Pharmacological aspects of Citrus aurantium (RUTACEAE) in anxiety disorders: an integrative review

Conteúdo do artigo principal

Dante Ferreira de Oliveira
Josue Andrade Martins
Carlos Rocha Oliveira


Anxiety is a mental disorder of high prevalence, being a topic of attention since the earliest historical records. In Brazil, it affects all life aspects of 9.3% of the population. Conventional treatments, which are most effective, can have adverse effects. Therefore, there is a significant increase in demand for alternative therapies which are less "aggressive" and cheaper, like phytotherapy. Among the numerous plants indicated for the treatment of anxiety, it is worth highlighting Citrus aurantium popularly known as "bitter orange" or "sour orange". Studies show the influence of its essential oils and plant extracts on the central nervous system, especially in the control of anxiety and depression. Although the use of plants, as a form of disease treatment and prevention, is an ancient practice, their indications are often based especially on popular knowledge. Thus, scientific evidence and studies are needed to ensure safety and efficacy in the use of plant species. Thus, the purpose of this study is to investigate the mechanism of action of Citrus aurantium in anxiety disorders. A bibliographical revision was carried out in health scientific databases using the descriptors “Citrus aurantium”, individually and, combined with the following descriptors “anxiety”, “central nervous system”, “mental disorders” and “mechanism of action”. Articles searched based on titles, abstracts, and year of publication (2010-2020), and those that did not address the anxiolytic effect of the species and/or its mechanism of action were excluded. We found 151 articles and considered for the review 16 articles that met the inclusion criteria. Although there are few works that study and prove the anxiolytic effect of Citrus aurantium, the vast majority of them only mention possible mechanisms of action. Analyzing the results reviewed, it was possible to observe that Citrus aurantium acts positively on anxiety, probably, as suggests the studies, through serotonergic pathway.

Detalhes do artigo

Como Citar
Ferreira de Oliveira D, Andrade Martins J, Rocha Oliveira C. Pharmacological aspects of Citrus aurantium (RUTACEAE) in anxiety disorders: an integrative review. Braz. J. Nat. Sci [Internet]. 3º de março de 2022 [citado 16º de abril de 2024];4(3):E1532022, 1 - 8. Disponível em:
Artigo de revisão em fluxo contínuo


- Braga JEF. Pordeus LC, Silva ATMC, Pimenta FCF, Diniz MFFM, Almeida RN. Pathological anxiety: neural bases and advances in the psychopharmacological approach . Rev Bras Ciênc Saúde. 2010;14(2):93–100

- Owens MJ, Nemeroff CB. The ole of HLC in the pathophysiology of affective disorders. John Wiley & Sons , New York , 1993. (Laboratory and Clinical Studies, 172).

- Organização Mundial de Saúde-OMS. Depression and other common mental disorders: global health estimates[Internet]. Geneva: WHO; 2017[cited 2017 Nov 04]. Available from:

- Fernandes MA, Vieira FER, Silva JS, Avelino FVSD, Santos JDM. Prevalence of anxious and depressive symptoms in college students of a public institution. Rev Bras Enferm.2018;71(suppl 5):2169-2175.

- Bortoluzzi MM, Schmitt V, Mazur CE. Herbal effect of medicinal plants on anxiety: a brief review. Research, Society and Development. 2020 1;9(1):e02911504.

- USDA United States Department of Agriculture (USDA), Natural Resource Conversation Service (NRCS), 24 September 2013. The PLANTS Database. National Plant Data Team, Greensboro, NC 27401–4901 USA.

- Mannucci C, Calapai F, Cardia L, Inferrera G, D’Arena G, Di Pietro M, et al. Clinical Pharmacology of Citrus aurantium and Citrus sinensis for the Treatment of Anxiety. Evidence-Based Complementary and Alternative Medicine. 2018:1–18.

- Costa CARA, Cury TC, Cassettari BO, Takahira RK, Flório JC, Costa M. Citrus aurantium L. essential oil exhibits anxiolytic-like activity mediated by 5-HT1A-receptors and reduces cholesterol after repeated oral treatment. BMC Complement Altern Med. 2013;13(1):42.

- Wolffenbüttel AN, Zamboni A, Becker G, dos Santos MK, Borille BT, de Cássia Mariotti K, et al. citrus essential oils inhalation by mice: behavioral testing, gcms plasma analysis, corticosterone, and melatonin levels evaluation. Phytotherapy Research. 2018;32(1):160–9

- Chaves G, Andrade HHN de, Braga JEF, Quintans LJ, Almeida RN de, Diniz M de FFM. Non-clinical study of the anxiolytic effect of Citrus aurantium L. essential oil in an inclusion complex with 2-hydroxypropyl-ß-cyclodextrin. Brazilian Journal of Basic and Applied Pharmaceutical Sciences. 2021;41, 705-717

- Saketi S, Bananej M, Jahromy MH. Effect of citrus aurantium l. Essential oil and its interaction with fluoxetine on anxiety in male mice. JBBS. 2014;04(07):285–90.

- Khosravi M, Khakpour S, Adibi L, Jahromy MH. A study of the effect of citrus aurantium l. essential oil on anxiety and its interaction with gabaergic pathways in male mice. JBBS. 2014;04(10):470–6.

– Silva SRF. Farmacocinética do Diazepam [master thesis on the internet]. Porto: Universidade Fernando Pessoa, 2013 [cited 2022 Feb 9]. Available from:

- Namazi M, Amir Ali Akbari S, Mojab F, Talebi A, Alavi Majd H, Jannesari S. Aromatherapy with citrus aurantium oil and anxiety during the first stage of labor. Iran Red Crescent Med J. 2014;16(6).

- Akhlaghi M, Shabanian G, Rafieian-Kopaei M, Parvin N, Saadat M, Akhlaghi M. Citrus aurantium blossom and preoperative anxiety. Rev Bras Anestesiol. 2011;61(6):707–12.

- Jafarzadeh M, Arman S, Pour FF. Effect of aromatherapy with orange essential oil on salivary cortisol and pulse rate in children during dental treatment: A randomized controlled clinical trial. Adv Biomed Res. 2013;2(1):10.

- Dehghan K, Kalani Z. Comparison of the effect of citrus aurantium and oxazepam on the preoperative anxiety of patients candidate for coronary artery implantation operation. J. Res Med Dent SCI. 2018;6(2): 1-5.

- Moradi K, Ashtarian H, Danzima NY, Saeedi H, Bijan B, Akbari F, et al. Essential oil from citrus aurantium alleviates anxiety of patients undergoing coronary angiography: a single-blind, randomized controlled trial. Chin J Integr Med. 2021;27(3):177–82.

- Pimenta FCF, Alves MF, Pimenta MBF, Melo SAL, Almeida AAF de, Leite JR, et al. Anxiolytic effect of citrus aurantium l. On patients with chronic myeloid leukemia: anxiolytic effect of citrus aurantium l. Phytother Res. 2016;30(4):613–7.

- Chaves Neto G, Braga JEF, Alves MF, de Morais Pordeus LC, Santos SG dos, Scotti MT, et al. Anxiolytic effect of citrus aurantium l. In crack users. Evidence-Based Complementary and Alternative Medicine. 2017:1–8.

- Farshbaf-Khalili A, Kamalifard M, Namadian M. Comparison of the effect of lavender and bitter orange on anxiety in postmenopausal women: A triple-blind, randomized, controlled clinical trial. Complementary Therapies in Clinical Practice. 2018;31:132–8.

- Fluoxetine hydrochloride: drug leaflet for health professional. Eurofarma , 2016. Available at: -

- Moslemi F, Alijaniha F, Naseri M, Kazemnejad A, Charkhkar M, Heidari MR. citrus aurantium aroma for anxiety in patients with acute coronary syndrome: a double-blind placebo-controlled trial. The Journal of Alternative and Complementary Medicine. 2019;25(8):833–9.

Artigos mais lidos pelo mesmo(s) autor(es)