HealthWatchlist verdict: Chamomile for anxiety has promising human research, mainly involving standardised oral extracts. The largest continuation trial did not establish a significant reduction in relapse. Tea and inhaled essential oil should not automatically inherit the extract results.
The preparation is central to the answer
A cup of chamomile tea, an extract capsule and a bottle of essential oil contain different mixtures at different concentrations. Calling them all “chamomile” can hide the most important fact about a study.
The clearest anxiety-disorder trials used German chamomile extracts. Those studies deserve consideration, while remaining separate from claims about inhaling an aroma or drinking tea before bed.
The early placebo-controlled trial
A 2009 trial randomised 57 people with mild to moderate generalised anxiety disorder. Participants received chamomile extract or placebo for eight weeks.
The primary anxiety score improved more with chamomile, with a reported P value of 0.047. It was a small positive study, and the authors called for replication rather than treating it as a definitive result.
The trial did not establish equivalence to a standard anxiety medicine. A placebo comparison and a head-to-head treatment comparison answer different questions.
The larger programme needs two separate readings
An open-label phase enrolled 179 people with moderate to severe generalised anxiety disorder. Symptoms improved during chamomile extract treatment, but everyone knew they were receiving it and there was no concurrent placebo group.
Expectations, symptom fluctuation and other influences can contribute to a before-and-after improvement. This report is also part of the same programme as the continuation trial, not a separate replication.
The randomised continuation phase included 93 responders. They either continued chamomile or switched to placebo. Relapse occurred in 7 of 46 continuing chamomile and 12 of 47 receiving placebo.
The primary time-to-relapse result was not statistically significant: the reported hazard ratio was 0.52, with a confidence interval spanning 1. Anxiety symptom scores during follow-up did favour chamomile.
Both findings belong in the conclusion. The trial suggests possible benefit, but does not establish relapse prevention. Because only initial responders entered this phase, its results do not apply equally to everyone starting treatment.
What the reviews add
A 2019 review separated generalised anxiety disorder from other anxiety and sleep outcomes. It found some favourable GAD results but no significant effect in its pooled general anxiety comparison.
A 2024 review of oral chamomile also found potential anxiolytic benefit. A favourable review does not remove the small-study limitations or turn multiple publications from one programme into independent confirmations.
These distinctions help explain why two summaries can sound different without necessarily disagreeing. They may be describing different diagnoses, outcomes or preparations.
Does the essential oil have the same evidence?
A cardiac-care trial tested chamomile combined with bitter-orange aroma in 76 patients. Anxiety scores improved compared with the control group over a short hospital intervention.
That is evidence about a mixture in a particular setting. It cannot isolate chamomile, establish long-term anxiety-disorder treatment or show that inhalation reproduces the oral-extract findings.
| Preparation | Reasonable conclusion |
|---|---|
| Standardised oral extract | Promising but limited direct GAD evidence. |
| Chamomile and bitter-orange aroma | A short-term mixture result in cardiac care. |
| Ordinary chamomile tea | Not proven equivalent to the trial extracts. |
Safety and practical decisions
NCCIH describes possible allergy and medicine-interaction concerns. People sensitive to related plants may react to chamomile. Discuss supplements with a pharmacist, particularly if you take warfarin or sedating medicines.
Do not swallow an essential oil to copy an extract trial. Extract doses are not a conversion guide for tea or oil, and products can differ in composition and quality.
A small study reporting few adverse events cannot rule out uncommon harms, interactions or problems during pregnancy. A proposed supplement should be considered alongside your existing treatment and circumstances.
Keep anxiety care focused on everyday functioning
NHS guidance supports assessment and established treatment when anxiety affects daily life. Psychological therapies and medicines can be considered according to need. Do not stop prescribed treatment in order to test a supplement.
If someone enjoys chamomile tea, that preference need not become a medical claim. The evidence question is whether a defined intervention produces a dependable clinical benefit.
Evidence score
John’s Evidence Score: 4/10 for standardised oral German chamomile extract improving GAD symptoms. This editorial score does not apply to bottled essential oil, and relapse prevention remains unestablished.
The most useful conclusion is cautious interest in the extract, with the non-significant primary continuation result kept visible.
How this review was researched
Research checked on 14 September 2026. We searched PubMed for the named oils or preparations and the condition, reviewed the retrieved study abstracts and relevant reviews, and checked the official guidance linked below. This is an editorial review, not an exhaustive systematic review. We distinguish human treatment outcomes from laboratory findings, and identify where a study tested a mixture or a different preparation.
Related reading
- Chamomile oil profile
- German chamomile profile
- Anxiety evidence overview
- Lavender preparations and anxiety
References
- A randomized, double-blind, placebo-controlled trial of oral Matricaria recutita (chamomile) extract therapy for generalized anxiety disorder.
- Short-term open-label chamomile (Matricaria chamomilla L.) therapy of moderate to severe generalized anxiety disorder.
- Long-term chamomile (Matricaria chamomilla L.) treatment for generalized anxiety disorder: A randomized clinical trial.
- Therapeutic efficacy and safety of chamomile for state anxiety, generalized anxiety disorder, insomnia, and sleep quality: A systematic review and meta-analysis of randomized trials and quasi-randomized trials.
- The Effect of Oral Chamomile on Anxiety: A Systematic Review of Clinical Trials.
- Effect of Citrus aurantium and chamomile aromas on anxiety and vital signs in cardiac care unit patients: A randomized clinical trial.
- NCCIH: Chamomile
- NHS: Generalised anxiety disorder