Bach Rescue Remedy and anxiety

On January 15th yet another superficial article All About Bach Rescue Remedy was posted. It is a trademarked combination of five flower remedies (or essences). Rescue Remedy has been recommended as being useful for reducing anxiety, including anxiety about public speaking or taking exams. The article contains a paragraph headlined: Scientific Support for Rescue Remedy which includes the following statement:

“….However, in 2007, a study by the University of Miami Nursing School in conjunction with The Sirkin Creative Living Center declared that Rescue Remedy ‘is an effective over-the-counter stress reliever with an effect similar to that of traditional pharmaceutical drugs.’ The study added that, unlike traditional stress medications, Rescue Remedy had no adverse side effects and was not addictive.”

The link provided about the University of Miami study just was to a re-issued press release from the US subsidiary of Nelsons (who make Rescue Remedy). You can also read the press release here.

The press release is more positive than the 2007 magazine article describing the details of the study. If you go to the Sirkin web site you can find the full text for Healing With Bach Flower Essences: Testing a Complementary Therapy as an Acrobat file.

As shown above in the diagram, they looked at a sample of 111 nursing students, and compared the effect of a placebo (58 students) with Rescue Remedy (53 students). They did not find a statistically significant difference in test anxiety after receiving the placebo or the remedy.

Then they split the sample into three subgroups based on their state of anxiety before the students received either the placebo or the remedy. When they analyzed the differences for the subgroups, as shown below in the diagram, they did find a statistically significant difference for the subgroup with high anxiety (but not for either low or medium anxiety). The abstract of the article concludes with this statement (my capitalization):

“The results SUGGEST that BFE Rescue Remedy MAY be effective in reducing HIGH levels of situational anxiety.”
















If you look for an independent review of Bach Flower Remedies on the web sites of some medical centers, you will find an article from Ebsco here, here, and here. Their discussion of the data analysis in the 2007 article says:

“However, after the study was concluded, researchers then explored the data, and found a relative benefit in one subgroup of participants. This may appear to support the use of Rescue Remedy. However, such ‘post-hoc’ statistical analyses are notoriously unreliable: based on the laws of chance alone, it is almost always possible to find some subgroup that showed benefit in a study. The process of doing this is called ‘data dredging,’ or sometimes, ‘going on a treasure hunt.’ Such investigatory analyses of data can provide fodder for future studies, but they make no positive statement about the results of a study already conducted.”

Read the original magazine article, and then make up your own mind. Don’t just get your information from a press release.

Flower remedies or essences for anxiety?

Many people are aware that preparation and practice are the best ways to reduce anxiety about public speaking. Some instead look to complementary and alternative medicine for a quick fix.

One therapy that has been recommended is the Bach flower remedies(or essences). More specifically, a trademarked combination of five flower essences, called Rescue Remedy, often has been described as being good for reducing anxiety about tasks like public speaking and taking exams.

Is there any solid evidence, like double-blind clinical trials, which shows that flower remedies actually are effective for reducing anxiety? (In a clinical trial the experimental treatment is compared with an inert placebo to see if there is a statistically significant difference in the results.)

Last year Thaler et al published an article in BMC Complementary and Alternative Medicine which discussed Bach Flower Remedies for psychological problems and pain: a systematic review. Thaler et al review three clinical trials of flower remedies for anxiety by students about taking examinations (test anxiety). There were two trials done in 2001. One used a five-flower remedy, and the other used a ten-flower combination. There was another trial done in 2007 which used the trademarked Rescue Remedy. You can read a summary in Table 3 of their article. No statistically significant difference was found in any of these studies. Based on these results Thaler et al concluded that there was no evidence that flower remedies were effective.

In 2004 Jorm et al published a broader review in the Medical Journal of Australia which discussed the Effectiveness of Complementary and Self-Help Treatments for Anxiety Disorders. They also reviewed the two trials of Bach flower remedies done in 2001, and concluded there was no evidence that flower remedies were effective.

Read these two serious review articles, and then make up your own mind about flower remedies or essences.

Does homeopathic Argentum nitricum reduce anxiety?

Back on November 17th Madeline Innocent (who is a natural health consultant in Perth, Australia) wrote briefly at Ezine Articles about Overcoming Your Fear of Public Speaking with Ease. She claimed that:

“The homeopathic medicine Argentum nitricum, Arg nit for short, is a wonderful medicine to allay anticipation anxiety.”

That same day she also posted three other articles praising that homeopathic medicine: Anticipation Anxiety Treatment in One Easy Step, Performance Anxiety Can Be a Help or a Hindrance, and Holistic Anxiety Treatment is Most Likely to Be Permanent.

There are lots of other articles which recommend homeopathic Argentum nitricum. For example, R. Oliva’s eHow article on Homeopathic Treatment of Anxiety says that:

“Argentum nitricum is most effective when used before a big event such as an important test or a public speaking event.”

What is Argentum nitricum? It just is fancy terminology for a tiny bit of silver nitrate dissolved in a whole lot of water. Does it really work for reducing anxiety?

In 2006 Karen Pilkington and her colleagues published a long article (in Homeopathy magazine) called Homeopathy for Anxiety and Anxiety Disorders: A Systematic Review of the Research. You can read the abstract and conclusion here at PubMed. They found no clear and compelling evidence that homeopathy was effective for treating anxiety.

In the article they mention that there were two clinical trials for Argentum nitricum on test anxiety, which is one important type of anticipation anxiety. The first one, done in 1982 by Stanton, found that it helped reduce test anxiety. A second one in 2003 by Don Baker et al attempted to replicate the first one, but found no effect compared with an inert placebo. By the way, that 2003 article reported on work done in Australia! You can read the abstract here at PubMed. Both studies used a concentration of 12X. That means one part per trillion, which is equivalent to 1 drop of water diluted into 20, two-meter-deep Olympic-size swimming pools (50,000 cubic meters), or one second of time in approximately 31,700 years.

What about results from university theses? There was yet another study on Argentum nitricum for test anxiety done in 2005. Christinette Snyman’s Masters of Technology (M Tech) thesis at the University of Johannesburg also found no effect when using a lower concentration (or higher potency) of 200CH. However, an M Tech thesis in 2000 by Gabrielle Traub found that a combination of Kalium Phosphoricum, Argentum Nitricum and Gelsemium at 200CH reduced anxiety. Another M Tech thesis in 2002 by Rowena Emmeline Kathyrn Thomson did not find an effect on anxiety for a combination. An M Tech thesis in 2002 by Karin Pelser also found no effect for Gelsemium sempervirens at 200 CH. Traub has mentioned her thesis results in an interview here. The other subsequent results also are interest.

So, I think you should take any claims about the effectiveness of homeopathy against anxiety with a grain of salt (or in their terminology, many truckloads of Natrum muriaticum). You should do your own research, read the literature, and make up your own mind.

Also, as I mentioned in a previous post, homeopathic tablets often incorporate lactose (which can be a problem for some of us).

Update: On December 19, 2009 the first article I mentioned by Madeline Innocent reappeared on another web page titled Cure Your Hemorrhoids.

More adolescents and young adults feared tests than feared public speaking

Do adolescents and young adults have different social fears than adults? They do. A decade ago the results of a survey of 3021 young people in Munich, Germany (ages 14 to 24) were reported. You can read the abstract here. The bar chart below shows the six specific social fears reported in Table 2. Performance situations/tests topped the list at 18.2%, while public speaking came in second at 13.2%. For that age range test anxiety is a big problem that affects about 1 in 5 people.