs res, 7: 1-8.
Heikkilä J, Paunonen M, Laippala P, Virtanen
V. 1998. Nurses’ ability to perceive
patients’ fears related to coronary
arteriography. J adv nurs, 28: 1225-1235
Hoshyar R, Bathaie SZ, Kyani A, Mousavi MF.
2012. Is there any interaction between
telomeric DNA structures, G-quadruplex
and I-motif, with saffron active metabolites?
Nucleosides, Nucleotides and Nucleic
Acids, 31: 801-812
Hosseinzadeh H, Noraei NB. 2009. Anxiolytic
and hypnotic effect of Crocus sativus
aqueous extract and its constituents, crocin
and safranal, in mice. Phytother Res, 23:
768-774
Javadi B, Sahebkar A, Emami SA. 2013. A
survey on saffron in major Islamic
traditional medicine books. Iran j basic med
sci, 16: 1.
Khazdair MR, Boskabady MH, Hosseini M,
Rezaee R, Tsatsakis AM. 2015. The effects
of Crocus sativus (saffron) and its
constituents on nervous system: A review.
Avicenna j phytomed, 5: 376-391.
Saffron and lippia on anxiety in coronary angiography patients
AJP, Vol. 11, No. 5, Sep-Oct 2021 525
Kianbakht S. 2008. A systematic review on
pharmacology of saffron and its active
constituents. J Med Plant, 4: 1-27
Kianmehr M, Khazdair MR.2020. Possible
therapeutic effects of Crocus sativus stigma
and its petal flavonoid, kaempferol, on
respiratory disorders. Pharm Biol, 58: 1140-
1149.
Lewis SL, Bucher L, Heitkemper MM, Dirksen
SR. 2014. Clinical Companion to MedicalSurgical Nursing-E-Book. Elsevier Health
Sciences; 2014 Jun 25.
Liakopoulou-Kyriakides M, Kyriakidis D.
2002. Croscus sativus-biological active
constitutents. Studies Nat Prod Chem, 26:
293-312.
Mazidi M, Shemshian M, Mousavi SH,
Norouzy A, Kermani T, Moghiman T,
Sadeghi A, Mokhber N, Ghayour-Mobarhan
M, Ferns GA. 2016. A double-blind,
randomized and placebo-controlled trial of
Saffron (Crocus sativus L.) in the treatment
of anxiety and depression. J Complement
Integrat Med, 13: 195-199.
Moazen-Zadeh E, Abbasi SH, Safi-Aghdam H,
Shahmansouri N, Arjmandi-Beglar A,
Hajhosseinn Talasaz A, Salehiomran A,
Forghani S, Akhondzadeh S. 2018. Effects
of saffron on cognition, anxiety, and
depression in patients undergoing coronary
artery bypass grafting: a randomized
double-blind placebo-controlled trial. J
Alternat Complement Med, 24: 361-368.
Moeini M, Sadat Kahangi L, Valiani M,
Heshmat R. 2010. The effect of
reflexotherapy on patients' vital signs before
coronary artery bypass graft surgery. Iran J
Nurs Midwifery Res, 16: 8-12.
Mohammad Hassani MR, Farahani B, Zohour
AR. Panahi A. 2010. Self-care ability based
on Orem’s theory in individuals with
coronary artery disease. Iran J Crit Care
Nurs, 3: 87-91.
Mokhtari-Zaer A, Khazdair MR, Boskabady
MH. 2015. Smooth muscle relaxant activity
of Crocus sativus (saffron) and its
constituents: possible mechanisms.
Avicenna J Phytomed, 5: 365-375.
Moosavi SM, Ahmadi M, Amini M,
Vazirzadeh B. 2014. The Effects of 40 and
80 mg Hydro-alcoholic Extract of Crocus
Sativus in the Treatment of Mild to
Moderate Depression. J Mazandaran Univ
Med Sci, 24: 48-53.
Mortazavi Moghaddam SG, Kianmehr M,
Khazdair MR. 2020. The possible
therapeutic effects of some medicinal plants
for chronic cough in children. Evid-Based
Complement Alternat Med, 2020: 2149328.
Pascual M, Slowing K, Carretero E, Mata DS,
Villar A. 2001. Lippia: traditional uses,
chemistry and pharmacology: a review. J
ethnopharmacol, 76: 201-214.
Pitsikas N, Boultadakis A, Georgiadou G,
Tarantilis P, Sakellaridis N.2008. Effects of
the active constituents of Crocus sativus L.,
crocins, in an animal model of anxiety.
Phytomedicine, 15: 1135-1139.
Ragone MI, Sella M, Pastore A, Consolini AE.
2010. Sedative and cardiovascular effects of
Aloysia citriodora Palau, on mice and rats.
Latin Am J Pharm, 29: 79-86.
Razavi BM, Zargarani N, Hosseinzadeh H.
2017. Anti-anxiety and hypnotic effects of
ethanolic and aqueous extracts of Lippia
citriodora leaves and verbascoside in mice.
Avicenna J Phytomed, 7: 353-365.
Sadephy M. 2007. The relation complications
post coronary artery graft with long time
intubation. In 15th National congress on
cardiovascular update. Tehran: Razi
conferences Hall.
Shahhoseini R, Ghorbani H, Saleh R,
Omidbaigi R. 2011. Identification of
essential oil content and composition of
Lippia citriodora seed. J Agric Sci Nat
Resourc, 18: 91-96.
Shahmansouri N, Farokhnia M, Abbasi S-H,
Kassaian SE, Tafti A-AN, Gougol A,
Yekehtaz H, Forghani S, Mahmoodian M,
Saroukhani S. 2014. A randomized, doubleblind, clinical trial comparing the efficacy
and safety of Crocus sativus L. with
fluoxetine for improving mild to moderate
depression in post percutaneous coronary
intervention patients. J Affective disorders,
155: 216-222
Shamsizadeh M. 2013. The effect of orientation
tour with angiography procedure on anxiety
and satisfaction of patients undergoing
coronary angiography. Iran J Psychiatric
Nursing, 1: 1-10.
Tahmasbi H, Mahmoodi G, Mokhberi V,
Hassani S, Akbarzadeh H, Rahnamai N.
2012. The impact of aromatherapy on the
anxiety of patients experiencing coronary
angiography. Zahedan J Res Med Sci, 14:
51-55.
Soheilipur et al.
AJP, Vol. 11, No. 5, Sep-Oct 2021 526
World Health Organization. 1978. The
promotion and development of traditional
medicine: report of a WHO meeting [held in
Geneva from 28 November to 2 December
1977]. World Health Organization.