Two herbal remedies, kava used to relieve anxiety symptoms, and valerian used for insomnia,// may not be anymore effective than placebo. This was reported in the first research study to be monitored over the Internet and published in the latest issue of the journal Medicine.

The researchers Dr. Bradly P. Jacobs and his colleagues of University of California-San Francisco had performed an innovative Internet trial to evaluate the effectiveness of kava and valerian. They had recruited potential subjects who reported anxiety and insomnia through e-mail and websites. The final study included 391 participants from 45 states of US.

By mail, one group of patients received kava plus an inactive valerian-placebo and one group received valerian plus kava-placebo; a third group received double placebos. After four weeks of treatment, subjects used a secure website to complete follow-up questionnaires.

The herbal extracts were no more effective than placebo in reducing the symptoms they were intended to treat. Anxiety scores decreased by 25 percent for patients taking placebo, compared to about 21 percent with either kava or valerian.

The effects on insomnia were also similar—in all three groups, insomnia scores and time to falling asleep decreased by about 50 percent. The results were comparable across patient subgroups, such as those with higher vs. lower depression scores.

Most side effects were comparable between groups, although patients taking valerian had a higher rate of diarrhea. The study was performed before recent safety warnings concerning liver damage related to kava. However, none of the patients taking kava reported any liver-related side effects.

Anxiety and insomnia are common symptoms that often occur together.

The study is the first randomized, controlled clinical research trial to be conducted entirely over the Internet. The "direct-to-participant" method used for the study includ
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