Globally, neurological diseases are among the major contributors to mortality and morbidity, particularly in developing nations. The well-known manifestations of neurological diseases include mood swing, restlessness, hopelessness, poor coordination, seizures, impaired cognition, paralysis, distress of sensation, muscle weakness, pain, and confusion [
About 45 million people of the world, above 18 years of age, suffer from schizophrenia at some stage of their lives, 340 million are affected by depression, and both these diseases are accountable for 60 % of all suicides, while Alzheimer and epilepsy affect about 11 and 45 million people, respectively, around the world accounting for 1% of the total disease burden in the world [
In Pakistan, about 10 % people suffer from mental diseases, representing a foggy picture with 2% prevalence of’ epilepsy, 5% depression, 1% Alzheimer, and 1.5% schizophrenia [
Global epidemiology of neurological diseases and theircomparative prevalence in Pakistan and neighboring countries.
Migraine | Stroke | Epilepsy | Depression | Anxiety | Parkinson | Alzheimer | |
---|---|---|---|---|---|---|---|
Worldwide | 14.9% [ | 5% [ | 0.5-1% [ | 4.4% [ | 3.6% [ | 1% [ | 11.2% [ |
Asia | 9.1% [ | 0.94%[ | 0.49% [ | 4.4% [ | 2.8% [ | 0.63% [ | 1.9% [ |
Africa | 5.61% [ | 0.4% [ | 1.13% [ | 5.2% [ | 4.4% [ | 0.44% [ | 1.6% [ |
North America | 14.4% [ | 2.7% [ | 0.8% [ | 10.6% [ | 7.7% [ | 1.3% [ | 6.4% [ |
South America | 11.6% [ | 0.7% [ | 0.98% [ | 13.8% [ | 10.4% [ | 2.3% [ | 4.6% [ |
Europe | 15% [ | 6.25%[ | 0.82% [ | 4.2% [ | 3.9% [ | 1.6% [ | 4.4% [ |
Australia | 6% [ | 1.8% [ | 0.44% [ | 5.9% [ | 7% [ | 0.46% [ | 6.4% [ |
Pakistan | 26.1% [ | 0.25% [ | 2% [ | 4.2% [ | 3.5% [ | 0.23% [ | 1% [ |
India | 25.2% [ | 3.69%[ | 0.39% [ | 4.5% [ | 3.0% [ | 0.07% [ | 1.91% [ |
Iran | 14% [ | 0.36% [ | 1.8% [ | 4.9% [ | 4.6% [ | 0.29% [ | 2.3% [ |
China | 9.3% [ | 4.3% [ | 0.3% [ | 4.2% [ | 3.1% [ | 1.7 % [ | 3.21% [ |
Afghanistan | 0.9% [ | 5.2% [ | 8.9% [ | 51.8% [ | 38.5% [ | 35.4% [ | 15.3% [ |
Medicinal plants have been used from the very beginning in health care systems. Studies have been carried out globally to verify their efficacy and some of the findings have led to the production of plant-based medicines. Due to limited access to modern medicine, the local population uses medicinal plants to treat most diseases [
Side effects of currently using drugs in treatment of various neurological diseases.
Drug Class | Subclasses | Drugs | Side effects | References |
---|---|---|---|---|
Antidepressants | TCA | Imipramine, Amitriptyline, Desipramine, Nortriptyline, Doxepin | weight gain, sedation, dry mouth, nausea, blurred vision, constipation, tachycardia, dry mouth, constipation, hypotension, increased heart rate | [ |
MAOI | Isocarboxazid, Phenelzine | weight gain, fatigue, sexual dysfunction, nausea, hypotension, dry mouth, diarrhea or constipation, headache, drowsiness, insomnia | ||
SSRI | Fluoxetine, Paroxetine, Fluvoxamine, Sertraline, Citalopram | headache, sedation, dizziness, nervousness, somnolence, extrapyramidal effects, nausea, dry mouth, diarrhea, agitation, insomnia, sexual dysfunction, weight gain, | [ | |
SNRI | Venlafaxine, Duloxetine, Desvenlafaxine, Levomilnacipran | nausea, insomnia, dry mouth, headache, increased blood pressure, sexual dysfunction, weight gain, urinary retention, hyponatremia, tremors, vertigo, tachycardia, shock-like sensations, paresthesia, myalgia, tinnitus, neuralgia, ataxia | [ | |
Atypical | Bupropion, Mirtazapine, Trazodone, Vilazodone | headache, agitation, insomnia, sweating, sedation, increased appetite, weight gain, nausea, dizziness | [ | |
| ||||
Anxiolytics | BZDs | Alprazolam, Clonazepam, Lorazepam, Midazolam, Diazepam | sedation, memory disturbances, tolerance, fatigue, dependence, drowsiness, lethargy, At higher dosages, impaired motor coordination, dizziness, vertigo, slurred speech, blurry vision, mood swings, euphoria | [ |
Azapirones | Buspirone, Binospirone, Gepirone, Tandospirone | dizziness, drowsiness, headaches, restlessness, nausea, diarrhea | [ | |
BAR | Phenobarbital, Amobarbital, Secobarbita, Butabarbital, Pentobarbital | sedation, dizziness, headache, nausea, withdrawal include, tremors, agitation, abnormal breathing, coma, confusion, fainting, hallucinations | [ | |
| ||||
Anti-Alzheimer | AChEIs | Donepezil, Rivastigmine, Galantamine | vomiting, diarrhea, weight loss, bradycardia, insomnia, nausea, agitation, syncope | [ |
Anti-A | Bapineuzumab, Solanezumab, Gantenerumab | microhemorrhage, vasogenic edema, arrhythmia, skin and subcutaneous tissue disorders | ||
NMDAR Antagonists | Memantine | psychosis, nausea, vomiting, memory impairment, and neuronal cell death, drowsiness | [ | |
| ||||
Anti-Parkinson | DA | Bromocriptine, Pergolide, Cabergoline, Pramipexole | nausea, hypotension, confusion, delirium, pulmonary fibrosis, vasospasm, erythromelalgia, sleep attacks | [ |
COMT Inhibitors | Entacapone, Tolcapone | dyskinesia, nausea, confusion, urine discoloration, diarrhea, abdominal pain | ||
MAO-B | Selegiline | confusion, delirium, hallucinations, unusual thoughts or behavior, dizziness, nausea, insomnia, trouble breathing | ||
| ||||
Antiepileptic | Sodium Channel Blockers | Phenytoin, Carbamazepine, Lamotrigine, Lacosamide, Oxcarbazepine, | dizziness, drowsiness, diplopia, nausea, vomiting, fatigue, ataxia, neurotoxicity, cardiac arrhythmias, hirsutism, hepatotoxicity, steven-johnson syndrome | [ |
Calcium Channel Blockers | Ethosuximide, Zonisamide, Trimethadione | nausea, vomiting, headache, mental status changes, neuropathy, change in weight | [ | |
GABA transaminase Inhibitors | Vigabatrin, L-Cycloserine, Ethanolamine-O-Sulfate, Valproate | drowsiness, nystagmus, hyperexcitability, insomnia, fever, memory impairment, depression, confusion, agitation, asthenia, laryngitis, weight gain, vomiting | [ |
TCA: tricyclic antidepressant; MAOI: monoamine oxidase inhibitor; SSRI: selective serotonin reuptake inhibitor; SNRI: serotonin norepinephrine reuptake inhibitor; BZDs: benzodiazepines; BAR: barbiturates; AChEIs: acetylcholinesterase inhibitors; A
Herbs may provide a source of new compounds including many drugs that are derived from plant sources. For several neurological diseases, modern medicine offers symptomatic treatment that is often expensive and associated with side effects. Indian system of medicine has traditionally been used in several neurological conditions. The accessibility, cost effectiveness, and lower incidence of side effects of plant products offer considerable advantages [
Various plant extracts have been screened and investigated for their potential neuropharmacological activities in different experimental models of animals comprising mice and rats. Herbal extracts and natural products including
In developing countries, plant-based medicines are being used by 75-80% of population [
In Pakistan, folk medicines have more use in rural and less developed areas for the treatment of various diseases because of easy access, cost effectiveness, less side effects, and unavailability of allopathic therapeutic agents [
First the articles published on the medicinal plants of various districts of Pakistan were searched in online research database, i.e., Medline, PubMed, Web of Science, Science Direct, and Google Scholar, by using special key words “medicinal plants”, herbal plants, neurological diseases, specific districts names, antialzheimer, antiparkinson, antidepression, sedative, anxiolytic, antiepileptics, epidemiology, and prevalence, from January to March 2018, and downloaded. These entire articles were then viewed and the data of medicinal plants, which have neurological effects, were collected and tabulated in (Table
Traditionally used medicinal plants for the treatment of various neurological diseases.
S # | Botanical Name | Local Name | Family | Habitat | Part Used | Used for | Mode of Applications | Location | Reference |
---|---|---|---|---|---|---|---|---|---|
1 | | Ayokanda | Amaranthaceae | Herb | Leaves and Shoot | Nerve tonic | Paste of dried leaves and shoots is applied on head | Sargodha | [ |
| |||||||||
2 | | Backyanra | Simarubacea | Tree | Bark | Hysteria | Decoction of bark to make tea | Malakand | [ |
| |||||||||
3 | | Sirin | Mimosaceae | Tree | Roots | Depression, Migraine and Anxiety | Decoction of root to make tea | Mianwali | [ |
| |||||||||
4 | | Ooga | Amaryllidaceae | Herb | Bulbs and Leaves | Hysteria and Epilepsy | Decoction of bulbs and leaves | Swat | [ |
| |||||||||
5 | | Geiray | Betulaceae | Tree | Flowers | Insomnia | Powder of dried flowers mixed with water and used orally | Dir | [ |
| |||||||||
6 | | Waglon | Amaranthaceae | Herb | Leaves | Neuralgia and Sedative | Sniffing of leaves sap | Bahawalpur | [ |
| |||||||||
7 | | Billy booti | Primulaceae | Herb | Whole plant | Nervine, mania and Epilepsy | Extract of whole plant | Bahawalpur | [ |
| |||||||||
8 | | Jaukay | Asteraceae | Herb | Roots | Epilepsy | Powder of roots taken with water | Dir | [ |
| |||||||||
9 | | Phala-moosa | Asparagaceae | Herb | Leaves | Insomnia | Tea of leaves are used on empty stomach | Lahore | [ |
| |||||||||
10 | | Bargak | Solanaceae | Herb | Leaves | Insomnia and narcotic | Powder of leaves are taken with water | Dir | [ |
| |||||||||
11 | Avena fatua | Jodal | Poaceae | Herb | Seeds | Depression and nervous exhaustion | Either the seeds fluid extract or oatmeal obtained by crushing and grinding seeds | Dera Ghazi Khan | [ |
| |||||||||
12 | | Jai | Poaceae | Herb | Seeds | Nerve tonic and Insomnia | A tincture of juice of immature seeds | Islamabad | [ |
| |||||||||
13 | | Brahmi sak | Scrophulariaceae | Herb | Whole plant | Epilepsy | Extract of whole plant is taken orally | Mianwali | [ |
| |||||||||
14 | | Kalu | Boraginaceae | Herb | Leaves | Insomnia | Infusion of leaves is used orally | Kotli | [ |
| |||||||||
15 | | Makanpat | Ranunculaceae | Herb | Whole plant | Insomnia | Extract of whole plant | Dir | [ |
| |||||||||
16 | | Beli Flower | Campanulaceae | Herb | Flowers | Insomnia | An infusion of flowers is used orally | Kotli | [ |
| |||||||||
17 | | Bhang | Cannabaceae | Herb | Flowers | Insomnia | The ground flowers are used by mixing with other fruits | Bannu | [ |
| |||||||||
18 | | kdler | Capparidaceae | Shrub | Flowers, fruits and shoots | Insomnia | The powder of flowers and shoots while fruits are eaten as such | Gawadar | [ |
| |||||||||
19 | | Kawir | Capparidaceae | Shrub | Whole plant | Mental disorders | Fresh extract of whole plant is used | Gilgat | [ |
| |||||||||
20 | | Tukhmiga-rtum | Asteraceae | Herb | Roots, oil and flowers | Insomnia | Decoction of roots to make tea while oil is applied externally | Rawalpindi | [ |
| |||||||||
21 | | Karr | Cannabaceae | Tree | Bark | Epilepsy | Decoction of bark is used orally | Sargodha | [ |
| |||||||||
22 | | Cheetah- gha | Poaceae | Herb | Leaves and fruits | Epilepsy | Extracts and juice of leaves and fruits | Hafizabad | [ |
| |||||||||
23 | | Tumma | Cucurbitaceae | Climber | Roots and fruits | Epilepsy | The extract of roots is taken with water while fruit’s powder is mixed with sugar | Jhelum | [ |
| |||||||||
24 | | Nimboo | Rutaceae | Tree | Whole plant | Anxiety and Depression | whole plant extract | Bahawalpur | [ |
| |||||||||
25 | | Khatti | Rutaceae | Tree | Leaves, seeds, latex | Insomnia | Powder of leaves, seeds and dry latex are taken orally with water | Bahawalpur | [ |
| |||||||||
26 | | Lansa | Lamiaceae | Shrub | Leaves and roots | Epilepsy | Fresh leaves extract and roots decoction tea is taken orally | Malakand | [ |
| |||||||||
27 | | Guggul, Mukul | Burseraceae | Herb | Gum | Nervous diseases | The aqueous extract of gum is used | Muzaffarabad | [ |
| |||||||||
28 | | Baily | Convolvulaceae | Herb | Whole plant | Epilepsy | whole plant extract | Malakand | [ |
| |||||||||
29 | | Walayti kadoo | Cucurbitaceae | Climber | Fruits | Nervous disorders | Juice of both unripe and ripe fruits is used | Azad Jammu & Kashmir | [ |
| |||||||||
30 | | Bepari, Kasus | Cuscutaceae | Tree | Seeds | Insomnia | An infusion of seed is used | Muzaffarabad | [ |
| |||||||||
31 | | Lemon- grass | Poaceae | Herb | Oil of whole plant | Nervous system tonic | Oil is externally applied on head | Bahawalpur | [ |
| |||||||||
32 | | Lawn grass | Poaceae | Herb | Whole plant | Epilepsy and Hysteria | Extracted juice of plant is used | Dera Ghazi Khan | [ |
| |||||||||
33 | | Deela | Cyperaceae | Herb | Tubers | Epilepsy | Oil obtained from tubers are used | Bahawalnagar | [ |
| |||||||||
34 | | Datura | Solanaceae | Shrub | Leaves and seeds | Neuralgia, Epilepsy, Hysteria and Insomnia | Lotion of seed’s powder is applied locally for neuralgia while tea of leaves is used for Epilepsy | Bahawalpur | [ |
| |||||||||
35 | | Datura | Solanaceae | Herb | Leaves | Epilepsy and Insomnia | Extract of leaves in water | Dir | [ |
| |||||||||
36 | | Dhaturo | Solanaceae | Herb | Leaves and seeds | Epilepsy and Insomnia | Leaves extract and seed’s decoction are used | Muzaffarabad | [ |
| |||||||||
37 | | Datura | Solanaceae | Herb | Whole plant | Insomnia and Parkinson | Extraction of whole plant is used | Dera Ghazi Khan | [ |
| |||||||||
38 | | Gajar | Apiaceae | Herb | Whole plant | Nerve tonic | Eaten as a whole or its juice is used | Sargodha | [ |
| |||||||||
39 | | Bhringaraj | Asteraceae | Herb | Roots, oil and leaves | Insomnia | Oil is externally applied while roots and leaves extract is used orally | Bahawalpur | [ |
| |||||||||
40 | | Tara meera | Cruciferaceae | Herb | Whole plant | Epilepsy | Fluid extraction of plant is used | Islamabad | [ |
| |||||||||
41 | | Sankha-holi | Convolvulaceae | Herb | Whole plant | Epilepsy | Decoction of whole plant is used | Islamabad | [ |
| |||||||||
42 | | Beeri patta | Moraceae | Tree | Leaves | Migraine | Extraction of leaves is used orally | Bahawalpur | [ |
| |||||||||
43 | | Shina | Phyllanthaceae | Shrub | Roots | Epilepsy | Decoction and extraction of roots are used | Dir | [ |
| |||||||||
44 | | Pitpapra | Fumariaceae | Herb | Leaves and stem | Insomnia | Fresh juice of leaves and stem is used | Rawalpindi | [ |
| |||||||||
45 | | Kumbar | Lamiaceae | Tree | Roots | Epilepsy | Extraction and decoction of roots tea is used | Sargodha | [ |
| |||||||||
46 | | Ajwain-i- Khurasani | Solanaceae | Herb | Leaves and seeds | Insomnia and Nervous afflection | Extraction of fresh leaves and powder of seeds are used orally | Gilgat | [ |
| |||||||||
47 | | Bulhsana | Hypericaceae | Herb | Whole plant | Depression and Insomnia | Fresh extract of whole plant is used orally | Gujrat | [ |
| |||||||||
48 | | Zufa, Zupa | Lamiaceae | Herb | Whole plant | Nervous affection | Extraction of fresh whole plant | Ziarat | [ |
| |||||||||
49 | | Kainthi | Papilionaceae | Shrub | Whole plant | Epilepsy and neuropathy | Extract of whole plant is used | Gilgat | [ |
| |||||||||
50 | | Chanbeli | Oleaceae | Climber | Whole plant | Anxiety, tension and Depression | Oil or tea of leaves and flowers extract are used | Bahawalpur | [ |
| |||||||||
51 | | Chanbeli | Oleaceae | Climber | Whole plant | Insomnia | Oil is rubbed on heart as nerve sedative | Swat | [ |
| |||||||||
52 | | Ghuz | Juglandaceae | Tree | Fruits | Depression | Fruits are taken as whole orally | Malakand | [ |
| |||||||||
53 | | Berham dandi | Asteraceae | Herb | Whole plant | Memory Enhancing | Fresh plant is ground in water along with black pepper | Jhelum | [ |
| |||||||||
54 | | Alsi | Linaceae | Herb | Stem | Depression, Schizophrenia and Anxiety | Extraction of fresh stem is used | Kotli | [ |
| |||||||||
55 | | Tamator | Solanaceae | Herb | Fruits | Nervous weakness | Eaten as a whole or its juice is used | Sargodha | [ |
| |||||||||
56 | | Babuna | Asteraceae | Herb | Whole plant | Insomnia | Extraction of whole plant is used orally and oil massage or aromatherapy into skin of head is performed | Rawalpindi | [ |
| |||||||||
57 | | Bichhu-butti | Martyniaceae | Herb | Leaves and fruits | Epilepsy | Juice of leaves or leaves are cooked to make curry and fruits are taken as dry powder with water | Kotli | [ |
| |||||||||
58 | | Bakyana | Meliaceae | Tree | Leaves | Hysteria | Decoction of leaves to makes tea | Malakand | [ |
| |||||||||
59 | | Jungli karela | Cucurbitaceae | Climber | Fruits and seeds | Insomnia | Fruit’s extract and seed oil are used | Mianwali | [ |
| |||||||||
60 | | Sohan-jana | Moringaceae | Tree | Seeds and bark | Migraine | Seeds oil used externally while powder of leaves | Gujrat | [ |
| |||||||||
61 | Ocimum basilicum | Niazbo | Lamiaceae | Herb | Leaves, flowers, seeds and roots | Migraine, Insomnia and Depression | Juice of fresh leaves and flowers while oil of seeds is applied externally on head | Bahawalnagar | [ |
| |||||||||
62 | | Mamaikh | Paeoniaceae | Herb | Rhizome | Epilepsy | Rhizome powder is given | Malakand | [ |
| |||||||||
63 | | Koko-kanga | Papaveraceae | Herb | Flowers | Insomnia | Fluid extract of flowers is used | Kotli | [ |
| |||||||||
64 | | Post | Papaveraceae | Herb | Fruits | Insomnia | Fruit and its decoction are used | Jhelum | [ |
| |||||||||
65 | | Zangali kashkash | Papaveraceae | Herb | Flowers | Insomnia | Fluid extract of flowers is used | Buner | [ |
| |||||||||
66 | | Alak jinai | Papaveraceae | Herb | Flowers | Insomnia | Fluid extract of flowers is used | Buner | [ |
| |||||||||
67 | | Qash-Qash | Papaveraceae | Herb | Fruit’s latex | Insomnia | Latex of unripe fruit is dissolved in water and used orally | Swat | [ |
| |||||||||
68 | | Ragweed | Asteraceae | Herb | Leaves | Insomnia | Leaves extraction is used | Buner | [ |
| |||||||||
69 | | Harmal | Zygophyllaceae | Herb | Seeds | Hysteria | A small amount of seeds added to sufficient grapes juice, boiled to make thick solution and used orally | Dera Ghazi Khan | [ |
| |||||||||
70 | | Nakhtar | Pinaceae | Tree | Fruits | Insomnia | Whole raw fruits are consumed | Malakand | [ |
| |||||||||
71 | | Cowslips | Primulaceae | Herb | Flowers | Insomnia | A tasty wine of flowers is made which is used orally | Gilgat | [ |
| |||||||||
72 | | Ardou | Rosaceae | Tree | Leaves, flowers and fruits | Insomnia | Extract of leaves & flowers and fruits are taken as such | Gilgat | [ |
| |||||||||
73 | | Darrona | Punicaceae | Shrub | Fruits | Memory enhancing | Fruit’s juice or fresh seeds are eaten as such | Azad Jammu & Kashmir | [ |
| |||||||||
74 | | Nashpatai | Rosaceae | Tree | Fruits | Insomnia | Fruits are eaten as such | Dir | [ |
| |||||||||
75 | | Tangai | Rosaceae | Herb | Fruits | Insomnia | Fruits are eaten as such | Swat | [ |
| |||||||||
76 | | Ziar Gulay | Ranunculaceae | Herb | Whole plant | Sciatic and nerve pain | Extraction of dried whole plant is used | Swat | [ |
| |||||||||
77 | | Mooli | Brassicaceae | Herb | Seeds | Nervous weakness | Decoction of seeds is used | Sargodha | [ |
| |||||||||
78 | | Arand | Euphorbiaceae | Shrub | Roots, seeds, leaves | Insomnia and as narcotic | Extract of leaves and roots while oil of seeds are used | Rawalpindi | [ |
| |||||||||
79 | | Peelu | Salvadoraceae | Tree | Whole plant | Epilepsy | Fruit is eaten as raw while tea of leaves and roots are also used | Bahawalpur | [ |
| |||||||||
80 | | False pepper | Anacardiaceae | Tree | Bark and leaves | Depression | Decoction of bark and leaves to make tea | Sargodha | [ |
| |||||||||
81 | | Skullcap | Lamiaceae | Herb | Shoots | Insomnia and Depression | Decoction of shoots to make its tea | Swat | [ |
| |||||||||
82 | | Peelak | Solanaceae | Herb | Whole plant | Insomnia | whole plant decoction is mixed with sugar | Jhelum | [ |
| |||||||||
83 | | Mako | Solanaceae | Herb | Whole plant | Insomnia | Juice of whole plant | Bahawalpur | [ |
| |||||||||
84 | | Wara-mara ghinrhye | Solanaceae | Herb | Fruits | Melancholia and Depression | The paste of fruits crushed powders is applied on head externally | Bannu | [ |
| |||||||||
85 | | Banhya | Taxaceae | Tree | Leaves and fruits | Epilepsy | Extraction of dried leaves and fruits are consumed as such | Swat | [ |
| |||||||||
86 | | Barmi | Taxaceae | Tree | Bark, leaves and fruits | Epilepsy and Insomnia | Extract of dried bark and leaves while flesh of fruits are consumed | Battagram | [ |
| |||||||||
87 | | Arjun | Combretaceae | Tree | Fruits, bark and leaves | Anxiety | Bark infusion left whole night, then its decoction taken early in the morning and used orally | Bahawalpur | [ |
| |||||||||
88 | | Bakhra | Zygophyllaceae | Herb | Whole plant | Epilepsy and Depression | Powder of dried whole plant | Bahawalnagar | [ |
| |||||||||
89 | | Mushk-bala | Vahliaceae | Herb | Whole plant | Epilepsy and neurosis | Fresh extract of whole plant | Muzaffarabad | [ |
| |||||||||
90 | | Jungle tambako | Scrophulariceae | Herb | Roots | Migraine | Decoction of root to make tea to use as drink | Mianwali | [ |
| |||||||||
91 | | Shamkay | Verbenaceae | Herb | Whole plant | Depression, Migraine and Epilepsy | Extract of dried whole plant is used | Battagram | [ |
| |||||||||
92 | | Guch | Caprifoliaceae | Shrub | Stem’s bark | Insomnia | Extract of stem’s bark | Muzaffarabad | [ |
| |||||||||
93 | | Sunaira Phul | Caprifoliaceae | Shrub | Bark | Insomnia and Hysteria | Decoction of bark is used | Muzaffarabad | [ |
| |||||||||
94 | | Blackhaw | Caprifoliaceae | Tree | Root’s bark | Hysteria, Anxiety and Epilepsy | Decoction of root’s bark is used | Muzaffarabad | [ |
| |||||||||
95 | | Muttri | Papilionaceae | Herb | Flowers | Epilepsy and nervous disorders | The juice of flowers petals is used | Kotli | [ |
| |||||||||
96 | | Banafsh | Violaceae | Herb | Whole plant | Epilepsy and nervous disorders | Fresh extract of whole plant orally | Malakand | [ |
| |||||||||
97 | | Banafsha | Violaceae | Herb | Whole plant | Insomnia and Epilepsy | Extract and decoction tea of whole plant | Swat | [ |
| |||||||||
98 | | Paneer doda | Solanaceae | Herb | Fruits, roots and leaves | Nervous Exhaustion, memory loss and tension | Extract of leaves, roots and fruits are used | Bahawalnagar | [ |
| |||||||||
99 | | Asgandh | Solanaceae | Shrub | Roots | Insomnia | Powder of roots is taken with water | Bahawalpur | [ |
| |||||||||
100 | | Chota dhatura | Asteraceae | Herbs | Fruits, seeds and roots | Insomnia | Decoction of fruits, roots and seeds to make tea | Attock | [ |
| |||||||||
101 | | Beri | Rhamnaceae | Tree | Leaves, roots and fruits | Anxiety and Insomnia | Extract of leaves, decoction of roots and dried fruits are consumed | Bahawalnagar | [ |
| |||||||||
102 | | Ber | Rhamnaceae | Tree | Roots | Nerve tonic | Decoction of roots is used as tea | Sargodha | [ |
| |||||||||
103 | Ziziphus nummularia | Jangli beri | Rhamnaceae | Shrub | Leaves and fruits | Insomnia | Extract of leaves while fruits are taken as such | Attock | [ |
A total of 54 families were found to be useful in various neurological diseases, of which the highest use was of Solanaceae (22.22 %), Asteraceae (12.96 %), Lamiaceae, Papaveraceae, and Poaceae, 9 % each, and Caprifoliaceae, Cucurbitaceae, Rhamnaceae, and Rosaceae, 5.5 % each (Table
District-wise percentage of plants used for neurological diseases.
This district-wise plant distribution will help the researchers, who are willing to research in neuropharmacological area, to easily collect the target plants from the regions to which the plants belong. According to the plant’s habit, out of total of 103 plants, 61.15% were found to be herbs, 22.33 % trees, 11.65% shrubs, and 4.85% climbers (Figure
Habit-wise percentage of plants used for neurological diseases.
The habit of plants shows that herbs are most important according to neuropharmacological point of view which is another benefit for researchers working in neuropharmacological area to concentrate on herbs more while selecting neurological active plants. According to the part used of plant, whole plant, leaves, fruits, roots, seeds, flowers, and other parts (bulbs, latex, gum, tubers, and rhizome) were found to be used 32.03 %, 24.27 %, 20.38 %, 16.50 %, 13.59 %, 11.65 %, and 15.53 %, respectively (Figure
Parts-wise percentage of plants used for neurological diseases.
According to disease’s types, 45.63 % were found to be of therapeutic value in insomnia, epilepsy (31.06%), depression (12.62%), anxiety (6.80%), hysteria (7.77%), and migraine (5.88%) and 20.38 % in other neurological diseases (neuralgia, mania, Parkinson, schizophrenia, and nerve pain) (Figure
Disease-wise percentage of plants used for neurological diseases.
The pharmacological activities of plants are due to the presence of various phytochemicals mainly alkaloids, flavonoids, tannins, saponins, resins, glycosides, terpenoids, phenols, sterols, essential oils, vitamins, and nutrients. Some of these are effective in the treatment of neurological diseases; some are useful for cardiovascular, respiratory, and gastrointestinal diseases while others have chemotherapeutic and antibacterial effects. Some of the important phytochemicals of the plants (Table
Phytochemical constituents and pharmacological properties of some well-known medicinal plants.
S.# | Medicinal Plants | Pharmacological Properties | Part used | Phytochemical Constituents | Chemical Compounds Identified | References |
---|---|---|---|---|---|---|
1 | | 1. Antidepressant | 1. Dried bulbs | Thiosulfinates, sapogenins phenols, saponins, volatile compounds, antioxidants, flavonoids, vitamins, minerals and proteins | Alliin, allixin, 1,2-vinyldithiin, ajoenes, S-allyl-cysteine sulfoxide, calcium, Potassium, vitamin B and vitamin C | [ |
| ||||||
2 | | 1. Antidepressant | 1. Leaves | Alkaloid,tannin, saponin, phlobatannin, glycoside, terpenoid, flavonoid, sterols, phenol, steroid, anthraquinone and carbohydrate | Brahmin, nicotine, herpestine, bacosides A & B, hersaponin, betulic acid, monnierin, apigenin, b-sitosterol, stigma-sterol and luteolin | [ |
| ||||||
3 | Cannabis sativa | 1. Antidepressant and anxiolytic | 1. Leaves | Alkaloid, flavonoids, tannins, phenols, resins, cardiac glucosides, terpenes, steroids, volatile oils and balsam | Cannabinoids, cannabidiol, dronabinol, cannabigerol, tetrahydrocannabinolic acid, cannabichromenic acid, cannabidiolic acid, anandamide, cannabigerolic acid and cannabichromene | [ |
| ||||||
4 | | 1. Antidepressant | 1. Leaves | Alkaloids, withanolide steroids, lignanamides, tyramine derivative, steroidal saponins, glycosides, lignans, coumarinolignan, and flavonoids | Apoatropine, L-DOPA, Cuscohygrine, choline Daturamine, Hyoscine, tropine, hyoscypicrin, phytin, aphoyoscine, alpha and beeta belladonine and Skimmianine | [ |
| ||||||
5 | | 1. Anti-seizure | 1. Leaves | Alkaloids, flavonoids, tannins, saponins, glycosides, proteins, carbohydrates, coumarins and phytosterols | Pinoresinol, syringaresinol, medioresinol, scopoletin, tetracosanoic acid and beta-sitosterol | [ |
| ||||||
6 | | 1. Anti-Parkinson | 1. Whole plant | Alkaloids, steroidal lactones, saponins and iron | Withanolides, withaferins, Withanine, isopellertierine, anferine, Anahygrine, Cuscohygrine, Beta-Sisterol, Chlorogenic acid, Scopoletin, choline, Somniferiene, Somniferinine and Tropanol | [ |
| ||||||
7 | | 1. Anticonvulsant | 1. Seeds | Alkaloids, glycosides, tannins, Phytosterols, Terpenoids, Flavanoids and Carbohydrates | Morphine, Codeine, thebaine, noscapine, papaverine, Salutarifine, meconidine, codmine, neoprene, lanthothine, rophyroxine, narcotisline and papaveramine | [ |
| ||||||
8 | | 1. Sedative and hypnotic | 1. Seeds | Triterpenic acids, flavonoids, saponins, cerebrosides, amino acids, phenolic acids, vitamins, total sugars and nucleosides | Zizybeoside I and II, Chryseoriol, Swertisin, Quercetin, Jujubasaponin IV, Lotoside I and II, Zizyphus saponin I and II | [ |
| ||||||
9 | | 1. Anxiolytic | 1. Leaves | Saponins, flavonoids, glycosides, alkaloids and tannins | Tigogenin, neotigogenin, rutin, chlorogenin, caffeoyl, ruscogenin, kaempferol, tribulosid, terrestribisamide, quercetin, | [ |
| ||||||
10 | | 1. Antidepressant | 1. Leaves | Alkaloids, flavonoids, diterpenes, proteins, amino acids, tannins, saponins, phytosterols and phenolic compounds | Verbenin, oleanolic acid, verbenalin, hastatoside, alpha-sitosterol, ursolic acid, kaempferol, aucubin, luteolin, verbascoside, apigenin, scutellarein, limonene and spathulenol | [ |
| ||||||
11 | | 1. Anticonvulsant | 1. Leaves | Alkaloids, flavonoids, phenols, saponins; steroids and terpenoids | Albizia saponins A, B and C, albizinin, melacacidin, catechin lebbecacidin, friedelin, and | [ |
| ||||||
12 | | 1. Antidepressant | 1. Seeds | Carbohydrates, alkaloids, flavanoids, steroids, glycosides, saponins, amino acids, gums and mucilage | Gramine, flavone, apigenin and luteolin, flavonolignans, saponins and ferulic acid | [ |
| ||||||
13 | | 1. Sedative and anticonvulsant | 1. Flowers and fruits | Alkaloids, glycosides, terpenoids, sterols, flavanoids, phenols and fatty acids | Capparine, cappariline, capparinine, | [ |
| ||||||
14 | | 1. Anticonvulsant | 1. Essential oil of leaves | Phenols, flavonoids, terpenoids, essential oils, carotenoids, citric acid and ascorbic acid | Limonene, | [ |
| ||||||
15 | | 1. Anticonvulsant | 1. Fruits | Alkaloids, flavonoids, glycosides, saponosides, Phenolic compounds and ascorbic acid | Colocynthin, colocynthein, colocynthetin, Cucurbitane type triterpen glycoside, quercetin and Flavone | [ |
| ||||||
16 | | 1. Antiepileptic | 1. Leaves | Alkaloids, resins, flavonoids, reducing sugars, tannins, terpenoids and steroid glycosides | Hyoscyamine, scopolamine, atropine, daturabietatriene, daturasterol,, b-sitosterol and Melatonin and serotonin | [ |
| ||||||
17 | Hypericum perforatum | 1. Antidepressant | 1. Flowers | Phenylpropanes, flavonoids, biflavones, phloroglucinols proanthocyanidins, amino acids, essential oil and naphthodianthrones | Hyperoside, adhyperforin Quercitrin, Rutin, Hypericin, Kaempferol, Biapigenin and Hyperforin | [ |
| ||||||
18 | | 1. Antidepressant | 1. Essential oil of plant | Coumarins, steroids, cardiac glycosides, essential oils, flavonoids, phenolics and saponins | Rutin, kaempferol, quercetin, | [ |
| ||||||
19 | | 1. Antidepressant | 1. Fruits | flavonoids, tannins, saponin, glycosides, Steroids, fatty acids, carbohydrates and proteins | Chlorogenic acid, rutin, naringenin, noradrenaline lycopene, dopamine, tomatin, tomatoside-A, ascorbic acid, bergapten, serotonin and adrenaline | [ |
| ||||||
20 | Ocimum basilicum | 1. Antidepressant | 1. Essential oil | Terpenoids, essential oil, polyphenols, tannins and flavonoids | Cineole, geraniol, linalool, cadinol and sabinene, methyl chavicol, | [ |
| ||||||
21 | | 1. Antidepressant | 1. Fruits | Flavonoids, glycosides, amino acids, pectin, indoleamines, tannins, sterols, polyphenols, carbohydrates, ellagitannins, anthocyanins and triterpenoid | Catechin, rutin, quercetin epicatechin, estriol, luteolin kaempferol, anthocyanins, gallagyldilacton, stigmasterol, | [ |
These chemical constituents of plants act on the central nervous system through various mechanisms including regulation of neurotransmitters like adrenergic, cholinergic and serotonergic activity, acting through receptor like GABA and N-methyl-D-aspartate, and ion channels like sodium, potassium, and calcium ion channels. Some of the plant-based drugs and phytochemicals which either are approved or are under clinical trials for the treatment of neurological diseases, mechanism of actions, and their current status in clinical trials are given in (Table
The different phytochemicals effective in various neurological diseases and their current clinical phase status.
Sr # | Phytochemicals | Source | Family | Disease | Mechanism | Development stage | Trade Name | Reference |
---|---|---|---|---|---|---|---|---|
1 | Cannabidiol | Cannabis sativa | Cannabaceae | Epilepsy | Modulation of intracellular calcium and neuronal inhibition | FDA approved, 2018 | Epidiolex as 5- 10 mg/kg/day | [ |
| ||||||||
2 | Cannabidol | Cannabis sativa L. | Cannabaceae | Chronic Neuropathic pain | CB1 and CB2 receptor activation | FDA approved, 2005 | Sativex Spray (CBD 25mg/ml + THC27mg/ml) | [ |
| ||||||||
3 | Capsaicin | Capsicum annum L. | Solanaceae | Postherpetic neuralgia | TRPV1 activator | FDA approved, 2010 | Qutenza as Patch (179mg capsacin) | [ |
| ||||||||
4 | Curcumin | Curcuma longa | Zingiberaceae | Dementia | Anti-amyloid, AChEI | phase II | [ | |
| ||||||||
5 | Galantamine | | Amaryllidaceae | Alzheimer | AChEI, allosteric modulation of nicotinic ACh receptor | FDA approved, 2004 | Razadyne as 8-12 mg BD | [ |
| ||||||||
6 | Huperzine A | | Huperziaceae | Alzheimer | AChEI, inhibits NMDA and glutamate toxicity | approved in China | [ | |
| ||||||||
7 | Ibogaine | Tabernanthe iboga | Apocynaceae | Parkinson | Dopaminergic agonist, NMDA antagonism | preclinical | [ | |
| ||||||||
8 | Psychollatine | Psychotria umbellate | Rubiaceae | Parkinson | MAO inhibitor | preclinical | [ | |
| ||||||||
9 | Resveratrol | Vitis vinifera L. | Vitaceae | Alzheimer | Reduces A | phase II | [ | |
| ||||||||
10 | Scyllo-Inositol | Cornus florida L. | Cornaceae | Alzheimer | Breakdown of neurotoxic fibrils, allowing amyloid peptides to clear the body rather than form amyloid plaques | phase II | [ |
FDA: food and drug administration; TRPV1: transient receptor potential vanilloid 1; CB1 and CB2: cannabinoid receptor type 1 & type 2; Ach: acetylcholine; AChEI: acetylcholinesterase inhibitor; CBD: cannabidiol; THC: tetrahydrocannabinol; BD: bis in die; NMDA: N-methyl-D-aspartate; MAO: monoamine oxidase; A
Taking into consideration this useful knowledge on the medicinal properties of plants for curing neurologic diseases, it is believed that the research in the areas of ethnomedicine and ethnopharmacology can bring auspicious results that have potential of adding importance to the very rich natural resources of Pakistan. Various phytochemicals from the above medicinal plants can be further researched under clinical trials and better drugs for treatment of neurological diseases can be obtained with outstanding results and lesser side effects. This study will help all the researchers, especially from Asian countries including Pakistan, China, Iran, India, Sri Lanka, and Bangladesh, working on plants based medicine for neurological diseases.
The mental illnesses are one of the major problems of the world mainly in communities presenting with poor socioeconomic conditions. In Pakistan and other countries of this region, there is no accurate and up to date record of the neurological ailments. In order to find any treatment for these diseases, first realistic survey would be required to find out the exact percentage of various neurological diseases. Being an alarming psychiatric problem, Alzheimer opens a new area of research, affecting an enormous part of world population, but it is still untreatable. A lot of attempts have been conducted but still there is no such drug that can either slow or stop the process of Alzheimer disease. Allopathic medicines are available for psychological diseases including anxiety, depression, epilepsy, Parkison, and Alzheimer, but these are either not so effective or costly or have serious associated adverse effects. The world is full of natural medicinal resources, of which the main source is plant. We should invest money and go for systemic scientific investigations to perceive such drug candidates’ form these plants, which are most efficacious, have minor side effects, and are cost friendly. For this purpose, this study is a gift for researchers who have interest to design and perform research based activities in the field of neuropharmacology by evaluating the unexplored medicinal plants mentioned here for their folkloric uses, determining its mechanistic pathways and identifying chemical constituents responsible for therapeutic effects.
No personal data was collected from the interviewees and therefore no such data is kept or shared in any form.
Prior informed consent was obtained from all participants before conducting interviews. This manuscript does not contain any individual person’s data and further consent for publication is not required.
The authors declare that they have no conflicts of interest.
Abdul Waheed Khan, Arif-ullah Khan, and Syed Muhammad Mukarram Shah designed the study, performed field work, and researched various medicinal plants articles on scientific search engines. Aziz Ullah, Muhammad Faheem, and Muhammad Saleem analyzed the data and drafted the manuscript. All authors read and approved the final manuscript.
The authors heartily thank all the contributors for taking part and sharing their valuable knowledge with us. They humbly acknowledge Mr. Muhammad Adnan, Mr. Mubashir Shahid, Mr. Rooh Ullah, Mr. Imran ul Haq, Mr. Najeeb Shah, Mr Rizwan Ullah, Ms Qurat ul Ain, Ms. Fizza Bukhari, and Ms Rubia Anwar for their continuous support in the dissemination and collection of the questionnaires in various districts of Pakistan.