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Heart palpitations are a fairly common symptom of the women patients in my practice. While they need to be investigated with a good history, medical exam, and potential testing with heart monitors and/or electrocardiograms or a referral to a cardiologist, fortunately, in my practice, most of them are what are called benign heart palpitations and most are due to anxiety or panic disorder and sometimes just too much caffeine. My most common natural therapies are relaxation techniques, magnesium and hawthorn berry.

Lemon balm (Melissa officinalis, Lamiaceae) leaf extracts are traditionally usedLemon Balm as a heart tonic, and to help relieve tension, restlessness, irritability, and even in some modern research, for depression. While it has been used traditionally for heart palpitations, there have not been any published trials to my knowledge, until this double-blind, placebo-controlled study.

In this study, individuals ages 18-60 were included if they had heart palpitations as a main complaint for 3 or more months. Patients received placebo or 1,000 mg/day of lemon balm extract for 2 weeks. A lyophilized aqueous extract of 100 g lemon balm leaves was prepared, yielding 20.9 g (20.9%) dried extract. Capsules were filled with 500 mg of the dried extract and patients took one capsule twice daily.

The primary outcome was a change in the frequency and intensity of the palpitation episodes over 24 hours. Patients completed a questionnaire about their symptoms each day, along with a report on any adverse effects.

The average duration of occurrence of palpitation episodes was 65 months in the placebo group and 60 months in the lemon balm group. There were eight patients in each group who discontinued treatment resulting in 27 placebo and 28 lemon balm patients who were included in the final analysis.

After the 2 weeks of treatment, the lemon balm group had 36.8% fewer palpitation episodes compared to baseline, and there was no significant change in the placebo group. Both the lemon balm group and the placebo group had a significant and similar decrease in intensity of palpitations. Other benefits found in the lemon balm group were that anxiety and insomnia were significantly decreased while not decreased in the placebo group. Other than an increase in appetite in the lemon balm group there were no other significant differences in frequency of adverse effects.

Commentary: After 2 weeks of treatment, lemon balm extract at 500 mg twice daily significantly decreased frequency of episodes of benign heart palpitations and anxiety. While this was a small study of short duration, clinical results within 2 weeks are what I would be looking for in a patient with heart palpitations, and anxiety. I look forward to using lemon balm even more, for heart palpitations that in particular seem to be associated with anxiety disorders.

Reference
Alijaniha F, Naseri M, Afsharypuor S, et al. Heart palpitation relief with Melissa officinalis leaf extract: double blind, randomized, placebo controlled trial of efficacy and safety. J Ethnopharmacol. 2015;164:378-384.

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