FWD 2 Expanded Commission E: Lemon Balm

Herbal Medicine: Expanded Commission E

Lemon Balm

Latin Name: Melissa officinalis
Pharmacopeial Name: Melissae folium
Other Names: balm, common balm, melissa, sweet balm

Overview

Lemon balm is an aromatic perennial subshrub native to the eastern Mediterranean region and western Asia, widely cultivated throughout much of Europe. The material of commerce comes from Bulgaria, Romania, and Spain (BHP, 1996; Bruneton, 1995; Leung and Foster, 1996; Wichtl and Bisset, 1994). Lemon balm is one of Germany's more important medicinal crops (Lange and Schippmann, 1997). Its genus name Melissa is from the Greek word for 'bee,' referring to the bee's attraction to its flower and the quality of the honey produced from it (Grieve, 1979).

Lemon balm steeped in wine was used orally and topically in ancient Greek and Roman medicines,as surgical dressing for wounds, and to treat venomous bites and stings, as mentioned in the writings of Dioscorides and Pliny the Elder. These same uses and medicinal wine dosage form, stemming from traditional Greek medicine, are also used in the Indian Materia Medica (Nadkarni, 1976). Old European medical herbals also report its memory-improving properties, recently corroborated as cholinergic activities identified in extracts of lemon balm (Perry et al., 1998). The Ayurvedic Pharmacopoeia (AP) lists Melissa officinalis, along with the related Indian species M. parviflora, for dyspepsia associated with anxiety or depressive states, in a dried herb or alcoholic fluidextract dosage form. The AP reports its actions as carminative, antispasmodic, diaphoretic, and sedative (Karnick, 1994).

In Germany, lemon balm is licensed as a standard medicinal tea for sleep disorders and gastrointestinal tract disorders (Braun et al., 1997; Meyer-Buchtela, 1999; Wichtl and Bisset, 1994). Aqueous and alcoholic extract of balm are also used as components of various sedative and hypnotic drug preparations (Wichtl and Bisset, 1994). It is often combined with other sedative and/or carminative herbs (BAnz, 1998; Wichtl and Bisset, 1994). In the United States, lemon balm is often used as a component of mild sleep aid and/or stomachic dietary supplement products, mainly in aqueous infusion and hydroalcoholic fluidextract and tincture dosage forms (Leung and Foster, 1996). Lemon balm was formerly official in the United States Pharmacopoeia (Leung and Foster, 1996).

No significant human studies in English relate to its Commission E-approved internal uses. Some modern studies have investigated its external use to treat cutaneous herpes simplex lesions (ESCOP, 1997). In one study on 115 patients, a proprietary preparation of lemon balm extract in a lip balm showed efficacy in treating lip sores associated with the herpes simplex virus (Wöbling and Leonhardt, 1994). The approved modern therapeutic applications for lemon balm are supportable based on its long history of use in well established systems of traditional medicine,on phytochemical investigations, and on its documented pharmacological actions reported in in vitro studies and in vivo experiments in animals.

Pharmacopeial grade lemon balm must contain not less than 0.05% volatile oil with citral, and pass a botanical identity test determined by thin-layer chromatography (TLC) (Bruneton, 1995; DAB, 1997; AB,1981; Ph.Fr.X, 1990;Wichtl and Bisset, 1994). Its water-soluble extractive content must be not less than 15% (BHP, 1996; Karnick, 1994). A technical note to the French Pharmacopoeia 10th edition recommends that pharmacopeial grade lemon balm be defined by at least of 6% total hydroxycinnamic derivatives, calculated as rosmarinic acid, as opposed to the current minimum volatile oil content requirement (Bruneton, 1995). Manufacturers of lemon balm extracts are already guaranteeing minimum content levels for both rosmarinic acid and total volatile oils.

Description

Lemon balm contains the fresh or dried leaf of M. officinalis L. [Lamiaceae], and its preparations in effective dosage. The leaf contains at least 0.05% (v/w) essential oil based on the dried herb. Main components are citronellal, citral a, and citral b, as well as other monoterpenes and sesquiterpenes. Other ingredients are tannins unique to the Lamiaceae, such as triterpenylic acid, bitter principles, and flavonoids.

Chemistry and Pharmacology

Lemon balm contains the flavonoids quercitrin, rhamnocitrin, and the 7-glucosides of apigenin, kaempferol, quercetin, and luteolin; phenolic acids and tannins, chiefly rosmarinic acid (up to 4%), and glycosidically bound caffeic and chlorogenic acids; triterpenes (ursolic, oleanolic acids); volatile oil (0.050.375%), of which the monoterpenoid citronellal is 30-40%, geranial (citral a) and neral (citral b) are 10-30%; and sesquiterpenes (b-caryophyllene, germacrene D). (Bruneton, 1995; ESCOP, 1997; Leung and Foster, 1996; Wichtl and Bisset, 1994).

The Commission E reported sedative and carminative activity.

The British Herbal Pharmacopoeia reported it is internally a sedative and externally a topical antiviral (BHP, 1996). The hydroalcoholic lemon balm extract is a central nervous system sedative in animal studies; its essential oil content does not appear to play a role in this activity (Bruneton, 1995). Preparations of lemon balm have sedative, spasmolytic, and antibacterial actions (Wichtl and Bisset, 1994).

Uses

The Commission E approved the internal use of lemon balm for nervous sleeping disorders and functional gastrointestinal complaints.

ESCOP lists its internal use for tenseness, restlessness, irritability, and symptomatic treatment of digestive disorders, such as minor spasms; externally, for herpes labialis (cold sores) (ESCOP, 1997). The German Standard License for lemon balm tea approves it for nervous disorders of sleep and of the gastrointestinal tract, and to stimulate the appetite (Wichtl and Bisset, 1994).

Contraindications

None known.

Side Effects

None known.

Use During Pregnancy and Lactation

No restrictions known.

Interactions with Other Drugs

None known.

Dosage and Administration

Unless otherwise prescribed: 1.5-4.5 g cut herb several times daily, as needed.

Note: Combinations with other sedative and/or carminative herbs may be beneficial.

Infusion: 1.5-4.5 g in 150 ml water.

Fluidextract 1:1 (g/ml): 1.5-4.5 ml.

Native dry extract 5.0-6.0:1 (w/w): 0.3-0.9 g.

References

BAnz. See Bundesanzeiger.

Braun, R. et al. 1997. Standardzulassungen für Fertigarzneimittel —Text and Kommentar. Stuttgart: Deutscher Apotheker Verlag.

British Herbal Pharmacopoeia (BHP). 1996. Exeter, U.K.: British Herbal Medicine Association. 29-30.

Bruneton, J. 1995. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier Publishing.

Bundesanzeiger (BAnz). 1998. Monographien der Kommission E (Zulassungs- und Aufbereitungskommission am BGA für den humanmed. Bereich, phytotherapeutische Therapierichtung und Stoffgruppe). Köln: Bundesgesundheitsamt (BGA).

Deutsches Arzneibuch (DAB 1997). 1997. Stuttgart: Deutscher Apotheker Verlag.

ESCOP. 1997. 'Melissae folium.' Monographs on the Medicinal Uses of Plant Drugs. Exeter, U.K.: European Scientific Cooperative on Phytotherapy.

Grieve, M. 1979. A Modern Herbal. New York: Dover Publications, Inc.

Karnick, C.R. 1994. Pharmacopoeial Standards of Herbal Plants, Vols. 12. Delhi: Sri Satguru Publications. Vol. 1:259260; Vol. 2: 83.

Lange D. and U. Schippmann. 1997. Trade Survey of Medicinal Plants in Germany —A Contribution to International Plant Species Conservation. Bonn: Bundesamt für Naturschutz. 32-33.

Leung, A.Y. and S. Foster. 1996. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2nd ed. New York: John Wiley & Sons, Inc.

Meyer-Buchtela, E. 1999. Tee-Rezepturen —Ein Handbuch für Apotheker und Ärzte. Stuttgart: Deutscher Apotheker Verlag.

Nadkarni, K.M. 1976. Indian Materia Medica. Bombay: Popular Prakashan. 786.

Österreichisches Arzneibuch,1st suppl. (ÖAB). 1981-1983. Wien: Verlag der sterreichischen Staatsdruckerei.

Perry, E.K., A.T. Pickering, W.W. Wang, P. Houghton, N.S. Perry. 1998. Medicinal plants and Alzheimer's disease: Integrating ethnobotanical and contemporary scientific evidence. J Altern Complement Med 4(4):419428.

Pharmacopée Française Xe Édition (Ph.Fr.X.). 1983-1990. Moulins-les-Metz: Maisonneuve S.A.

Wichtl, M. and N.G. Bisset (eds.). 1994. Herbal Drugs and Phytopharmaceuticals. Stuttgart: Medpharm Scientific Publishers.

Wöbling, R.H. and K. Leonhardt. 1994. Local therapy of herpes simplex with dried extract from Melissa officinalis. Phytomedicine 1:2531.

Additional Resources

Braun, H. and D. Frohne. 1987. Heilpflanzenlexikon für Ärzte und Apotheker. Stuttgart-New York: G. Fischer.

Enjalbert, F., J.M. Bessire, J. Pellecuer, G. Privat, G. Doucet. 1983. Analyse des essences de Mlisse. Fitoterapia 2:59-65.

Glowatzki, G. 1970. Die Melisse, Arzneimittel seit 2000 Jahren [Melissa, a drug for 2000 years] Med Klin 65(16):800-803.

Hnsel, R. and H. Haas. 1984. Therapie mit Phytopharmaka. Berlin-Heidelberg: Springer Verlag.

Hänsel, R., K. Keller, H. Rimpler, G. Schneider (eds.). 1992-1994. Hagers Handbuch der Pharmazeutischen Praxis, 5th ed. Vol. 46. Berlin-Heidelberg: Springer Verlag. 135-156.

Morelli, I. 1977. Costituenti e usi della 'Melissa officinalis' [Constituents and uses of Melissa officinalis]. Boll Chim Farm 116(6):334-340.

Mulkens, A. and I. Kapetanidis. 1987. Flavonoides des feuilles de Melissa officinalis L. (Lamiaceae) [Flavonoids of the leaves of Melissa officinalis L. (Lamiaceae)]. Pharm Acta Helv 62(1):19-22.

Soulimani, R. et al. 1991. Neurotropic action of the hydroalcoholic extract of Melissa officinalis in the mouse. Planta Med 57(2):105-109.

Tagashira, M. and Y. Ohtake. 1998. A new antioxidative 1,3-benzodioxole from Melissa officinalis. Planta Med 64:555-558.

Vogt, H.J., I. Tausch, R.H. Wöbling, P.M. Kaiser. 1991. Melissenextrakt bei Herpes simplex. Der Allgemeinarzt 13:832-841.

Wöbling, R.H. and R. Milbradt. 1984. Klinik und Therapie des Herpes simplex. Vorstellung eines neuen phytotherapeutischen Wirkstoffes. Therapiewoche 34:1193-1200.

This material was adapted from The Complete German Commission E Monographs —Therapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.

1) The Overview section is new information.

2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references.

3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example:

  • Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]
  • Infusion: 2 g in 150 ml of water
  • Fluidextract 1:1 (g/ml): 2 ml
  • Tincture 1:5 (g/ml): 10 ml

4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes.

This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.

Excerpt from Herbal Medicine: Expanded Commission E Monographs
Copyright 2000 American Botanical Council
Published by Integrative Medicine Communications
Available from the American Botanical Council.