Which Patients with Anxiety Symptoms Benefit Most from Treatment with Bryophyllum pinnatum? A Secondary Analysis of a Prospective, Single-Arm Study

Introduction Bryophyllum spp. preparations are frequently used in integrative settings. A recent study observed a reduction in anxiety symptoms among a heterogeneous group of psychiatric/psychosomatic patients after two weeks of treatment with Bryophyllum 50% chewable tablets. This secondary analysis aims to identify variables associated with stronger reduction in anxiety symptoms. Methods Fifty-four patients with anxiety symptoms were recruited from the waiting list for inpatient care at the "Klinik Arlesheim", Department of Psychiatry and Psychosomatics and treated with Bryophyllum 50% chewable tablets (3x2 per day; Weleda AG, Arlesheim, Switzerland). The primary outcome was a change in anxiety symptoms, measured by the Beck Anxiety Inventory (BAI) after two weeks of treatment relatively to baseline (ΔBAI). Comparisons were made across subgroups using one-way ANOVA. Multivariate analyses were conducted to assess the relative importance of various independent variables, including the Depression Scale (PHQ-9). Results BAI score decreased by an average of 5 points (from 27.4 ± 12.0 to 22.4 ± 12.1; p < 0.001, n = 54). ΔBAI decreased progressively across age quartiles, and increased with baseline BAI scores (BAIbl). Patients on benzodiazepines showed less improvement compared to those who were not. MVA indicated that ΔBAI was significantly associated with age (inversely) and with BAIbl (proportionally), after adjusting for other relevant variables. When BAIbl was excluded from the MVA model, a non-significant association was observed between ΔBAI and PHQ-9. Conclusion Due to the uncontrolled single-arm design, our findings are exploratory and do not permit causal inferences. Nevertheless, this explorative analysis suggests that younger age and more severe anxiety symptoms were associated with greater reductions in anxiety symptoms burden during treatment with Bryophyllum 50% chewable tablets.