Top 10 Evidence-Based Recommendations

Standardized lavender oil (Silexan) modulates serotonin/voltage-gated calcium channels and reduces sympathetic arousal—lowering both 'mind' and 'body' anxiety without sedation. ^{[1] [2]}

Multiple RCTs and pooled analyses show Silexan 160 mg/day reduces HAM-A by ~14 points and outperforms placebo; 80 mg works for subthreshold anxiety. Network/meta-analyses confirm benefits and SSRI-like effects with placebo-level side effects. ^{[1] [2] [3] [4]}

Acts on phosphatidyl-inositol second-messenger signaling, normalizing 5-HT pathways involved in panic circuitry. ^[5]

In a double-blind crossover, 18 g/day myo-inositol reduced weekly panic attacks more than 150 mg/day fluvoxamine during the first month; multiple small trials support benefit in panic/OCD-spectrum anxiety. ^[5]

Saffron's crocins/safranal modulate serotonin, BDNF, and anti-inflammatory pathways that link to anxious distress. ^{[12] [13]}

Meta-analyses and RCTs show saffron reduces anxiety scores (BAI) and performs similarly to SSRIs for depressive/anxious symptoms with fewer adverse events. ^{[10] [11] [12] [13]}

EPA resolves neuroinflammation and may upregulate BDNF and modulate HPA-axis tone—mechanisms tied to anxious hyperarousal. ^[9]

Dose–response meta-analysis of 23 RCTs: greatest anxiety reduction around 2 g/day; sub-2 g often ineffective. Safety comparable to placebo. ^[9]

Kavalactones positively modulate GABA-A and inhibit voltage-gated channels, reducing somatic tension and worry rapidly. ^[6]

Systematic review of RCTs shows higher responder rates vs placebo; best as short-term treatment. Hepatotoxicity is rare but documented, especially with non-root/solvent extracts or prolonged use. ^[6]

May dampen HPA-axis and enhance GABAergic signaling, lowering perceived stress and trait anxiety. ^{[7] [15]}

2022 meta-analysis of 12 RCTs shows significant anxiety reduction, but evidence certainty is low and heterogeneity high. Recent regulators report rare liver injury; use short-term and avoid if liver issues. ^{[7] [8] [16]}

Boosts alpha-wave activity and modulates glutamate/GABA to smooth arousal without impairment. ^[19]

Improves stress/anxiety in healthy adults; adjunctive trial in GAD did not beat placebo on HAM-A, so treat as symptom-relief, not a GAD monotherapy. ^{[18] [19]}

Apigenin and related flavonoids bind benzodiazepine sites on GABA-A receptors and reduce inflammatory signaling. ^[3]

In moderate–severe GAD, long-term chamomile reduced symptoms and maintained lower anxiety vs placebo; relapse reduction signal not definitive. Well tolerated; slight BP/weight benefits noted. ^[3]

Microbiome shifts modulate cytokines, vagal tone, cortisol, and GABA metabolites—nudging anxiety down. ^[20]

2023 meta-analysis of 29 RCTs: probiotics and synbiotics significantly reduced anxiety scores; effects are modest and strain-dependent. ^[20]

Magnesium modulates NMDA/GABA signaling and HPA-axis; brain-penetrant Mg-threonate may especially aid sleep and mood. ^{[23] [24]}

Direct anxiety RCTs are mixed, but Mg-threonate improves sleep/mood in RCTs and is brain-bioavailable per EFSA review; use as foundation for sleep-linked anxiety. ^{[21] [22] [23] [24]}