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Lemon balm and mood: grade C

Limited evidence. Direction: Benefit.

C LimitedShort-term onlySubjective outcome only

Educational guidance, not medical advice

Why this grade

Rubric condition met: Meta-analysis pooling symptomatic and clinical populations with high heterogeneity, plus one RCT (n = 100) in healthy adults with distress whose product was donated by the supplier and whose abstract reports within-trial improvement without a placebo comparison

A 2021 meta-analysis in patients with symptoms of anxiety or depression found lower anxiety (SMD -0.98) and depression (SMD -0.47) scores with lemon balm than placebo, with high heterogeneity and few trials. A 3-week trial of 100 healthy adults with moderate distress or poor sleep, with product donated by Indena, reported improved mood, anxiety and stress scores over the trial; the abstract does not report a comparison with placebo. Trials in type 2 diabetes and chronic stable angina were also positive. The pooled evidence comes mostly from symptomatic or clinical groups, so the grade is capped at C.

How we grade evidence

Studies this grade rests on

EffectMixedNo effectSize shows participants (n)201520202025Meta-analysisRCTBano 2023, 2023: RCT, n = 100, result not recordedHaybar 2018, 2018: RCT, n = 80, result not recordedSafari 2023, 2023: RCT, n = 60, result not recordedGhazizadeh 2021, 2021: meta-analysis, n not recorded, result not recorded
each study this grade rests on, by publication year and design. Solid: effect versus the comparator; half-filled: mixed; hollow: no effect; dashed: result not recorded yet. Larger marks had more participants.
Show the numbers
StudyYearDesignParticipantsResult
Haybar 20182018RCT80result not recorded
Ghazizadeh 20212021meta-analysisnot recordedresult not recorded
Safari 20232023RCT60result not recorded
Bano 20232023RCT100result not recorded

The effects of Melissa officinalis supplementation on depression, anxiety, stress, and sleep disorder in patients with chronic stable angina.

Haybar H, Javid AZ, Haghighizadeh MH. The effects of Melissa officinalis supplementation on depression, anxiety, stress, and sleep disorder in patients with chronic stable angina Clin Nutr ESPEN, 2018. PMID 29908682

Result not recorded
Design
Randomized, double-blind, placebo-controlled trial, 8 weeks
Sample
n = 80
Population
Patients with chronic stable angina (clinical population)
Funding
Ahvaz Jundishapur University of Medical Sciences; Nutrition and Metabolic Diseases Research Center; Student Research Committee (Crossref funders)

The effects of melissa officinalis on depression and anxiety in type 2 diabetes patients with depression: a randomized double-blinded placebo-controlled clinical trial.

Safari M, Asadi A, Aryaeian N. The effects of melissa officinalis on depression and anxiety in type 2 diabetes patients with depression: a randomized double-blinded placebo-controlled clinical trial BMC Complement Med Ther, 2023. PMID 37131158

Result not recorded
Design
Randomized, double-blind, placebo-controlled trial, 12 weeks
Sample
n = 60
Population
Adults with type 2 diabetes and depressive symptoms (clinical population)
Funding
not stated in the PubMed or Crossref record; full text not read (authors declared no conflict of interest)

The possible "calming effect" of subchronic supplementation of a standardised phospholipid carrier-based Melissa officinalis L. extract in healthy adults with emotional distress and poor sleep conditions: results from a prospective, randomised, double-blinded, placebo-controlled clinical trial.

Bano A, Hepsomali P, Rabbani F. The possible "calming effect" of subchronic supplementation of a standardised phospholipid carrier-based Melissa officinalis L. extract in healthy adults with emotional distress and poor sleep conditions: results from a prospective, randomised, double-blinded, placebo-controlled clinical trial Front Pharmacol, 2023. PMID 37927585

Result not recorded
Design
Randomized, double-blind, placebo-controlled, parallel-group trial, 3 weeks
Sample
n = 100
Population
Healthy adults with moderate depression, anxiety or stress scores or poor sleep
Funding
No funding statement; authors declare no commercial relationships; Indena S.p.A. provided the extract (Relissa) and placebo tablets

The effects of lemon balm (Melissa officinalis L.) on depression and anxiety in clinical trials: A systematic review and meta-analysis.

Ghazizadeh J, Sadigh-Eteghad S, Marx W. The effects of lemon balm (Melissa officinalis L.) on depression and anxiety in clinical trials: A systematic review and meta-analysis Phytother Res, 2021. PMID 34449930

Result not recorded
Design
Systematic review and meta-analysis of randomized clinical trials
Population
Patients with symptoms of depression or anxiety (clinical and symptomatic populations)
Funding
not stated in the PubMed or Crossref record; full text not read

Search and history

Search (): (melissa[tiab] OR "lemon balm"[tiab]) AND (sleep[tiab] OR anxiety[tiab] OR insomnia[tiab]) AND (meta-analysis[pt] OR systematic review[pt] OR meta-analysis[ti])

  • Graded C (proposed): Proposed in the monograph draft
  • C to C (approved): Editor sign-off November 13, 2026: grade matches the editor-approved final page