Syrian Rue

Syrian Rue

• Syrian rue (Peganum harmala) is a white flower shrub that grows in the Mediterranean regions. The parts of the plant that are thought to be medicinal include the beta-carboline and quinazoline alkaloids (harmine, harmaline, and tetrahydroharmine).

• It has been used as a stimulant, a sedative while also containing hallucinogenic properties. It is thought to have many mechanisms in the body, most importantly it can inhibit monoamine oxidase, act as an anticholinergic, antispasmodic, antihista-minic, and antiadrenergic. It may have some antineoplastic properties. It is most likely unsafe in pregnancy and breastfeeding.

Dosage:

• More clinical trials need to be completed to determine if a safe oral dose can be used. A topical dose of four drops three times a day for 4 weeks has been studied in knee pain/osteoarthritic patients as detailed below.

• The main uses for Syrian rue include:

• Anti-hypertensive: In vitro studies have shown that Syrian rue can cause vasorelaxant effects on vessels, lowering blood pressure. However, there are no available randomized-control trials that support the in vitro studies.

• Osteoarthritis: In a 2015 randomized controlled trial, 54 participants (27 in treatment, 27 in control) with knee pain rubbed four drops of Syrian rue three times a day on their knees for 4 weeks or olive oil. The study showed decrease in pain and function difficulty when compared to placebo.

• Some limited data is available that shows improvement in anti-depressant symptoms, amenorrhea, rheumatoid arthritis, and Parkinson's disease.

Safety:

• Possibly safe when used topically. The safety when used orally is unclear and has been shown to be a strong hallucinogenic. It may cause hypertension, tachycardia, and tachypnea at high doses.

Medication Interactions:

• Medication interactions include CYP 450 2D6 and 3A4 substrates, serotonergic drugs, anticholinergic and cholinergic drugs, dopamine agonists, hepato-toxic drugs, and caffeine as seen in in vitro and animal studies.