Herbal medications extracts

Herbal remedies hold a different place in medical practice in many European countries than in the United States. One of the most dramatic examples of the difference is in the treatment of benign prostate disease. This very common condition affects about 25 percent of men in their forties and nearly 80 percent of men who are over 70. In Germany, several hundred million dollars are spent annually on prostate remedies, with 80 percent of that spent on herbal medications. Herbal medications dominate the market for treating nonmalignant prostate disease. They have very few side effects and cost per dose approximately 20 to 35 percent of what synthetic drugs do. Treatment with herbal preparations typically costs under a dollar a day. Four of the most popular in Germany are extracts from the fruit of the saw palmetto, pumpkin seeds, rye pollen extract, and nettle root. 

Rohdewald, P. A review of the French maritime pine bark extract (Pycnogenol), a herbal medication with a diverse clinical pharmacology. Int. J. Clin. Pharmacol. Ther. 2002, 40 (4), 158-168. 

Powdered fresh or dried stem bark or seeds is extracted with water by decoction or by maceration Herbal Medical Practitioners... 

The fresh leaves are cut into pieces and aqueous decoction obtained. Used alone or in combination with other herbs by Herbal Medical Practitioners The fresh or dried seeds are ground to coarse powder and extracted with alcoholic beverages by maceration... 

Pharmaceuticals are a 40-billion-a-year enterprise in the United States with an additional 7 billion spent on over-the-counter drugs (Goode, 1992b). The use of herbal medication has also increased with an estimated 2 billion in preparations, extracts, and teas (Brevoort, 1997). It is estimated that three out of every four doctor s visits result in prescriptions and that approximately 2.8 billion prescriptions were written in 1999 alone (Friebert Greeley, 1999). This in turn relates to the power of the pharmaceutical company in setting prescription prices. As some clients are able to purchase their own prescription medications for a lower price at a veterinarian office rather than at a pharmacy because the pharmaceutical companies charge less if the same medication is for animals as opposed to people (Foumeir, 2000). 

Due to their complex composition the pharmacokinetic assessment of herbal medications generally imposes serious technical and regulatory problems. As the active principle(s) of plant extracts are often not known it is difficult to decide which constituent(s) should actually be studied [218]. In the absence of a well defined therapeutically relevant chemical entity, characteristic constituents of herbal preparations are frequently employed for the purpose of standardization. Correspondingly, pharmacokinetic evaluations of Hypericum extracts have almost exclusively been based on the analysis of the naphthodianthrones hypericin 1 and pseudohypericin 2 which represent typical products of members of the genus Hypericum and are considered to be involved in some of their clinical effects. 

We have developed a system based on SNOW-MED to extract medical information from herbal texts. SNOW-MED is a semantic index that recognizes relationships between groups of words [26], For example, the semantic map for thrush is related to yeast, infection, and microbe. Although this system may eventually allow a potential pharmacological function to be extrapolated, we are currently using the system to simply extract disorders from the text. We have used the Mayo Vocabulary Server to perform this data mining [34, 35]. 

Antihistamines such as diphenhydramine are known for their sedating properties and are frequently used over-the-counter medications (usual doses 25-50 mg) for difficulty sleeping. Diphenhydramine is approved by the FDA for the treatment of insomnia and can be effective at reducing sleep latency and increasing sleep time.43 However, diphenhydramine produces undesirable anticholinergic effects and carryover sedation that limit its use. As with TCAs and BZDRAs, diphenhydramine should be used with caution in the elderly. Valerian root is an herbal sleep remedy that has inconsistent effects on sleep but may reduce sleep latency and efficiency at commonly used doses of 400 to 900 mg valerian extract. Ramelteon, a new melatonin receptor agonist, is indicated for insomnia characterized by difficulty with sleep onset. The recommended dose is 8 mg at bedtime. Ramelteon is not a controlled substance and thus may be a viable option for patients with a history of substance abuse. 

Over the last decade, there has been a steady increase in the popularity and usage of natural products to enhance overall health. These nutraceuticals and functional foods modulate the function of various physiological systems including the immune system. By altering immunity, it is possible to augment an individual s ability to ward off infection, or suppress autoimmunity and chronic inflammatory diseases. Thus, the renaissance of herbal extracts as well as the increased consumption of other dietary components has afforded the public a relatively inexpensive way to self-medicate. 

Because of the interest in and popularity of alternative and complementary medicines and healing practices, the scientific method is being applied to a wide variety of these remedies. Different types of studies seek to establish if and how individual, alternative medicines exert their effect. Clinical trials are being conducted to compare a specific alternative medicines with the accepted conventional medical standard of care for a specific condition thus, for example, an herbal extract may be compared with a pharmaceutical-grade drug to demonstrate unequivocally the safety and effectiveness of a product or practice. However, complementary and alternative medicine has only recently been deemed worthy of scientific scrutiny (for decades many natural remedies and practices were dismissed outright as being obviously inferior to Western science-based medicine), and many alternative therapies have not yet been... 

This herbal product has the most data available to support its usefulness as an antidepressant. Nevertheless, only minimal information is available about its pharmacology and its relative risk-benefit ratio. At least seven different biologically active chemicals have been isolated from crude extracts of hypericum. Several are ubiquitous in the plant kingdom. The exceptions are hypericin and pseudohypericin, which have been assumed to be responsible for any antidepressant activity of this product. Nevertheless, there is the potential for one or more of these seven compounds and their metabolites to mediate desired or undesired effects, particularly when used in combination with other medications (i.e., herb-drug interactions). 

A recent survey demonstrated that one third of men choosing nonsurgical therapy for benign prostatic hyperplasia were using herbal preparations alone or in combination with prescription medications. There is emerging evidence that several plant extracts are well tolerated and provide at least short-term improvement in urologic symptoms and flow. 

This book summarizes current knowledge of the molecular basis of our interaction with plant defensive components that represents a major aspect of our dance with nature. However, knowledge must be used responsibly and has intrinsic dangers as illustrated in the ancient Greek myth of Pandora s box and as more recently explored in The Magic Mountain by Thomas Mann. Herbal medicine still represents a major therapeutic resort for a large part of humanity but the potential for deleterious effects of plant bioactive compounds means that expert medical advice should be sought before use of herbal extracts for medical conditions. 

A 78-year-old man and an 84-year-old woman with previously well-controlled epilepsy presented with recurrent seizures (4). There were no obvious reasons for these events, and the investigator suspected self-medication with G. biloba extracts. Both patients had started taking G. biloba within 2 weeks of the start of the seizures. The herbal remedy was withdrawn and both patients remained seizure-free several months later. No other change of medication was made. 

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