Panic Disorder and Hawthorn

The name "hawthorn" is derived from "hedgethorn," reflecting this spiny tree's use as a living fence in much of Europe. Besides protecting estates from trespassers, hawthorn has also been used medicinally since ancient times. Roman physicians used hawthorn as a heart drug in the first century AD, but most of the literature from that period focuses on its symbolic use for religious rites and political ceremonies.

Though hawthorn has mostly been studied for its ability to treat congestive heart failure, one study used it in combination with magnesium and California poppy, and found it to be helpful in treating general anxiety disorder, and perhaps then could be useful for treating panic disorder as well.

Read more details about Hawthorn.

Hawthorn has been shown to help treat anxiety in one small study that used a combination treatment of it plus California poppy and magnesium. Study participants all suffered from generalized anxiety disorder of mild-to-moderate intensity. The results indicated that the combination treatment was more effective than placebo. No significant side effects were seen. This particular combination therapy is currently used in France.⁴⁴

In an analysis that mathematically combined the results of 10 controlled trials involving 855 patients, hawthorn extract was found to be significantly better than placebo for improving exercise tolerance, decreasing shortness of breath and fatigue, and enhancing the physiologic function of an ailing heart in mild to moderate CHF.³

Again though, these studies were used to see if hawthorn as effective in treating GAD and heart conditions, so while we can make implications about its effectiveness for treating panic disorder, we cannot be sure of them.

Safety Issues

Hawthorn appears to be generally safe. Germany's Commission E lists no known risks, contraindications, or drug interactions with hawthorn, and mice and rats have been given very large doses without showing significant toxicity. ¹ In clinical trials, reported side effects were relatively rare and nonspecific, consisting primarily of mild dizziness, stomach upset, headache, and occasional allergic reactions (skin rash). ² Perhaps the biggest risk with hawthorn is that using it instead of conventional treatment might increase risk of death or other complications of CHF. In addition, it is not known whether hawthorn can be safely combined with other drugs that affect the heart. Therefore (to reiterate), do notself-treat CHF with hawthorn. A physician's supervision is essential.

Safety in young children, pregnant or nursing women, or those with severe liver, heart, or kidney disease has not been established.

Interactions You Should Know About

• If you are taking any medications that affect the heart: It is possible that taking hawthorn could cause problems. It is not clear whether one can safely combine hawthorn with other drugs that affect the heart.

1. Ammon HPT, Handel M. Crataegus, toxicology and pharmacology. Parts I, II and III [translated from German]. Planta Med. 1981;43:105-120, 209-239, 313-322.
2. Daniele C, Mazzanti G, Pittler MH, Ernst E. Adverse-event profile of Crataegus spp.: a systematic review. Drug Saf. 29(6):523-35.

3. Pittler MH, Guo R, Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane Database Syst Rev. (1):CD005312.

44. Hanus M, Lafon J, Mathieu M. Double-blind, randomised, placebo-controlled study to evaluate the efficacy and safety of a fixed combination containing two plant extracts ( Crataegus oxyacantha and Eschscholtzia californica) and magnesium in mild-to-moderate anxiety disorders. Curr Med Res Opin. 2004;20:63-71.