Clinical Pharmacology of Citrus aurantium and Citrus sinensis for the Treatment of Anxiety

doi:10.1155/2018/3624094

Review

. 2018 Dec 2:2018:3624094.

doi: 10.1155/2018/3624094. eCollection 2018.

Clinical Pharmacology of Citrus aurantium and Citrus sinensis for the Treatment of Anxiety

Affiliations

¹ Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy.
² Anesthesia, Intensive Care and Pain Therapy, A.O.U. G. Martino Messina, University of Messina, Messina, Italy.
³ Hospital Pharmacy Service, Policlinico "G. Martino", University of Messina, Messina, Italy.
⁴ Hematology and Stem Cell Transplantation Unit, IRCCS Cancer Referral Center of Basilicata, Rionero in Vulture, Italy.
⁵ Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy.
⁶ School and Operative Unit of Allergy and Clinical Immunology, Policlinico "G. Martino", Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
⁷ Legal Medicine Section, Department for Health Promotion and Mother-Child Care, University of Palermo, Palermo, Italy.

PMID: 30622597
PMCID: PMC6304613
DOI: 10.1155/2018/3624094

Review

Clinical Pharmacology of Citrus aurantium and Citrus sinensis for the Treatment of Anxiety

Carmen Mannucci et al. Evid Based Complement Alternat Med. 2018.

. 2018 Dec 2:2018:3624094.

doi: 10.1155/2018/3624094. eCollection 2018.

Affiliations

¹ Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy.
² Anesthesia, Intensive Care and Pain Therapy, A.O.U. G. Martino Messina, University of Messina, Messina, Italy.
³ Hospital Pharmacy Service, Policlinico "G. Martino", University of Messina, Messina, Italy.
⁴ Hematology and Stem Cell Transplantation Unit, IRCCS Cancer Referral Center of Basilicata, Rionero in Vulture, Italy.
⁵ Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy.
⁶ School and Operative Unit of Allergy and Clinical Immunology, Policlinico "G. Martino", Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
⁷ Legal Medicine Section, Department for Health Promotion and Mother-Child Care, University of Palermo, Palermo, Italy.

PMID: 30622597
PMCID: PMC6304613
DOI: 10.1155/2018/3624094

Abstract

Objective: The aim of this review is to analyze preclinical and clinical studies investigating the anxiety effects of Citrus aurantium or Citrus sinensis essential oils (EOs).

Design: The bibliographic research was made on the major scientific databases. Analysis included only articles written in English and published on peer-reviewed scientific journals describing preclinical experiments and clinical trials carried out to investigate the antianxiety effects of Citrus aurantium or Citrus sinensis EOs on anxiety disorders. Clinical studies reporting the antianxiety effects of products containing Citrus aurantium or Citrus sinensis EOs in combination with other active substances, including medicinal plants, were excluded. Nine clinical studies fulfilled the criteria adopted for analysis.

Results: Data show that Citrus aurantium or Citrus sinensis EOs produce anxiolytic effects both in preclinical experiments and in different clinical conditions. Citrus aurantium EO aromatherapy reduced anxiety level in the great part of stress conditions studied (subjects affected by chronic myeloid leukemia and preoperative patients) except for a sample of patients subjected to colonoscopy. Exposition to Citrus sinensis EO in clinical studies shows to be positive in reducing anxiety level in patients waiting for dental treatment as well as in healthy volunteers submitted to an anxiogenic situation.

Conclusions: Overview of clinical trials conducted with Citrus aurantium or Citrus sinensis on people with anxiety showed that inhalation or oral administration of Citrus aurantium and inhalation of Citrus sinensis can exert beneficial effects on anxiety; however, because of incomplete accuracy in the reporting of methodology, further more complete clinical studies are warranted.

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Figures

**Figure 1**
PRISMA flowchart showing the process of literature search and studies selection.

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References

1. Nicolosi E., Deng Z. N., Gentile A., La Malfa S., Continella G., Tribulato E. Citrus phylogeny and genetic origin of important species as investigated by molecular markers. Theoretical and Applied Genetics. 2000;100(8):1155–1166. doi: 10.1007/s001220051419. - DOI
1. Horowitz R. M., Gentili B. Flavonoid constituents of Citrus. In: Nagy S., Shaw P. E., Vedhuis K., editors. Citrus Science and Technology. Westport, CT, USA: AVI Publishing; 1977. pp. 397–426.
1. Sommella E., Pagano F., Pepe G., et al. Flavonoid Composition of Tarocco (Citrus sinensis L. Osbeck) Clone “Lempso” and Fast Antioxidant Activity Screening by DPPH-UHPLC-PDA-IT-TOF. Phytochemical Analysis. 2017;28(6):521–528. doi: 10.1002/pca.2701. - DOI - PubMed
1. Calapai G., Firenzuoli F., Saitta A., et al. Antiobesity and cardiovascular toxic effects of Citrus aurantium extracts in the rat: A preliminary report. Fitoterapia. 1999;70(6):586–592. doi: 10.1016/S0367-326X(99)00093-3. - DOI
1. Prouillet C., Mazière J.-C., Mazière C., Wattel A., Brazier M., Kamel S. Stimulatory effect of naturally occurring flavonols quercetin and kaempferol on alkaline phosphatase activity in MG-63 human osteoblasts through ERK and estrogen receptor pathway. Biochemical Pharmacology. 2004;67(7):1307–1313. doi: 10.1016/j.bcp.2003.11.009. - DOI - PubMed

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[1] Nicolosi E., Deng Z. N., Gentile A., La Malfa S., Continella G., Tribulato E. Citrus phylogeny and genetic origin of important species as investigated by molecular markers. Theoretical and Applied Genetics. 2000;100(8):1155–1166. doi: 10.1007/s001220051419. - DOI

[2] Nicolosi E., Deng Z. N., Gentile A., La Malfa S., Continella G., Tribulato E. Citrus phylogeny and genetic origin of important species as investigated by molecular markers. Theoretical and Applied Genetics. 2000;100(8):1155–1166. doi: 10.1007/s001220051419. - DOI

[3] Horowitz R. M., Gentili B. Flavonoid constituents of Citrus. In: Nagy S., Shaw P. E., Vedhuis K., editors. Citrus Science and Technology. Westport, CT, USA: AVI Publishing; 1977. pp. 397–426.

[4] Horowitz R. M., Gentili B. Flavonoid constituents of Citrus. In: Nagy S., Shaw P. E., Vedhuis K., editors. Citrus Science and Technology. Westport, CT, USA: AVI Publishing; 1977. pp. 397–426.

[5] Sommella E., Pagano F., Pepe G., et al. Flavonoid Composition of Tarocco (Citrus sinensis L. Osbeck) Clone “Lempso” and Fast Antioxidant Activity Screening by DPPH-UHPLC-PDA-IT-TOF. Phytochemical Analysis. 2017;28(6):521–528. doi: 10.1002/pca.2701. - DOI - PubMed

[6] Sommella E., Pagano F., Pepe G., et al. Flavonoid Composition of Tarocco (Citrus sinensis L. Osbeck) Clone “Lempso” and Fast Antioxidant Activity Screening by DPPH-UHPLC-PDA-IT-TOF. Phytochemical Analysis. 2017;28(6):521–528. doi: 10.1002/pca.2701. - DOI - PubMed

[7] Calapai G., Firenzuoli F., Saitta A., et al. Antiobesity and cardiovascular toxic effects of Citrus aurantium extracts in the rat: A preliminary report. Fitoterapia. 1999;70(6):586–592. doi: 10.1016/S0367-326X(99)00093-3. - DOI

[8] Calapai G., Firenzuoli F., Saitta A., et al. Antiobesity and cardiovascular toxic effects of Citrus aurantium extracts in the rat: A preliminary report. Fitoterapia. 1999;70(6):586–592. doi: 10.1016/S0367-326X(99)00093-3. - DOI

[9] Prouillet C., Mazière J.-C., Mazière C., Wattel A., Brazier M., Kamel S. Stimulatory effect of naturally occurring flavonols quercetin and kaempferol on alkaline phosphatase activity in MG-63 human osteoblasts through ERK and estrogen receptor pathway. Biochemical Pharmacology. 2004;67(7):1307–1313. doi: 10.1016/j.bcp.2003.11.009. - DOI - PubMed

[10] Prouillet C., Mazière J.-C., Mazière C., Wattel A., Brazier M., Kamel S. Stimulatory effect of naturally occurring flavonols quercetin and kaempferol on alkaline phosphatase activity in MG-63 human osteoblasts through ERK and estrogen receptor pathway. Biochemical Pharmacology. 2004;67(7):1307–1313. doi: 10.1016/j.bcp.2003.11.009. - DOI - PubMed

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Clinical Pharmacology of Citrus aurantium and Citrus sinensis for the Treatment of Anxiety

Affiliations

Clinical Pharmacology of Citrus aurantium and Citrus sinensis for the Treatment of Anxiety

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