Understanding Nervines and Antispasmodics

Nervines and antispasmodics have similarities and differences in their mechanisms of action and their applications. In a general sense, they have similarities that allow both to be utilized in treatment of conditions that involve imbalances of the nervous system and its various related components. In more specific terms, they can be differentiated into their particular modes of action depending on whether they act more upon the mind, heart and shen (spirit) and emotional states, or the physical nerve, muscular and circulatory functions, although these emotional and physical symptoms and manifestations often overlap and coexist.

Nervines:

Nervines have a variety of properties, actions and uses including anodyne, supplementation/tonification, stimulation, relaxation, restoration, astringent, analgesic, anti-anxiety, anti-depressive, Qi regulating, Blood and Yin nourishing, hypnotic, vasodilation, cardiotonic, and Yang calming.

According to TCM, these herbs may calm, anchor, or settle the Shen, stabilize and bind to astringe/prevent loss and anchor, prevent or treat painful obstructions due to various patterns of Qi, Blood, Cold or Phlegm stagnation (either in isolation or formulas with other herbs), nourish underlying deficiencies that cause stagnation (Blood, Yin, Qi), and calm other patterns of excess that may cause stagnation (Yang). Some nerivnes are powerful Qi-regulating herbs that counteract effect of Qi stagnation via Qi regulation. Some nervines also have antispasmodic action in addition and act to calm Liver Wind.

From a Western herbal perspective, nervines tend to have effects on the neuroendocrine system and its constituents as one of their primary actions. The mechanisms of this system depend on adequate functioning of the nerve cells (neurons) themselves, and endocrine-regulated activities that are mediated by hormones, enzymes, and other chemical messengers and neurotransmitters like minerals and electrolytes. The autonomic nervous system (ANS) is largely involved in these mechanisms.

The ANS has a TCM counterpart, which is essentially Kidney Yang and Kidney Yin. Kidney Yang represents the sympathetic flow (responsible for the flight or fight response during stress or danger) and Kidney Yin represents the parasympathetic flow which counteracts and balances sympathetic output (Yang) to maintain homeostasis. With this in mind, adrenal dis-regulation can be viewed as a Yin-Yang imbalance with Kidney Yang, Yin and Qi patterns being root causes of nervous disorders treatable by nervines.

There are various reasons that a nervine might not have the desired effect, or might not sustain the desired effect over a prolonged period. The most likely and crucial reason is that underlying or accompanying imbalances/patterns are not treated.

  Applications of nervines include:

• Depression
• Anxiety
• Insomnia
• Menopausal imbalances
• PMS
• Moos swings
• Stress
• Restlessness or irritability
• Mania
• Dementia, Alzheimer’s
• ADHD
• Adrenal fatigue and nervous exhaustion
• Pain syndromes and neuralgias
• Cognitive decline, poor memory, poor concentration
• Hypertension
• Autism
• Seizures, epilepsy, convulsions, tremors when there is Phlegm obstruction of the orifices, or Liver Yang Rising, or deficient Yin /Blood
• Headache/migraines
• Earache
• Teething
• Substance withdrawal
• PTSD
• IBS
• Parkinson’s
• Dizziness/vertigo
• Coughing with wheezing, asthma, sputum
• Tachycardia and palpitations, cardiac insufficiencies
• Tinnitus

*Note that many uses will overlap with the uses of antispasmodics in the next section, as many herbs have actions that treat a variety of associated conditions, and are even more effective when combined with other herbs with complementary actions. For example, one herb can be analgesic, antispasmodic, Blood nourishing, Qi regulating, calm Shen and rising Liver Yang and Internal Wind.

Antispasmodics:

Spasms are involuntary muscular contractions, which can be sustained (continuous contraction/freezing) called tonic, or alternating contraction with relaxation called clonic. Both internal and external muscles can be involved, and both skeletal and the internal organs and structures (smooth muscle).

Spams can have various underlying causes including mineral and electrolyte imbalances, hormone and neurotransmitter imbalances, physical trauma such as head injury, spinal cord injury, CVA, chronic disease processes which interrupt neuron function such as MS, Parkinson’s and epilepsy, circulatory changes that directly affect neuron and nervous system functioning such as seen with atherosclerosis, diabetes and ischemia, reactive bodily responses to eliminate irritants as in asthma, coughing, and ureter/renal spasms, poisons and toxicity, labor and childbirth, and psychological causes.

Typically spasms cause dysfunction or varying degrees of pain, especially if they accompany a longer-term chronic disease, although some of the most intense pain can be found in acute situations. This necessitates treatment with herbs that have antispasmodic properties, typically in combination with other herbs that treat the underlying cause and patterns. As mentioned previously many herbs have a combination of properties in and of themselves, and as a single herb may work to allay both acute symptom manifestation and underlying imbalances of a condition. The antispasmodic property itself reduces muscular tension thereby decreasing contraction and improving circulation to decrease pain.

In TCM, spasms, contractions, and convulsions are considered Internal Wind. Internal Wind is generated by and associated to the liver, Typically Liver deficiencies (Blood and Yin) or Liver excesses (Yang) cause Heat, which produces Internal Wind.

In Ayurveda, spasms are related to Vata and in Tibetan Medicine, they can be related to Loong/Wind that is imbalanced in the way of excess, deficiency, or incorrect movement and location.

Antispasmodics can be used for conditions such as:

• CVA
• Tremor, seizures, convulsions, chorea, epilepsy
• Asthma, croup, whooping cough
• Esophageal spasm
• Parkinson’s
• Spinal cord injury with reflexive hypertonic spasms
• Bell’s Palsy
• Menstrual cramping and dysmenorrhea
• Renal colic
• IBS, diarrhea, griping, colitis
• UTIs and cystitis with bladder spasms
• Labor pains, eclampsia
• Neuralgia, sciatica
• Rheumatism
• Headaches/migraines
• Tetany
• General muscle spasms such as occur with skeletal injury
• Hypertension
• Dizziness
• Tinnitus

There are various reasons that a nervine or antispasmodic might not have the desired effect, or might not sustain the desired effect over a prolonged period. The most likely and crucial reason is that underlying or accompanying imbalances/patterns are not treated. If for example there is liver fire, and nervines or antispasmodics are given to subdue some symptoms, but the entire pattern is not treated at a deeper level where cellular and organ dysfunction is occurring, the nervine will have temporary beneficial effects at best, and may not even affect the symptoms to its full potential.

Causative factors accompanying the underlying imbalance must be addressed, whether by the practitioner or the client themselves in the case of lifestyle choices, etc.…. Sometimes a client’s level of commitment to becoming well and the necessary changes to do so can affect treatment. Associated causative factors if left in play will continue to influence the biochemical and energetic properties of the mind and body. Causative factors can be numerous and include emotional mind states, stress, nutritional imbalances, and deficiencies, environmental inputs and exposures, trauma, etc.….

Nervines can also be ineffective if the energy and/or actions of the herb are not balancing for the constitutional energy and/or pattern imbalances of the client. For example, valerian is a warm herb, and if used in a situation of excess heat, can cause effects such as excessive stimulation or restlessness. A particular imbalance may respond to and require specific herbal actions to be treated effectively, and whether the pattern requires nourishment of Blood and Yin, or transformation of Phlegm, for example, this will definitely affect the choice of herbal remedy.

Adequate or appropriate dosage is a huge consideration, given that client’s can easily be undertreated with lower than effective dosages.

Lastly, client compliance is, of course, necessary to ensure adequate treatment.