Remali Juwairiah, Aizat Wan Mohd
Department of Pathology, Hospital Pulau Pinang, Jalan Residensi, 10450, George Town, Pulau Pinang, Malaysia.
Institute of Systems Biology (INBIOSIS), Universiti Kebangsaan Malaysia (UKM), 43600, Bangi, Selangor, Malaysia.
Heliyon. 2024 Oct 5;10(20):e38986. doi: 10.1016/j.heliyon.2024.e38986. eCollection 2024 Oct 30.
Clinical depression is a serious public health issue that affects 4.7 % of the world's population and can lead to suicide tendencies. Although drug medications are available, only 60 % of the depressed patients respond positively to the treatments, while the rest experience side effects that resulted in the discontinuation of their medication. Thus, there is an urgent need for developing a new anti-depressant with a distinct mode of action and manageable side effects. One of the options is using medicinal plants or plant-based traditional medicine as alternative therapies for psychiatric disorders.
Therefore, the objective of this review was twofold; to identify and critically evaluate anti-depressant properties of medicinal plants or those incorporated in traditional medicine; and to discuss their possible mechanism of action as well as challenges and way forward for this alternative treatment approach.
Relevant research articles were retrieved from various databases, including Scopus, PubMed, and Web of Science, for the period from 2018 to 2020, and the search was updated in September 2024. The inclusion criterion was relevance to antidepressants, while the exclusion criteria included duplicates, lack of full-text availability, and non-English publications.
Through an extensive literature review, more than 40 medicinal plant species with antidepressant effects were identified, some of which are part of traditional medicine. The list of the said plant species included (DC.) J.F.Macbr., Sativus, Willd. sp., Willd., Delile, Linn., Benth, and Thunb. Anti-depressant mechanisms associated with those plants were further characterised based on their modes of action such as anti-oxidation system, anti-inflammation action, modulation of various neurotransmitters, neuroprotective effect, the regulation of hypothalamic-pituitary-adrenal (HPA) axis and anti-depressant mechanism. The challenges and future outlook of this alternative and complementary medicine are also explored and discussed.
This pool of identified plant species is hoped to offer health care professionals the best possible alternatives of anti-depressants from natural phytocompounds that are efficacious, safe and affordable for applications in future clinical settings.
临床抑郁症是一个严重的公共卫生问题，影响着全球4.7%的人口，并可能导致自杀倾向。尽管有药物可用，但只有60%的抑郁症患者对治疗有积极反应，其余患者会出现副作用，导致停药。因此，迫切需要开发一种具有独特作用方式和可控制副作用的新型抗抑郁药。选择之一是使用药用植物或基于植物的传统药物作为精神疾病的替代疗法。
因此，本综述的目的有两个；识别并批判性评估药用植物或传统药物中所含植物的抗抑郁特性；并讨论其可能的作用机制以及这种替代治疗方法面临的挑战和未来方向。
从包括Scopus、PubMed和Web of Science在内的各种数据库中检索2018年至2020年期间的相关研究文章，并于2024年9月更新搜索。纳入标准是与抗抑郁药相关，而排除标准包括重复、缺乏全文可用性和非英文出版物。
通过广泛的文献综述，确定了40多种具有抗抑郁作用的药用植物物种，其中一些是传统药物的一部分。上述植物物种列表包括（DC.）J.F.Macbr.、Sativus、Willd. sp.、Willd.、Delile、Linn.、Benth和Thunb。基于其作用方式，如抗氧化系统、抗炎作用、各种神经递质的调节、神经保护作用、下丘脑-垂体-肾上腺（HPA）轴的调节和抗抑郁机制，进一步表征了与这些植物相关的抗抑郁机制。还探讨和讨论了这种替代和补充医学面临的挑战和未来前景。
希望这组已识别的植物物种能为医疗保健专业人员提供来自天然植物化合物的最佳抗抑郁药替代方案，这些方案在未来临床环境中有效、安全且价格合理。
