Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Mesembrine is a naturally occurring alkaloid found primarily in the plant Sceletium tortuosum (commonly known as kanna), which has a long history of traditional use in South Africa for mood elevation and stress relief. Its use in the context of anxiety disorders is based on both traditional use and emerging scientific evidence. Mesembrine acts as a selective serotonin reuptake inhibitor (SSRI) and also inhibits phosphodiesterase 4 (PDE4), mechanisms that are relevant to the modulation of mood and anxiety. Preclinical studies have demonstrated that mesembrine and extracts of Sceletium tortuosum exhibit anxiolytic (anxiety-reducing) effects in animal models, likely due to their influence on serotonergic and possibly dopaminergic pathways. There are also a small number of human studies and case series indicating potential benefit for anxiety, though these studies are generally limited in size, duration, and methodological rigor. Systematic reviews have noted that while the pharmacological rationale is plausible and there is some preliminary clinical support, high-quality randomized controlled trials are lacking. In summary, while there is scientific rationale and some early evidence supporting the use of mesembrine-containing preparations for anxiety, current evidence is limited and not robust enough to recommend widespread clinical use. The evidence is stronger than pure tradition but falls short of well-validated pharmaceutical interventions.

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