Australians are increasingly using complementary medicines. Australian Prescriber will therefore be commenting occasionally on some of these medicines. This is not an endorsement of their effectiveness, but an attempt to provide health professionals with some information about the products their patients may be taking.
Agnus castus fruit
The fruits of the chaste tree (Vitex agnus castus) have historically been used as a remedy for gynaecological problems. While the active ingredient is uncertain, the fruits contain flavonoids and iridoids. Although the mechanism of action is unknown the active ingredient is thought to modulate the secretion of prolactin. It may also bind to opioid receptors.
A recent placebo-controlled trial studied an extract (Ze440) of agnus castus fruit in 170 women with premenstrual syndrome.1 After three months, women who took the extract reported a greater reduction in symptoms than the women taking a placebo did. There were significant reductions in anger, irritability, headache, and breast fullness.
The fruit is not known to have serious adverse effects and none emerged in this trial. It is not known if there are any significant drug interactions with the extract.
Although significantly more women responded to the extract only 52% had an improvement of more than 50% in their symptoms. (24% of the women taking a placebo had a greater than 50% improvement.) The trial did not investigate if these benefits were maintained after the end of the study. Other formulations cannot be assumed to have the same efficacy as the extract used in this trial.
- Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. Br Med J 2001;322:134-7 .