Lemon balm exhibits CNS acetylcholine receptor activity, with both nicotinic and muscarinic binding properties (Wake et al 2000). In vitro data has demonstrated that lemon balm is a weak inhibitor of acetylcholinesterase and has a moderate affinity to the GABA-A benzodiazepine receptor site (Salah & Jager 2005). This indicates that lemon balm may have a role to play in the treatment of Alzheimer's disease and epilepsy. However, a 2003 randomised, double-blind, placebo-controlled, crossover trial demonstrated that lemon balm did not inhibit cholinesterase. The trial demonstrated improved cognitive function and mood and concluded that for these reasons it was a valuable adjunct to Alzheimer's therapy (Kennedy et al 2003).

Clinical note

Long before the current biologically based theory of cholinergic abnormalities in Alzheimer's dementia emerged, western European medicine systems have traditionally used several herbs that are now known to exert cholinergic activity (such as sage and lemon balm) for their dementia-treating properties.


The plant extract exerts analgesic activity at high doses in vivo (Soulimani et al 1991). Two constituents in lemon balm have documented anti-inflammatory activity, achieved through different mechanisms of action. Rosmarinic acid, a naturally occurring constituent found in M. officinalis, inhibits several complement-dependent inflammatory processes (Englberger et al 1988, Peake et al 1991). Eugenol, another © 2007 Elsevier Australia

important component, inhibits COX-1 and -2 activities in vitro (Huss et al 2002, Kelm et a I 2000). Both the whole volatile oil and its main component citral have demonstrated antispasmodic ability on isolated rat ileum (Sadraei et al 2003).

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