Anxiolytic Potential of Passiflora incarnata in Oral Surgery: Mechanisms, Evidence and Clinical Application

Panagiotis Kafas, Theodoros Lillis and Nikolaos Dabarakis

Passiflora incarnata (passion flower) is a climbing plant with pharmacologically active compounds such as flavonoids, alkaloids and glycosides that exhibit anxiolytic properties. This literature review explores the potential of passion flower as a natural alternative for managing anxiety in oral surgery. In this field, patient anxiety significantly impacts cooperation, pain perception and surgical outcomes. Unlike conventional benzodiazepines, passion flower modulates the gamma-aminobutyric acid (GABA) system without causing significant cognitive impairment or dependence, making it an attractive option for mild to moderate anxiety management. Clinical evidence from randomized controlled trials demonstrates that passion flower effectively reduces preoperative anxiety in dental and surgical settings, performing comparably to traditional anxiolytics like midazolam and oxazepam, but with fewer side effects and minimal psychomotor impairment. The anxiolytic mechanisms are believed to involve GABAergic modulation, regulation of monoamine neurotransmitters and antioxidant effects, which contribute to its calming influence. Despite promising results, challenges remain regarding the standardization of formulations, dosage, pharmacokinetics and long-term safety. Ethical considerations could emphasize the importance of informed consent, transparency and respect for patient autonomy when integrating passion flower into clinical practice. Cultural attitudes toward herbal remedies also influence acceptance and trust. In general, this review highlights the need for larger, multicenter trials and standardized preparations to establish passion flower’s efficacy and safety conclusively. With further research and careful clinical integration, passion flower may become a valuable adjunct or alternative to conventional anxiolytics in oral surgery, improving patient comfort and surgical outcomes through a gentler, natural approach to anxiety management.

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