In a broad-based review of studies focused on drugs that treat anxiety, a Saint Louis University doctor found no evidence supporting the use of so-called “natural” treatments in combating the effects of anxiety. St. John’s wort, kava extract, and valerian, herbal remedies touted on the Internet, have not been proven to be effective in treating anxiety, wrote Kimberly Zoberi, M.D., associate professor of family and community medicine at Saint Louis University School of Medicine. She also raised concerns about the safety of valerian, saying that there is a lack of any long-term studies of the herb. “Patients should be extremely cautious about garnering medical advice from the Internet,” says Zoberi. “There is no evidence that those medications are effective. If a patient wishes to avoid drug therapy, her doctor can suggest alternatives such as cognitive behavioral therapy.” In addition to the findings regarding “natural” treatments, Zoberi compared the differing prescription drug regimens available on the market for patients suffering from anxiety. According to Zoberi, most physicians recommend selective serotonin reuptake inhibitors (SSRIs) as a first-line treatment because they were safe, effective, and less expensive. However, some patients suffer sexual or gastrointestinal side effects. Zoberi found that medications from the anticonvulsant class of drugs are among the quickest and most effective ways to provide relief to patients in distress without the side effects of other first-line treatments. The downside is that these prescriptions are fairly expensive compared to other treatments. In conclusion, Zoberi strongly recommends consulting with a health care professional before beginning any drug regimen for anxiety. The review article was published in last month’s issue of the Journal of Family Practice.