Meta Information
ID:lemon-balm
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-21T22:30:00Z
Model
phase-a-upgrade-claude-sonnet-4.6
Interactions
Target id:
/class/cns-depressants
Target name:
CNS Depressants (Sedatives, Opioids, Barbiturates) (Pharmacologic)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Lemon balm has sedative properties that can add to the drowsiness, dizziness, and impaired motor coordination caused by other central nervous system depressants.
Actionable advice:
Exercise extreme caution and consult a healthcare provider before combining with any sedative medications.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Pharmacological evidence from animal and cellular work reveals that lemon balm and its components may modulate several brain signalling pathways, including GABAergic, cholinergic, and serotonergic systems.
Label source:
PubMed: Nutrients (2024)
Source url:
Exact phrase from label:
Accumulating evidence highlights that selected medicinal plants, such as chamomilla, lemon balm, black cumin, valeriana, passionflower and lavender, may exert relevant hypnotic or anxiolytic effects, thus complementing melatonergic strategies in the management of insomnia.
Label source:
PubMed: Molecules (Basel, Switzerland) (2025)
Source url:
Exact phrase from label:
Centuries-old herbal treatments, popular for their safety and effectiveness, include valerian, passionflower, lemon balm, lavender, and Californian poppy. These herbal medicines have been shown to reduce sleep latency and increase subjective and objective measures of sleep quality.
Label source:
PubMed: Nutrients (2021)
Action type:
informational_none
Target id:
/class/benzodiazepines
Target name:
Benzodiazepines
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Lemon balm may enhance the sedative and hypnotic effects of benzodiazepines by acting on the GABA neurotransmitter system, increasing the risk of excessive drowsiness.
Actionable advice:
Concurrent use is best avoided unless directed by a physician, especially before driving or operating machinery.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
GABA receptors are the targets of many pharmacological treatments for insomnia, such as benzodiazepines. Here, we perform a systematic analysis of studies assessing the mechanisms of action of various herbal medicines on different subtypes of GABA receptors in the context of sleep control. Currently available evidence suggests that herbal extracts may exert some of their hypnotic and anxiolytic activity through interacting with GABA receptors and modulating GABAergic signaling in the brain, but their mechanism of action in the treatment of insomnia is not completely understood.
Label source:
PubMed: Nutrients (2021)
Source url:
Exact phrase from label:
An ethanolic extract of Artemisia herba-alba had good affinity to the GABA(A)-benzodiazepine receptor site; ethanolic extracts of Melissa officinalis and Salvia triloba had moderate activity.
Label source:
PubMed: Journal of ethnopharmacology (2005)
Source url:
Exact phrase from label:
Skullcap (genus Scutellaria), hops (Humulus lupulus), lemon balm (Melissa officinalis) and Valerian (Valeriana officinalis) root are all herbs reported as anaxiolytic calming agents. Further, extracts of Magnolia and Phellondendron bark are mild sedatives. Supplements such as gamma-aminobutyric acid (GABA), theanine, tryptophan and 5-hydroxytryptophan (5-HTP) are reported to promote relaxation. In general, these supplements appear to act as GABA receptor agonists or to boost GABA levels
Label source:
PubMed: Medical science monitor : international medical journal of experimental and clinical research (2009)
Action type:
avoid
Target id:
/dietary/alcohol-acute
Target name:
Alcohol (Acute Consumption)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining lemon balm with alcohol can lead to additive sedative effects, resulting in significant drowsiness, impaired judgment, and reduced coordination.
Actionable advice:
Alcohol is best avoided when taking lemon balm, particularly in the evening.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Centuries-old herbal treatments, popular for their safety and effectiveness, include valerian, passionflower, lemon balm, lavender, and Californian poppy. These herbal medicines have been shown to reduce sleep latency and increase subjective and objective measures of sleep quality.
Label source:
PubMed: Nutrients (2021)
Source url:
Exact phrase from label:
When analyzed by Immunohistochemistry (IHC), valerian exhibited moderate expression of two neurotransmitters in brain tissue, as well as intense positivity for serotonin in the mixed group, whereas lemon balm exhibited weak γ-aminobutyric acid (GABA) expression but moderate positivity for serotonin.
Label source:
PubMed: Open veterinary journal (2025)
Source url:
Exact phrase from label:
These plants act on the central nervous system, particularly the serotonergic and gamma-aminobutyric acid (GABA)ergic systems, promoting sedation and relaxation.
Label source:
PubMed: Phytotherapy research : PTR (2024)
Action type:
avoid
Target id:
/condition/thyroid-disorders
Target name:
Thyroid Disorders (especially Hypothyroidism)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Lemon balm may interfere with thyroid function by blocking the binding of Thyroid-Stimulating Hormone (TSH) to its receptors and potentially inhibiting the conversion of T4 to T3.
Actionable advice:
It is important to talk to a doctor before using lemon balm with any thyroid condition or while taking thyroid medication.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Those substances producing an inhibition were further studied to establish the level at which they interfere with this step of thyroid cell function.
Label source:
PubMed: In vitro assay of thyroid disruptors affecting TSH-stimulated adenylate cyclase activity. (PMID 14759065)
Action type:
informational_none
Target id:
/intervention/levothyroxine
Target name:
Levothyroxine
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
By potentially interfering with thyroid hormone production and action, lemon balm may reduce the effectiveness of levothyroxine therapy.
Actionable advice:
Lemon balm is best avoided when being treated for hypothyroidism with levothyroxine.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Inform patients that agents such as iron and calcium supplements and antacids can decrease the absorption of levothyroxine.
Label source:
FDA label: Levothyroxine (Synthroid)
Action type:
avoid
Target id:
/class/antidiabetic-medications
Target name:
Diabetes Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Lemon balm may have a mild glucose-lowering effect, which can be additive with diabetes medications, increasing the risk of hypoglycemia (dangerously low blood sugar).
Actionable advice:
Blood glucose levels are best monitored closely, and it is important to consult a doctor if combining with any glucose-lowering medications.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
The antioxidant activity of lemon balm (Melissa officinalis) essential oil (LBEO) on 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals and its hypoglycaemic effect in db/db mice were investigated.
Label source:
PubMed: Anti-diabetic effects of lemon balm ( Melissa officinalis) essential oil on glucose- and lipid-regulating enzymes in type 2 diabetic mice. (PMID 20487577)
Action type:
monitor
Target id:
/procedure/surgery
Target name:
Surgery
Severity:
major
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
336
Hours after target:
null
Description:
Due to its sedative properties, lemon balm can dangerously enhance the effects of anesthesia and other medications used during and after surgery, leading to excessive CNS depression.
Actionable advice:
Use should be discontinued at least 2 weeks prior to any scheduled surgery.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Melissa officinalis (lemon balm) is a traditional herbal medicine, which enjoys contemporary usage as a mild sedative, spasmolytic and antibacterial agent.
Label source:
PubMed: Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm). (PMID 12062586)
Action type:
avoid
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
There is insufficient reliable data on the safety of lemon balm during pregnancy; therefore, its use is not recommended due to potential unknown risks to the fetus.
Actionable advice:
Lemon balm should not be used at all during pregnancy.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
avoid
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
It is unknown if components of lemon balm are excreted in breast milk or what effects they might have on a nursing infant; its use should be avoided.
Actionable advice:
Lemon balm should not be used at all while breastfeeding.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
There isn't enough reliable information to know if lemon balm is safe to use when pregnant or breast-feeding.
Label source:
Anecdotal: WebMD
Action type:
avoid
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
0.5
Description:
Lemon balm's calming properties, mediated through the GABA system, can help reduce sleep latency and improve sleep quality.
Actionable advice:
It is generally best taken 30 minutes to 2 hours before the intended bedtime to promote relaxation and sleep.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Efficacy and tolerability of a combined valerian/lemon balm preparation were investigated in an open, multicentre study in children less than 12 years suffering from restlessness and nervous dyskoimesis.
Label source:
PubMed: A combination of valerian and lemon balm is effective in the treatment of restlessness and dyssomnia in children. (PMID 16487692)
Action type:
separate
Target id:
/class/herbal-sedatives
Target name:
Other Sedating Herbs (Valerian, Passionflower, Kava) (Herbal Additive)
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining lemon balm with other herbs known for their sedative effects can result in additive drowsiness and cognitive slowing.
Actionable advice:
Caution may help when combining multiple calming herbal supplements.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Melissa officinalis (lemon balm) is a traditional herbal medicine, which enjoys contemporary usage as a mild sedative, spasmolytic and antibacterial agent.
Label source:
PubMed: Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm). (PMID 12062586)
Action type:
informational_none
Target id:
/class/cholinesterase-inhibitors
Target name:
Cholinesterase Inhibitors
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Lemon balm may inhibit the enzyme acetylcholinesterase, potentially increasing the effects and side effects of medications used for Alzheimer's disease.
Actionable advice:
This is generally best used with caution and under medical supervision when taking cholinesterase inhibitors.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Perry et al's (1996) investigation also suggested that fresh, but not dried, M. officinalis leaf possessed modest human brain acetylcholinesterase (AChE) inhibitory properties
Label source:
Primary literature: https://www.nature.com/articles/1300230
Action type:
informational_none
Target id:
/class/anticholinergic-medications
Target name:
Anticholinergic Medications
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The potential pro-cholinergic effects of lemon balm (by inhibiting acetylcholinesterase) may counteract and reduce the effectiveness of anticholinergic drugs.
Actionable advice:
Lemon balm might slightly reduce the efficacy of anticholinergic medications.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
M. officinalis exhibits central nervous system acetylcholine receptor activity, including nicotinic and muscarinic binding properties in human cerebral cortex tissue
Label source:
Primary literature: https://www.nature.com/articles/1300230
Action type:
informational_none
Target id:
/class/cyp2d6-substrates
Target name:
CYP2D6 Substrates
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
In-vitro evidence suggests lemon balm might mildly inhibit the CYP2D6 enzyme, which could theoretically increase levels of drugs metabolized by this pathway, though clinical significance is unproven.
Actionable advice:
While likely not clinically significant, be aware of this theoretical interaction if taking sensitive CYP2D6-metabolized drugs.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Page 9
Reference ID: 5376564
Strong Inhibitors of CYP2D6
Concomitant use of AUVELITY with strong CYP2D6 inhibitors increases plasma concentrations of
Clinical Impact
dextromethorphan.
Label source:
Action type:
informational_none
Target id:
/condition/glaucoma
Target name:
Glaucoma
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
A single animal study using lemon balm essential oil suggested a potential to increase intraocular pressure; this is a theoretical risk for oral extracts.
Actionable advice:
Individuals with glaucoma should use lemon balm with caution and consult their ophthalmologist.
Validation status:
validated_via_expert_review
Evidence tier:
tier_c
Evidence basis:
expert_review_verbatim
Evidence anchors:
Exact phrase from label:
Increased eye pressure, which could worsen eye conditions like glaucoma
Label source:
Expert review: WebMD and clinical pharmacist databases list 'increased eye pressure, which could worsen eye conditions like glaucoma' as a known side effect concern for lemon balm, based on animal studies with essential oil
Action type:
informational_none