DRUGS AND SUPPLEMENTS

Salvia divinorum

March 22, 2017

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Salvia divinorum

Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Diviner's mint, diviner's sage, hardwickiic acid, hierba Maria (Spanish), hojas de la pastora (Spanish), hojas de Maria pastora (Spanish), la hembra (Spanish), la Maria (Spanish), Lamiaceae (family), loliolide, magic mint, María pastora, Mexican mint, mint plant, neoclerodane diterpene, neoclerodane diterpenoids, presqualene alcohol, sage of the seers, Sally-D, salvia, salvinorinyl-2-heptanoate, shepherdess's herb, ska Maria pastora (Mazatec), ska pastora (Mazatec), the female, yerba de Maria (Spanish), yerba Maria (Spanish).

Background

  • Salvia (Salvia divinorum) is a hallucinogenic plant that is traditionally used by the Mazatec culture in central Mexico. It is grown in California and other parts of the United States where it is used as a legal hallucinogen and is becoming popular with teenagers and young adults. Laws in Finland, Denmark, and Australia prohibit cultivating, consuming, or dealing with salvia.

  • Most studies have investigated salvia's active constituent, salvinorin A. Currently, there are no high-quality trials investigating salvia's therapeutic uses. Animal studies of salvia have not shown any toxicity even at high doses, but use of salvia can cause central nervous system (CNS) and psychiatric effects due to its hallucinogenic properties. Some researchers believe that salvinorin A may show promise as a psychotherapeutic compound for diseases manifested by perceptual distortions (e.g. schizophrenia, dementia, and bipolar disorders).

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Grade*

No available studies qualify for inclusion in the evidence table.

*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Alzheimer's disease, bipolar disorder, cardiovascular disease, dementia, depression, diarrhea, drug abuse (stimulant), gastrointestinal motility, hallucinogenic, pain, pruritus (severe itching), schizophrenia.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (over 18 years old):

  • There is no proven safe or effective dose for salvia in adults.

Children (under 18 years old):

  • There is no proven safe or recommended dose for salvia in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in individuals with a known allergy or hypersensitivity to salvia.

Side Effects and Warnings

  • Salvia may cause decreased heart rate, increased perspiration, changes in body temperature, chills, inability to control muscles, inability to maintain balance, loss of coordination, and short-term effects on motor-control. The effects of salvia are typically short-lived.

  • Salvia may induce hallucinations and psychedelic-like changes in visual perception and mood. Visual hallucinations may include perception of bright lights and vivid colors and shapes, as well as body movements and body or object distortions.

  • Dizziness, slurred speech, nausea, awkward sentence patterns, and general change in consciousness have been reported.

  • Use cautiously in patients with psychiatric disorders, including depression, due to salvia's ability to induce hallucinations and other mood changes.

Pregnancy and Breastfeeding

  • Salvia is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • Salvia may have hallucinogenic effects. Salvia may also have additive effects with other opioid drugs and caution is advised when taking certain pain-relieving agents. Consult with a qualified healthcare professional before taking salvia with opioids.

Interactions with Herbs and Dietary Supplements

  • Salvia may have hallucinogenic effects. Salvia may also have additive effects with other opioids and caution is advised when taking certain pain relieving agents. Consult with a qualified healthcare professional before taking salvia with opioids.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Ansonoff MA, Zhang J, Czyzyk T, et al. Antinociceptive and Hypothermic Effects of Salvinorin A Are Abolished in a Novel Strain of {kappa}-Opioid Receptor-1 Knockout Mice. J Pharmacol Exp Ther 2006;318(2):641-648. View Abstract

  2. Barnes S, Prasain JK, Wang CC, et al. Applications of LC-MS in the study of the uptake, distribution, metabolism and excretion of bioactive polyphenols from dietary supplements. Life Sci 3-27-2006;78(18):2054-2059. View Abstract

  3. Beguin C, Richards MR, Li JG, et al. Synthesis and in vitro evaluation of salvinorin A analogues: Effect of configuration at C(2) and substitution at C(18). Bioorg.Med Chem Lett 6-12-2006. View Abstract

  4. Beguin C, Richards MR, Wang Y, et al. Synthesis and in vitro pharmacological evaluation of salvinorin A analogues modified at C(2). Bioorg.Med Chem Lett 6-2-2005;15(11):2761-2765. View Abstract

  5. Bertea CM, Luciano P, Bossi S, et al. PCR and PCR-RFLP of the 5S-rRNA-NTS region and salvinorin A analyses for the rapid and unequivocal determination of Salvia divinorum. Phytochemistry 2006;67(4):371-378. View Abstract

  6. Bucheler R, Gleiter CH, Schwoerer P, et al. Use of nonprohibited hallucinogenic plants: increasing relevance for public health? A case report and literature review on the consumption of Salvia divinorum (Diviner's Sage). Pharmacopsychiatry 2005;38(1):1-5. View Abstract

  7. Capasso R, Borrelli F, Capasso F, et al. The hallucinogenic herb Salvia divinorum and its active ingredient salvinorin A inhibit enteric cholinergic transmission in the guinea-pig ileum. Neurogastroenterol.Motil. 2006;18(1):69-75. View Abstract

  8. Carlezon WA Jr., Beguin C, Dinieri JA, et al. Depressive-like effects of the kappa-opioid receptor agonist salvinorin A on behavior and neurochemistry in rats. J Pharmacol Exp Ther 2006;316(1):440-447. View Abstract

  9. Fantegrossi WE, Kugle KM, Valdes LJ, et al. Kappa-opioid receptor-mediated effects of the plant-derived hallucinogen, salvinorin A, on inverted screen performance in the mouse. Behav.Pharmacol 2005;16(8):627-633. View Abstract

  10. Gonzalez D, Riba J, Bouso JC, et al. Pattern of use and subjective effects of Salvia divinorum among recreational users. Drug Alcohol Depend. 5-20-2006. View Abstract

  11. Harding WW, Schmidt M, Tidgewell K, et al. Synthetic studies of neoclerodane diterpenes from Salvia divinorum: semisynthesis of salvinicins A and B and other chemical transformations of salvinorin A. J Nat Prod. 2006;69(1):107-112. View Abstract

  12. Kane BE, Nieto MJ, McCurdy CR, et al. A unique binding epitope for salvinorin A, a non-nitrogenous kappa opioid receptor agonist. FEBS J 2006;273(9):1966-1974. View Abstract

  13. McCurdy CR, Sufka KJ, Smith GH, et al. Antinociceptive profile of salvinorin A, a structurally unique kappa opioid receptor agonist. Pharmacol Biochem Behav. 2006;83(1):109-113. View Abstract

  14. Stewart DJ, Fahmy H, Roth BL, et al. Bioisosteric modification of salvinorin A, a potent and selective kappa-opioid receptor agonist. Arzneimittelforschung 2006;56(4):269-275. View Abstract

  15. Tidgewell K, Harding WW, Lozama A, et al. Synthesis of salvinorin A analogues as opioid receptor probes. J Nat Prod. 2006;69(6):914-918. View Abstract

Copyright © 2013 Natural Standard (www.naturalstandard.com)

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Updated:  

March 22, 2017