Medically reviewed by Drugs.com. Last updated on Jul 20, 2020.
Scientific Name(s): Melissa officinalis L.
Common Name(s): Balm, Lemon balm, Melissa, Sweet balm
Primary interest in lemon balm surrounds its effects on the central nervous system. One small study demonstrated decreased stress and agitation in patients with dementia and Alzheimer disease. Another small trial supports a potential cholesterol benefit. Lemon balm cream has shown some efficacy in herpes virus lesions in a few small placebo-controlled trials.
Crude lemon balm herb is typically dosed at 1.5 to 4.5 g/day. Doses of 600 to 1,600 mg extract have been studied in trials. A standardized preparation of lemon balm (80 mg) and valerian extract (160 mg) has been given 2 or 3 times/day as a sleep aid, and has also been studied in children. A 1% extract cream has been studied as a topical agent for treatment of herpes virus lesions.
Contraindications have not yet been identified.
Information regarding safety and efficacy in pregnancy and lactation is lacking.
None well documented.
Clinical trials generally report no adverse reactions.
Research reveals little or no information regarding toxicology with the use of this product.
- Lamiaceae (mint)
Lemon balm is a low-growing perennial herb with ovate- or heart-shaped leaves that emit a lemon odor when bruised. The small yellow or white flowers are attractive to bees and other insects. It is indigenous to the Mediterranean region and western Asia, and widely naturalized in Europe, Asia, and North America. The leaves are harvested before flowering and used medicinally.1
Lemon balm has been used in herbal medicine since the times of Pliny (Roman, AD 23-79), Dioscorides (Greek, AD 40-90), Paracelsus (Austrian 1493-1541), and John Gerard (English, 1545-1612). The name Melissa corresponds to the Greek word for bee, while balm is a contraction of balsam. The plant has culinary and medicinal uses, with principal historical medicinal uses being carminative, diaphoretic, and antipyretic.2
Lemon balm leaves contain 0.2% to 0.3% of a lemon-scented essential oil similar to that of lemon grass. Major mono- and sesquiterpenes include geranial, neral, beta-caryophyllene, beta-caryophyllene oxide, linalool, citronellal, nerol, and geraniol.3, 4, 5 R(+)-methyl citronellate is characteristic of Melissa oil and distinguishes it from lemon grass oil.6, 7 Flavonoids, oleanane, and triterpenes have also been isolated from the plant.4, 8 Major nonvolatile constituents are caffeic acid and its di- and trimeric derivatives, including rosmarinic acid and melitric acids A and B.7, 9, 10
Uses and Pharmacology
Rosmarinic acid was found to inhibit the C3 and C5 convertase steps in the complement cascade.27, 28, 29 This action may play a role in the anti-inflammatory action of Melissa extract, because the action was observed in vitro and in vivo in rats with oral administration of the compound.
Lemon balm has antiviral activity against a variety of viruses, including herpes simplex virus (HSV) and HIV-1.11, 12 The activity has been attributed to caffeic acid and its di- and trimeric derivatives, as well as to tannins. A concentration-dependent inhibition of HSV-2 proliferation by lemon balm essential oil has been demonstrated, possibly due to the citral or citronellal components.13 Activity against bacteria and fungi has been evaluated with varying results.4, 8, 14 Activity against culex mosquito larvae has also been demonstrated.15
Activity against human and mouse cancer cell lines has been demonstrated in vitro.5
A double-blind, randomized, placebo controlled trial (n=58) in borderline hyperlipidemic adults documented a significant improvement in low-density lipoprotein (LDL) cholesterol levels (P=0.022) as well as AST (P=0.009) with administration of M. officinalis leaf powder (500 mg 3 times daily for 2 months) compared to placebo. Baseline mean LDL dropped by 13.96 mg/dL with the intervention compared to a 1.17 mg/dL increase with placebo. Similarly, mean AST decreased 1.35 units/L with treatment and increased 2.23 units/L with placebo. No significant differences were found between groups in total cholesterol (TC), high-density lipoprotein (HDL), LDL:HDL, TC:HDL, fasting blood sugar, triglycerides, ALT, creatinine, body mass index, or physical activity. No serious adverse events were reported.41
The lyophilized hydroalcoholic extract, which does not contain the volatile oil components, exhibited sedative activity in several mouse models when given intraperitoneally.19 This extract was also active in an acetic acid writhing analgesia assay but not in a hot plate test. The volatile oil of the plant had much weaker activity or was inactive in the same assays.
In a series of trials investigating the effects of lemon balm extract on laboratory-induced stress, a dose-dependent effect was demonstrated for single doses of Melissa officinalis.2, 20, 21 Cholinergic receptor-binding properties have also been demonstrated.20 With 600 mg of extract, increased calmness and decreased alertness were demonstrated compared with placebo. With 300 mg, no modulation of stress was found, but speed and accuracy of mathematical processing increased.21 At the highest dosage of 1,600 mg, a paradoxically negative effect on mood resulted, with reduced alertness.20 Lemon balm 80 mg combined with valerian 160 mg taken for 1 month significantly improved sleep quality compared with baseline (P = 0.001) and placebo (P = 0.0001) in women experiencing sleep disruption/disorders subsequent to natural menopause. The placebo group in this randomized trial (n = 100) also experienced a significant improvement in sleep scores compared with baseline (P = 0.0001). No adverse events were reported.40
In patients with mild to moderate Alzheimer disease, 60 drops of lemon balm extract (citral 500 mcg/mL) increased cognitive function and decreased agitation over placebo.22, 23, 24 Essential oil of lemon balm applied to the faces of patients with dementia decreased agitation compared with placebo.25, 26
The contractility of rat ileum was reduced with essential oil of lemon balm and its citral extract.33 Babies with colic given a combination preparation containing lemon balm extract as well as 2 other extracts showed improved symptoms.34
Crude lemon balm herb typically is dosed at 1.5 to 4.5 g/day. Doses of 600 to 1,600 mg have been studied in trials. A standardized preparation of lemon balm 80 mg and valerian extract 160 mg, Euvegal Forte, has been given 2 or 3 times/day as a sleep aid, and has also been studied in children.35, 36, 37 A 1% extract cream has been studied as a topical agent for herpes.17
Pregnancy / Lactation
Information regarding safety and efficacy in pregnancy and lactation is lacking.
None well documented. A small trial evaluated the cardiac effects of lemon balm and reported possible cardiac muscarinic receptor stimulation or calcium channel-dependent blockage.38 Potentiation of pharmacologic agents may be possible.
Melissa extract was not found to be genotoxic in a screen of several medicinal plants.39
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