A retrospective study on Vitex agnus castus L. preperation

Abstract

A retrospective study on Vitex agnus castus L. preperationAim: To retrospectively evaluate short- and medium-term use of a preparation marketed in Turkey containingVitex agnus castus at ordinary doses for various gynecologic indications.Materials and methods: The study group consisted of women using VAC fruit extract preparation for at least3 months throughout a 1-year-period (n=215). Women prescribed non-steroidal anti-inflammatory drugs(NSAID) for dysmenorrhea during the same period served as controls (n=108). Demographic data andprimary diagnoses were retrieved from the files. Persistence of symptoms (present/absent) at week 6 and12 were classified. Chi-square and students t-test were used for comparisons.Results: There were no differences among groups considering demographic variables. At week 6, 83% ofwomen in the VAC group versus 80% of the controls had reported symptom regression (p=0.72). At week12, 87% of the VAC users stated resolution of symptoms, whereas this figure remained at 50% in the controlgroup (p=0.009). Mild and transient side effects (stomachache and headache) were recorded (3.6%).Conclusion: VAC treatment can induce symptomatic relief with an acceptable side effect profile in gynecologicpatients. Double-blind randomized clinical trials with a cross-over design are warranted to reveal whetherthis is a placebo effect or not

Keywords

• Dysmenorrhea
• gynecologic diseases
• Vitex agnus-castus

Vitex agnus castus L. preparatı ile retrospektif bir çalışma

Abstract

Amaç: Türkiye'de pazarlanan ve Vitex agnus castus (VAC) ekstresi içeren preparatın mutat dozlarda çeşitli jinekolojik endikasyonlar için kullanımının kısa-orta dönemde geriye dönük değerlendirilmesidir. Gereç ve Yöntem: Bir yıllık süre içinde tek bir merkezde en az 3 ay süre ile VAC meyve ekstresi içeren preparat kullanan kadınlar çalışma grubunu (n=215); aynı döneminde dismenore nedeniyle nonsteroidal anti-inflamatuvar ilaç (NSAİİ) reçete edilenler ise kontrol grubunu (n=108) oluşturdu. Dosyalardan demografik veriler ve birincil tanılar kaydedildi. Altıncı ve 12inci haftalarda şikayetlerin devam edip etmediği (var/yok olarak) gruplandırıldı. Karşılaştırmalarda ki-kare testi ve “student's t-test” kullanıldı. Bulgular: Gruplar arasında demografik değişkenler açısından fark yoktu. Tedavinin 6ıncı haftasında VAC grubundakilerin %83'ünde kontrollerin ise %80'inde şikayetlerinin gerilediği saptandı (p=0.72). On ikinci haftada ise VAC kullananların %87'si “şikayetlerinin geçtiğini” belirtirken, bu oran kontrol grubunda %50'de kaldı (p=0.009). Kaydedilen yan etkiler (%3.6) hafif (karın ve baş ağrısı) ve geçiciydi. Sonuç: Jinekolojik hasta grubunda VAC tedavisi, kabul edilebilir yan etki profili ile belirgin semptomatik düzelme sağlayabilmektedir. Bunun, plasebo etkisine bağlı olup olmadığı çift-kör randomize ve çapraz geçişli klinik çalışmalar ile araştırılmalıdır.

Keywords

• Dismenore
• jinekolojik hastalýk
• Vitex agnus-castus

References

1. Hajdş Z, Hohmann J, Forgo P, Martinek T, Dervarics M, Zupkó I, et al. Diterpenoids and flavonoids from the fruits of Vitex agnus-castus and antioxidant activity of the fruit extracts and their constituents. Phytother Res 2007;21:391-4
2. Kuruüzüm-Uz A,Stroch K, Demirezer L.O, Zeeck A. Glucosides from Vitex agnus castus. Phytochemistry 2003;63:959-64
3. Cossuta D, Simandi B, Vagi E, Hohmann J, Prechl A, Lemberkovics E, et al. Supercritical fluid extraction of Vitex agnus castus fruit. The Journal of Supercritical Fluids 2008;47:188- 94
4. Sliutz G, Speiser P, Schultz AM, Spona J, Zeilling R. Agnus castus extracts inhibit prolactin secretion of rat pituitary cells. Horm Metab Res 1993;25:253-5
5. Christoffel V, Spengler B, Jarry H, Wuttke W (1999) Prolactin inhibiting dopaminergic activity of diterpenes from Vitex agnus castus. In: Phyto-Pharmaka V - Forschung und klinische Anwendung (eds Loew D, Blume H, Dingermann T): 209-214, Steinkopff Darmstadt
6. Öztürk A, Ýlman AA, Saðlam H, Yalçýnkaya U, Aykut S, Akgöz S, ve ark. Fitoöstrojenlerin kýrýk iyileþmesi üzerine etkileri: Yeni Zelanda tavþanlarýnda deneysel çalýþma. Ulus Travma Acil Cerrahi Dergisi 2008;14:21- 7.
7. Sehmisch S, Boeckhoff J, Wille J, Seidlova-Wuttke D, Rack T, Tezval M, et al. Vitex agnus castus as prophylaxis for osteopenia after orchidectomy in rats compared with estradiol and testosterone supplementation. Phytother Res 2009;23:851-8
8. Liu J, Burdette JE, Sun Y, Deng S, Schlecht SM, Zheng W, et al. Isolation of linoleic acid as an estrogenic compound from the fruits of Vitex agnus-castus L. (chaste-berry). Phytomedicine 2004;11:18-23.

9. Webster DE, Lu J, Chen SN, Farnsworth NR, Wang ZJ. Activation of the mu-opiate receptor by Vitex agnus- castus methanol extracts: implication for its use in PMS. J Ethnopharmacol 2006;106:216-21.
10. Webster DE, He Y, Chen SN, Pauli GF, Farnsworth NR, Wang ZJ. Opioidergic mechanisms underlying the actions of Vitex agnus castus L. Biochem Pharmacol 2011;81:170-7.
11. Ohyama K, Akaike T, Hirobe C, Yamakava T. Cytotoxicity and apoptotic inducibility of Vitex agnus- castus fruit extract in cultured human normal and cancer cells and effect on growth. Biol Pharm Bull 2003;26:10- 18
12. Ohyama K, Akaike T, Imai M, Toyoda H, Hirobe C, Bessho T. Human gastric signet ring carcinoma (KATO- III) cell apoptosis induced by Vitex agnus-castus fruit extract through intracellular oxidative stress. Int J Biochem Cell Biol 2005;37:1496-510
13. Mazzio EA, Soliman KFA. In vitro screening for the tumoricidal properties of international medicinal herbs. Phytother Res 2009;23:385-98
14. Choudhary MI, Azizuddin C, Jalil S, Nawaz SA, Khan KM, Tareen RB, et al. Anti-inflammatory and lipoxygenase inhibitory compounds from Vitex agnus castus. Phytother Res. 2009;23:1336-9
15. Paupoo AA, Blackwell RE. Galactorrhea. The Global L i b r a r y o f W o m e n ' s M e d i c i n e [http://www.glowm.com/index.html?p=glowm.cml/s ection_view&articleid=305], eriþim tarihi: Þubat, 2013
16. Daniele C, Thompson Coon J, Pittler MH, Ernst E. Vitex agnus castus: a systematic review of adverse events. Drug Saf 2005;28:319-32
17. Loch EG, Selle H, Boblitz N. Treatment of premenstrual syndrome with a phytopharmaceutical formulation containing Vitex agnus castus. J Womens H e a l t h G e n d B a s e d M e d 2 0 0 0 ; 9 : 3 1 5 - 2 0
18. Bergmann J, Luft B, Boehmann S, Runnebaum B, Gerhard I. The efficacy of the
19. complex medication Phyto-Hypophyson L in female, hormone-related sterility. A randomized, placebo- controlled clinical double-blind study. Forsch Komplementarmed Klass Naturheilkd 2000;7:190-9
20. Roemheld-Hamm B. Chasteberry. Am Fam Physician 2005;72:821-4
21. Cahil DJ, Fox R, Wardle PG, Harlow CR. Multiple follicular development associated with herbal medicine. Hum Reprod 1994;9:1469-70
22. Westphal LM, Polan ML, Trant AS. Double-blind, placebo-controlled study of FertilityBlend: a nutritional supplement for improving fertility in women. Clin Exp Obstet Gynecol 2006;33:205-8
23. Dante G, Facchinetti F. Herbal treatments for alleviating premenstrual symptoms: a systematic review. J Psychosom Obstet Gynaecol 2011;32:42-51
24. Freeman EW. Therapeutic management of premenstrual syndrome. Expert Opin Pharmacother 2010;11:2879- 89
25. Ma L, Lin S, Chen R, Wang X. Treatment of moderate to severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Gynecol Endocrinol 2010;26:612-6
26. Ma L, Lin S, Chen R, Zhang Y, Chen F, Wang X. Evaluating therapeutic effect in symptoms of moderate-to-severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Aust NZJ Obstet Gynaecol 2010;50:189-93
27. Atmaca M, Kumru S, Tezcan E. Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Hum Psychopharmacol 2003;18:191-5
28. Wuttke W, Jarry H, Christoffel V, Spengler B, Seidlova-Wuttke D. Chaste tree
29. (Vitex agnus-castus) - pharmacology and clinical indications. Phytomedicine 2003;10:348-57
30. Carmichael AR. Can Vitex Agnus Castus be used for the Treatment of Mastalgia?
31. What is the Current Evidence? Evid Based Complement Alternat Med 2008;5:247-50
32. Halaska M, Raus K, Beles P, Martan A, Paither KG. Treatment of cyclical mastodynia using an extract of Vitex agnus castus: results of a double- blind comparison with a placebo. Ceska Gynecol 1998;63:388-92
33. Milewicz A, Gejdel E, Sworen H, Sienkiewicz K, Jedrzejak J, Teucher T, et al. Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study. A r z ne i m i t t e l f o r s c h u n g 1 9 9 3 ; 4 3 : 7 5 2 - 6
34. Jarry H, Splenger B, Parzel A, Schmid J, Wuttke W, Christoffel V. Evidence for estrogen receptor â-selective activity for Vitex agnus castus and isolated flovones. Planta Med 2003; 69:945-7
35. Liu J, Burdette JE, Xu H, Gu C, van Breemen RB, Bhat KP, et al. Evaluation of estrogenic activity of plant extracts for the potential treatment of menopausal symptoms. J Agric Food Chem 2001;49:2472-9.
36. Campagne DM, Campagne G. The premenstrual syndrome revisited. Eur J Obstet Gynecol Reprod Biol 2007;130:4-17
37. Maruo T, Ohara N, Yoshida S, Nakabayashi K, Sasaki H, Xu Q, et al. Translational research with progesterone receptor modulator motivated by the use of levonorgestrel-releasing intrauterine system. Contraception 2010;82:435-41.
38. Dugoua JJ, Seely D, Perri D, Koren G, Mills E. Safety and efficacy of chaste tree (Vitex agnus- castus) during pregnancy and lactation. Can J Clin Pharmacol 2008;15:e74-9.
39. Rein MS, Barbieri RL, Friedman AJ. Progesterone: a critical role in the pathogenesis of uterine myomas. Am J Obstet Gynecol 1995;172:14-8.