Research commentaries

A comment on Armstrong & Ernst's trial

A randomised, double-blind, placebo-controlled trial
of a Bach Flower Remedy
N C Armstrong BSc Dphil
E Ernst MD PhD FRCP (Edin)
Exeter University Department of Complementary Medicine

This was a study to test the efficacy of ‘Five Flower Remedy’, also known as ‘Rescue Remedy’, for examination anxiety in healthy university students.

Participants were asked to take 1 to 4 doses of placebo or verum prior to exams. Various methods were used to measure anxiety through the 7 day trial period.

The trial report concluded that there were no specific effects in treating anxiety under these conditions.

In publishing the results the following was noted:

• Although 100 students were recruited only 45% completed the study.

• ‘On day 3 participants taking the active (verum) remedy reported significantly less anxiety on the ‘VAS’ scale than those in the placebo group.’

• ‘No other statistically significant effects were observed over the study period.’

• No explanation was given for the decision to set a 7 day period for the trial.

A clinical trial which has a group of 45 people is not reliable and yet the authors felt confident to assert that Bach flower remedies are not effective in relieving exam nerves.

The authors stated that ‘this is the most rigorous test of BFRs published so far’ while at the same time saying that ‘the present study failed in a major way’ (in that the sample was so small).

The reported reduction in anxiety on day 3 was simply overlooked or ignored on the grounds that ‘this may simply be the result of multiple comparisons’ and ‘we have no a priori expectation for this finding’.

Surely, we have to ask ourselves whether people experience a benefit from taking a flower essence on day 1, day 3, day 7. Why not send us your thoughts on this subject

A more complicated study was undertaken in the USA by Dr Jeffrey R. Cram PhD.

This relied on measuring the temperature and electro-conductivity of the skin at specified locations on the body.

This sample was also small (24) but statistical results were nonetheless clear.

Dr Cram concluded ‘that the Five-Flower Formula has been demonstrated to significantly attenuate the stress response [which] lends credence to the use of these substances in the treatment of stress-related disorders.