Roseroot: A Natural Treatment Option for Depression?

Roseroot may help with symptoms of depression.
Roseroot may help with symptoms of depression.

Rhodiola rosea, or roseroot, is native to the arctic regions of Europe, Asia and North America. With a long history of medicinal use in Scandinavia, Russia and ancient Greece, rhodiola has been employed to treat ailments of the nervous system, including depression, muscle weakness and muscle fatigue, and altitude sickness.1

Rhodiola is commonly referred to as an adaptogen, a type of plant purported to decrease cellular sensitivity to stress.1 Practitioners of complementary and alternative medicine assert that adaptogens allow the body to adapt to — or even resist — physical, chemical, and environmental stressors.


Background


R. rosea is a perennial plant that grows to a typical height of less than 3 ft.2 It yields delicate yellow flowers but has a thick rhizome structure.2 These rhizomes, which have a rose fragrance when cut, are harvested for medicinal use.2 Researchers have identified at least six specific categories of antioxidative, stress-mediating compounds within the plant's roots.1 



Science


Most of R. rosea's medical utility stems from two specific mechanisms of action. Scientists believe that the plant's effects are related to optimizing serotonin and dopamine levels as a result of monoamine-oxidase inhibition and its influence on such opioid peptides as beta-endorphins. However, these specific neurochemical mechanisms have not been clearly documented.2,3

One 2009 study examined R. rosea's effect in blocking two different enzymes within the monoamine oxidase family. Both enzymes showed a statistically significant inhibitory effect >80%.2

Stress-related fatigue and depression have been widely studied in connection with R. rosea supplementation. In one trial, researchers randomized 60 healthy adults to a daily treatment of R. rosea extract.4 Pre- and post-study scores on two assessment scales (the Montgomery-Asberg Depression Scale and the Pines' burnout scale), the Conners' Computerized Continuous Performance Test II (CCPT II), and awakening salivary cortisol levels were evaluated for efficacy.

After a 28-day treatment period, improvements over placebo were seen in the Pines' burnout scale and the CCPT II. Post-treatment salivary cortisol levels to awakening stress were also blunted by as much as 30% over pretreatment levels.


In a pilot study exploring the effect of R. rosea in generalized anxiety disorder, 10 volunteers were given daily doses of R. rosea extract for 10 weeks.5 Pre- and post-treatment assessments using the Hamilton Anxiety Rating Scale (HARS), the four-dimensional anxiety and depression scale, and the Clinical Global Impression scales of severity and improvement were made. The post-treatment scores on the HARS were significantly lower than pretreatment, with corresponding improvements in anxiety indices.5

The potential neuroprotective action of a multi-herb compound containing R. rosea was explored in patients with Parkinson disease.6 A total of 32 patients were evaluated pre- and post-treatment for impairments to motor function. The three-month trial allowed participants to continue their established regimen of antiparkinson therapies while being given two courses of the experimental herb compound during that time. By adjusting for previous levels of steady state or decline, the post-treatment data showed an improvement in such symptoms as tremor, rigidity, and gait. 


A literature review of randomized clinical trials of R. rosea identified 11 placebo-controlled trials.7 Physical and mental performance measures were identified as assessment criteria in each, with single-compound R. rosea as the experimental agent. Across-the-board findings supported a possible mild benefit from R. rosea intervention but indicated a need for larger, more robust and replicable clinical data. 


In a 2012 literature review, the same performance measures were evaluated but subjected to more rigid scientific criteria.8 In all 11 trials, efficacy of R. rosea was considered contradictory.8 These findings also suggest that more rigorous testing is needed to evaluate R. rosea's clinical utility.8

The systematic review shows some evidence suggesting that the herb may help alleviate mental fatigue and increase physical stamina, but methodologic flaws in the studies to date limit accurate assessment of efficacy.8



Safety, interactions 


All studies cited only mild side effects, including sedation and nausea. No serious adverse effects were documented. However, these trials are relatively small, so safety factors are still in question. Allergic reactions are always a possibility, and pregnant or nursing women, infants, and children should not use R. rosea without discussing this move with a health-care provider.


Dose, how supplied, cost


R. rosea is typically available as a capsule, and doses range from 200 mg to more than 400 mg orally b.i.d. Since the bulk of this herb is found in challenging climates, harvesting the pure product increases cost. In the United States, most formulations and strengths are available for less than $40 for a one-month supply.



Summary 


As adequate safety and efficacy data is lacking at present, R. rosea should not be recommended as a reliable supplement. 



References


  1. Khanum F, Bawa, AS, Singh B, Rhodiola rosea: A versatile adaptogen. Comprehensive Reviews in Food Science and Food Safety. 2005;4:55-62.

  2. van Diermen D, Marston A, Bravo J, et al. Monoamine oxidase inhibition by Rhodiola rosea L. roots. J Ethnopharmacol. 2009;122:397-401.

  3. Edwards D, Heufelder A, Zimmermann A. Therapeutic effects and safety of Rhodiola rosea extract WS® 1375 in subjects with life-stress symptoms—results of an open-label study. Phytother Res. 2012;26:1220-1225.

  4. Olsson EM, von Schéele B, Panossian AG. A randomized, double-blind, placebo-controlled, parallel-group study of the standardized extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. Planta Med. 2009;75:105-112.

  5. Bystritsky A, Kerwin L, Feusner JD. A pilot study of Rhodiola rosea (Rhodax) for generalized anxiety disorder (GAD). J Altern Complement Med. 2008;14:175-180.

  6. Bocharov EV, Ivanova-Smolenskaya IA, Poleshchuk VV, et al. Therapeutic efficacy of the neuroprotective plant adaptogen in neurodegenerative disease (Parkinson's disease as an example). Bull Exp Biol Med. 2010;149:682-684.

  7. Hung SK, Perry R, Ernst E. The effectiveness and efficacy of Rhodiola rosea L.: A systematic review of randomized clinical trials. Phytomedicine. 2011;18:235-244.

  8. Ishaque S, Shamseer L, Bukutu C, Vohra S. Rhodiola rosea for physical and mental fatigue: A systematic review. BMC Complement Altern Med. 2012;29:12-70. Available at www.biomedcentral.com/1472-6882/12/70. 



All electronic documents accessed September 15, 2013.


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