Rhodiola Rosea (Roseroot) for Generalized Anxiety, Depression, and Fatigue
Second of Two Reviews
Note: In this article, the data from part 1 on Rhodiola will be reviewed and additional data considered.
By Dónal P. O'Mathúna, PhD. Dr. O'Mathúna is Senior Lecturer in Ethics, Decision-Making & Evidence, School of Nursing, Dublin City University, Ireland; he reports no financial relationships relevant to this field of study.
Rhodiola is a herbal remedy becoming increasingly popular to improve mood, relieve generalized anxiety and depression, and help people feel more energetic. The herb is particularly popular in northern Europe and Russia where it has a long history of traditional use.1 Rhodiola is made from the roots of Rhodiola rosea, also called roseroot, Arctic root, or Siberian Golden Root. Note that "golden root" is the common name for a number of herbal remedies from unrelated plants. Also, several Rhodiola species are being evaluated for their therapeutic potential.2 Given the various names used, Rhodiola rosea will be referred to as roseroot in this article.
The roseroot plant is native to cold, mountainous regions of Europe and Asia, including Siberia and the Alps.3 The hardy plant has a reputation for helping people to cope with life in such difficult environments. Among herbalists, it is known as an adaptogen, as is ginseng. This is a term used to describe a herb that helps people adapt to the stresses of life.4 Marketing often claims that roseroot is frequently used by Russian athletes and cosmonauts. One website claims it will bring "an inner oasis of peace and energy in our hurly-burly world." Such a pill would be attractive in our increasingly stressful worlds.
Mechanism of Action
Extracts of roseroot contain around 30 chemical constituents which have been shown to be biologically active.5 Several of these compounds have antioxidant activity, which may play a role in the herb's mechanism of action.6 The active ingredients most commonly used to standardize roseroot extracts are rosavin and salidroside. Their mechanism of action is unknown.
Most attention has focused on the claim that roseroot acts as an adaptogen. Such a classification requires that a herb satisfy three criteria: an adaptogen produces a non-specific response in an organism to physical, chemical, or biological stressors; normalizes the physiological changes due to stressors, irrespective of the direction of change caused by the stressor; and is incapable of influencing the body's normal functions more than required to gain non-specific resistance.5
How an adaptogen can elicit such various effects is unclear and controversial. Somehow adaptogens are believed to cause biochemical changes that allow the body to adapt better to the changes caused by stressors. In the case of roseroot, specific active ingredients influence the levels of monoamines and beta-endorphins.7 However, a precise mechanism of action remains unknown at this time.
Clinical Studies
Several in vitro studies have shown that roseroot influences the levels of various hormones and neurotransmitters.5 Some animal studies have found that roseroot can affect behavior under stressful situations, but the findings have not been consistent.6 Moreover, most of these studies were conducted in Russia and are not available in English.5 Replications are beginning to appear in English-language journals.3
How roseroot might affect people experiencing stressful circumstances has been examined in a small number of clinical trials. Forty male medical students studying in Russia were assessed during their examination period.8 The researchers used a standardized roseroot extract called SHR-5 made by the Swedish Herbal Institute. Participants were randomized to placebo or 100 mg extract/d for 20 days before and during their exams. Physical and mental performance was assessed before and after administration with a number of objective and subjective tools. Those taking roseroot had significantly better scores on physical fitness, mental fatigue, and a motor skills test (p < 0.01), but no significant differences were found in several other tests.
A group of 56 young, healthy physicians (male and female) participated in a randomized controlled trial examining fatigue while on night duty.9 Five cognitive tests were used to give an overall Fatigue Index. Participants were randomized to receive either placebo or 170 mg SHR-5 extract/d for 2 weeks of night duty. This was followed by a 2-week wash-out period and then another 2-week test period where participants crossed over to the other group. Scores on the Fatigue Index were significantly better in the roseroot group during the first test period, reverted to baseline during the wash-out period, but showed no differences during the second test period.
Russian military cadets on night duty were recruited for a study of the effects of roseroot on fatigue.1 The 121 male cadets (aged 19-21 years) were randomly assigned to one of four groups: 370 mg SHR-5/d, 555 mg SHR-5/d, placebo, or no treatment. Several tests were used to derive an overall antifatigue index which indicated the quality and quantity of mental work performed. The two groups receiving roseroot had significantly less fatigue and higher quality mental work than the two control groups (p < 0.001). The scores did not differ significantly between the two dosage groups.
A complex study examined the effect of roseroot on healthy, physically active college students.7 One part examined the acute effect of one dose on exercise endurance and found significant improvements for those taking roseroot. The part of more direct relevance here examined the impact of roseroot on aural and visual reaction times, mental alertness, and sustained attention. Twelve students were randomly assigned to receive placebo or 200 mg extract/d for 4 weeks. No significant differences were found between the groups.
A randomized controlled trial of roseroot was conducted over 6 weeks.4 Eighty-nine patients with mild to moderate depression were randomized to one of three groups to receive 340 mg SHR-5/d extract, 680 mg SHR-5/day, or placebo. The mean overall depression scores were reduced significantly with both roseroot doses (p < 0.0001), but not with placebo. Depressive symptoms were measured using the Beck Depression Inventory and the Hamilton Rating Scale for Depression questionnaires. In addition, all participants initially scored low on a self-esteem scale. These scores were unchanged on placebo or 340 mg roseroot, but improved significantly with 640 mg (p = 0.0002).
A pilot study similar to the above has recently been published.10 Ten patients with generalized anxiety disorder were given 340 mg roseroot extract daily for 10 weeks. Participants had significantly improved scores on the Hamilton Anxiety Rating Scale (p = 0.01).
An open-label study was conducted with 120 adults with physical and cognitive deficiencies.11 For twelve weeks, participants took either 2 capsules after breakfast or 1 capsule after breakfast and 1 after lunch. After 12 weeks taking roseroot, both groups demonstrated significant improvements in measures of physical fatigue and cognitive functioning (p < 0.001). Overall, the treatment was evaluated as "good" or "very good" by 81 percent of physicians and 80 percent of patients.
Adverse Effects
Traditional users of roseroot claim it is very safe. Most studies reported no adverse effects. At higher doses, irritability and insomnia are said to occur. One study found some instances of dizziness and dry mouth which were generally mild or moderate in severity.10 No information is available on drug interactions.
Formulation
Extracts of varying concentrations have been used in studies and are available on the market. The most commonly used standardized extracts have a minimum of 3 percent rosavin and 1 percent salidroside.3 For improving symptoms of fatigue and stress, a daily dose of 170-340 mg of the Swedish extract, SHR-5, is most commonly recommended.
Conclusion
Roseroot has a long history of use as an adaptogen in helping people cope with various stressful situations. A small number of studies have found that roseroot is associated with generalized psychological benefits for people under stress (athletes, students taking exams, nightshift workers). A larger body of research has been conducted in Eastern Europe, but is not readily available to assess. The studies that are available are limited in having few participants and lasting only a few weeks.
Recommendation
In the few studies carried out to date, roseroot has been generally safe. The evidence does point towards its potential to benefit people who have generalized psychological difficulties coping with stressful situations. However, there is currently insufficient evidence to clearly recommend the use of roseroot. The design of the available studies also contrasts with the traditional way that adaptogens are used. This involves taking the herb for several weeks prior to and during the stressful situation, and then discontinuing its use for a period.5 Given that symptoms are often reported after chronic exposure to stress, much more research is needed to establish whether roseroot has a place is combating the psychological symptoms of stress.
References
1. Shevtsov VA, et al. A randomized trial of two different doses of a SHR-5 Rhodiola rosea extract versus placebo and control of capacity for mental work. Phytomedicine. 2003;10:95-105.
2. Ming DS, et al. Bioactive compounds from Rhodiola rosea (Crassulaceae). Phytother Res. 2005;19:740-743.
3. Perfumi M, Mattioli L. Adaptogenic and central nervous system effects of single doses of 3% rosavin and 1% salidroside Rhodiola rosea L. extract in mice. Phytother Res. 2007;21:37-43.
4. Darbinyan V, et al. Clinical trial of Rhodiola rosea L. extract SHR-5 in the treatment of mild to moderate depression. Nord J Psychiatry. 2007;61:343-348.
5. Kelly GS. Rhodiola rosea: a possible plant adaptogen. Altern Med Rev. 2001;6:293-302.
6. Walker TB, Robergs RA. Does Rhodiola rosea possess ergogenic properties? Int J Sport Nutr Exerc Metab. 2006;16:305-315.
7. De Bock K, et al. Acute Rhodiola rosea intake can improve endurance exercise performance. Int J Sport Nutr Exerc Metab. 2004;14:298-307.
8. Spasov AA, et al. A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of Rhodiola rosea SHR-5 extract on the fatigue of students caused by stress during an examination period with a repeated low-dose regimen. Phytomedicine. 2000;7:85-89.
9. Darbinyan V, et al. Rhodiola rosea in stress induced fatiguea double blind cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty. Phytomedicine. 2000;7:365-371.
10. Bystritsky A, Kerwin L, et al. A pilot study of Rhodiola rosea (Rhodax®) for generalized anxiety disorder (GAD). J Altern Complement Med. 2008;14:175-180.
11. Fintelmann V, Gruenwald J. Efficacy and tolerability of a Rhodiola rosea extract in adults with physical and cognitive deficiencies. Adv Ther. 2007;24:929-939.
O’Mathuna D. Rhodiola Rosea (Roseroot) for Generalized Anxiety, Depression, and Fatigue. Alter Med Alert. 2008:11;73-75.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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