Passionflower (Passiflora incarnata, aerial parts)

Passionflower is used for mild nervous tension and transient anxiety. EMA HMPC in 2014 confirmed traditional-use status based on 30 years of European practice. The Miyasaka Cochrane review 2007 pooled 2 RCTs in GAD and preoperative anxiety – conclusion: data are too sparse to recommend passionflower as monotherapy for anxiety disorders. Several small comparator trials showed effect comparable to low-dose oxazepam in GAD, but methodology was weak and samples small. NICE CG113 (2019) does not mention passionflower. For episodic anxiety before dental procedures or public speaking a short course of 250–500 mg of extract is acceptable. If passionflower was offered for diagnosed anxiety disorder or panic attacks as a replacement for psychotherapy and SSRIs, consider seeking a second opinion.

Passionflower is positioned as a sleep aid, often combined with valerian and lemon balm. EMA HMPC recognises use for «transient sleep disturbance linked to nervous tension». Passionflower monotherapy RCTs in insomnia are few: one study with a 2 g/day infusion showed improvement in subjective sleep quality, but the sample was 41 people. The AASM 2021 guideline does not include passionflower. For mild episodic insomnia a short course is acceptable. For chronic insomnia the evidence base of CBT-I is substantially stronger.