Phytotherapy for Anxiety: A Narrative Review of Efficacy, Mechanisms and Clinical Considerations

Background: Anxiety disorders are among the most prevalent mental health conditions world-wide, and current pharmacological treatments, although effective, are often associated with ad-verse effects and incomplete symptom remission. These limitations have intensified interest in complementary and alternative therapeutic approaches, including herbal medicine.Objective: This narrative review examines the evidence supporting the use of medicinal plants for the management of anxiety, highlighting their mechanisms of action, clinical efficacy and safety considerations.Methods: A search of the scientific literature was conducted to identify studies investigating me-dicinal plants traditionally used for anxiety treatment. Particular attention was given to findings related to phytochemical activity within the central nervous system, clinical outcomes and re-ported adverse effects.Results: Several plants, including Valeriana officinalis, Passiflora incarnata, Melissa officinalis, Matricaria chamomilla L., Withania somnifera and Lavandula angustifolia, demonstrate anxio-lytic effects supported by preclinical and clinical evidence. Their primary mechanisms involve modulation of GABAergic neurotransmission, alongside antioxidant and anti-inflammatory pathways. Despite these promising results, the literature shows considerable variability in study design, formulation standardisation and sample size, limiting the generalisability of findings.Conclusions: Herbal medicine presents a valuable complementary approach to anxiety man-agement, offering potential therapeutic benefits with generally favourable safety profiles. Nev-ertheless, further high-quality, standardised clinical trials are necessary to confirm efficacy, es-tablish optimal dosages and ensure long-term safety. Integrating herbal therapies into broader healthcare frameworks requires strengthened regulation, professional training and informed public use.