Scutellaria: A Multipurpose Plant for People of All Ages

NOTE: Skullcap should generally be avoided during pregnancy because it has been known to cause miscarriage, especially during the early stages of pregnancy. Skullcap can inhibit pituitary and chorionic gonadotropin hormones during pregnancy. Women who are breastfeeding should use this herb with caution since it has been known to lower prolactin levels in some cases, thus potentially lowering milk supply.

There are a few different medicinal varieties of skullcap, but the two most popular are Scutellaria baicalensis (Chinese skullcap/Huang Qin) and Scutellaria lateriflora (American skullcap). It’s important to note that although these two plants are closely related, they are different plants with some distinct differences. Throughout this article, please note that I will use “skullcap” to refer to both of these plants, and the individual names for each plant species when referring to either one or the other of these herbs. Other names for this herb include scullcap, mad-dog herb (due to the plant’s purported ability to treat rabies), hoodwort, and helmet flower.

The key constituents found in both Scutellaria baicalensis and Scutellaria lateriflora include various flavonoids, steroidal saponins, glycosides, tannins, and volatile oils, as well as the specific compounds baicalein, apigenin, oroxylin A, wogonoside, and scutellarin (among many, many other constituents found in lesser quantities). 

Baicalein has been studied in regard to its positive effects on the cardiovascular system, immune system, and the liver/gallbladder. This flavonoid can stimulate gallbladder activity and may encourage the release of bile from the liver and/or gallbladder, thus promoting digestion and hormonal processing. In the immune system, baicalein has also been found to inhibit inflammation and prevent viral and bacterial replication; it also may help prevent the proliferation of leukemia-derived T-cells. 

Medicinal Properties of Chinese Skullcap / Huang Qin (Scutellaria baicalensis)

Both the aerial parts and the root of Chinese skullcap may be used medicinally, so be sure to check which part of the plant should be used to treat which ailment (this is somewhat different from American skullcap, where the aerial parts are those most commonly used). Below are the medicinal uses of both parts of Chinese skullcap (Scutellaria baicalensis): 

• Sore throat
• Common cold
• Diarrhea
• Agitation
• Calms the fetus during pregnancy (NOTE: Some source advise against the use of skullcap during pregnancy, however it's worth noting that it does have a place in Traditional Chinese Medicine as an herbal remedy for some pregnancy issues)
• Diabetes
• Heart disease
• Cancer
• Bacterial infection
  • Staphylococcus aureus (one study even found that Scutellaria baicalensis could effectively treat penicillin-resistant S. aureus)
  • Bacillus cereus
  • Escherichia coli
  • Listeria monocytogenes
  • Salmonella anatum
• Fungal infection
  • Aspergillus fumigatus
  • Candida albicans
  • Geotrichumcandidum
  • Rhodotorula rubra
• Viral infections
  • Viral hepatitis
  • HIV-1
  • Rabies
  • Influenza
• Dysentery
• Hypertension
• Respiratory disease and other lung problems
• Liver problems
  • Hepatitis
  • Hepatic carcinoma
  • Hepatic fibrosis
• Insomnia
• Inflammation

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Antibacterial, Antifungal, and Antiviral Properties

Chinese skullcap has been used in homemade mayonnaise and other homemade foods to prevent the growth of Salmonella and Staphylococcus bacteria specifically. It also can potentiate the antimicrobial effects of certain pharmaceutical drugs that can be used against Staphylococcus aureus, including ciprofloxacin, ceftriaxone, gentamicin, and penicillin G.

Huang Qin (Scutellaria baicalensis root) has been studied as an effective, stand-alone treatment for both the common cold and bacterial pneumonia, including during pregnancy (although use of this herb should not be used flippantly during pregnancy since some research does suggest that it might cause miscarriage early in pregnancy). Chinese skullcap root is also frequently included in different antimicrobial TCM herbal remedies, including these: 

• Xiao Chai Hu Tang (Sho-Saiko-To in Japanese) - A TCM herbal remedy that includes Scutellaria baicalensis has been found to have positive results in the treatment of viral hepatitis. In this context, extracts of Chinese skullcap have been observed to specifically inhibit RNA replication of the hepatitis C virus. Other research has demonstrated that this herbal remedy improves liver function in 78% of hepatitis B cases and in 67% of non-A non-B type hepatitis cases; it can significantly reduce serum levels of the liver markers aminotransferase AST, ALT, and rGTP. Another study done on a group of 80 interferon-resistant hepatitis C patients found that the combination of a conventional medicine with Xiao Chai Hu Tang resulted in fully normalized liver enzyme function and significantly lower risk of liver cancer, compared to the control group of patients who only received conventional medicine treatments. This herbal remedy contains Chinese skullcap (Scutellaria baicalensis), Chai Hu (Bupleurum falcatum), Qing Han Ban Xia (Pinellia ternata), ginseng (Panax ginseng), licorice root (Glycyrrhiza uralensis), Ginger (Zingiber officinale), and red date (Ziziphus jujuba).

Aqueous extracts of Scutellaria baicalensis have demonstrated up to 91.1% inhibition of HIV-1 protease activity when administered at a concentration of 200mcg/mL, indicating this herb’s powerful action against the HIV. Baicalin is an important flavone found in Chinese skullcap that may be responsible for the plant’s effects against the HIV-1 virus. This flavone is a non-nucleoside reverse transcriptase inhibitor, meaning that it can ultimately prevent viral replication of HIV-1. In addition, baicalin can also help prevent the entry of the HIV-1 virus into cells, and the related flavone baicalein may also inhibit HIV-1 integrase, an enzyme vital for the life cycle of the HIV virus.

Chinese Skullcap for Cancer

Chinese skullcap has been found to have medicinal action against the following specific types of cancer in the body: 

• Brain tumors
• Prostate cancer
• HNSCC (head and neck squamous cell carcinoma)
• Lymphoma
• Myeloma
• Lung cancer
• Acute myeloid leukemia

Aqueous extracts of Scutellaria baicalensis, such as teas or decoctions, have been found to induce apoptosis in some cancer cell lines by altering expression levels of the Bcl genes in lymphoma and myeloma, and by increasing cyclin-dependant kinase inhibitor p27 (KIP1) activity and decreasing expression of the c-myc oncogene. In the treatment of some lung cancers, an increase in p53 and Bax protein activities after treatment with Scutellaria baicalensis may play a role in the plant’s anticancer effects. 

Of the various compounds found in Chinese skullcap, a few have been studied and found to have especially potent action against cancer. Baicalin, a flavone, specifically inhibits myeloma and lymphoma cell growth, while wogonoside (another flavone) has action against acute myeloid leukemia. 

Below are 2 TCM herbal remedies that contain Scutellaria baicalensis. Both have been used successfully to treat cancer: 

• Lung Fu Fang - This remedy has been found to prolong survival rates in patients with primary bronchial squamous cell carcinoma and/or non-small cell lung cancer. It may help improve quality of life and reduce clinical symptoms in patients with these specific types of cancer. This herbal remedy contains ginseng (Panax ginseng), Astragalus (Astragalus membranaceus), goji berry (Lycium barbarum), glossy privet fruit (Ligustrum lucidum), Sichuan fritillary bulb (Fritillaria cirrhosa), Radix Ophiopogonis (Ophiopogon japonicus), Chinese bellflower (Platycodon grandiflorum), Chinese skullcap (Scutellaria baicalensis), lily bulb (Lilium brownii), zedoary (Curcuma zedoaria), pseudo-ginseng (Panax notoginseng), and Bai Hua She She Cao (Oldenlandia diffusa).

• Fu Zheng - Scutellaria baicalensis is a major component in this TCM herbal remedy. Studies have found that the combination of Fu Zheng with conventional chemotherapy treatments can improve outcomes in patients with middle- and late-stage non-small cell lung cancer. This herbal remedy contains astragalus (Astragalus membranaceus), American ginseng (Panax quinquefolius), citrus peel (Citrus reticulata), Qing Han Ban Xia (Pinellia ternata), Chinese skullcap (Scutellaria baicalensis), Poria cocos fungus, Atractylodes (Atractylodes lancea), schisandra berry (Schisandra chinensis), Bai Hua She She Cao (Oldenlandia diffusa), ladybells (Adenophora stricta), and red sage (Salvia miltiorrhiza).

Medicinal Properties of American Skullcap (Scutellaria lateriflora)

And here are the medicinal uses of American skullcap (Scutellaria lateriflora):

• Hysteria
• Hydrophobia
• Nervous disorders
• Insomnia and other sleep disorders
• Rabies
  • NOTE: Skullcap is NOT a cure for rabies. It has, however, been proven to be a helpful supportive herb in treating this condition and can help relieve spasms, pain, and related rabies symptoms.
• Gynecological conditions
  • Menstrual irregularities
  • Postpartum recovery (among Cherokee women, a decoction of American skullcap root was given after childbirth to stimulate and support the recovery of the reproductive organs)
  • Menstrual cramps and pain
  • Premenstrual tension and PMS
• Anxiety
• Depression
• Muscle tension
• Nervous tension
• Epilepsy
• Chorea
• Kidney problems (Native American tribes used American skullcap as a kidney tonic)
• Panic attacks
• Schizophrenia
• Restless leg syndrome
• Fibromyalgia
• Alzheimer’s disease
• Parkinson’s disease
• Huntington’s disease
• Edema
• Inflammatory bowel conditions
• Problems caused by substance abuse
  • Sleeplessness and restlessness caused by opiate withdrawals
  • Benzodiazepine withdrawals
  • Delirium tremens (alcohol withdrawal)
• Migraines/headaches (including those that arise from incessant coughing)
• Nervous stress/tension following shock or loss

Scutellaria lateriflora possesses the following specific medicinal actions in the body: 

• Febrifuge
• Relaxant
• Decongestant
• Anti-tumor/Anticancer
• Nervine
  • As a nervine, American skullcap calms the nervous and muscular systems, thus relieving issues such as insomnia, muscle twitches and spasms, tremors, convulsions, restlessness, irritability, and more. While it may not cure certain conditions that are characterized by these symptoms, it can become an important part of a treatment protocol for these problems.
• Anti-angiogenesis
• Neuroprotective
• Anticonvulsant
• Bronchodilatory
• Analgesic
• Anxiolytic
• Central nervous system vasodilatory

Herbalism experts agree that American skullcap is generally a milder, less intense herb than Chinese skullcap. While the two have a lot in common medicinally, American skullcap may be a better choice in cases where children or particularly weak people are being treated since it can be gentler in its medicinal action.

American skullcap was not only a medicinal plant among Native American tribes, but also a ceremonial plant. In fact, some groups smoked this Scutellaria plant similarly to tobacco in order to produce visions. It was also commonly used as a part of purification rituals in some cases, or to aid spirit exorcisms and provide protection during shamanic journeys. 

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Skullcap in Traditional Chinese Medicine

In Traditional Chinese Medicine (TCM), Chinese skullcap root is known as Huang Qin, or the “Golden Herb”. It is an official entry in the Chinese Pharmacopeia, owing to its 2000+ year history of medicinal use in China and the surrounding areas. 

Both Chinese and American skullcaps are Bitter and Cold herbs. Scutellaria baicalensis specifically is known to be a valuable herbal treatment for clearing all of the “superficial evils” from the body, which include not only Heat and Damp, but also Cold, Wind, and Damp Heat; Scutellaria baicalensis works to clear away all of these, but excels specifically at clearing Heat, Damp, and Damp Heat. Chinese skullcap is thought to interact primarily with the Gallbladder, Large Intestine, Lung, and Stomach meridians, while American skullcap works with the Stomach, Lung, and Kidney meridians. 

Chinese skullcap works as a sedative, and for this purpose it is frequently combined with other herbs that have similar properties, such as valerian root. For example, an infusion of Chinese skullcap and valerian root has previously been employed to treat neuralgia, headaches, and other similar complaints.

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Scutellaria for Seizures and Epilepsy

Scutellaria lateriflora has long been used as a treatment for seizures and epilepsy. It has a long history of use specifically for the management of petit mal seizures, as well as for other types of seizures and convulsive disorders. Different species of Scutellaria have been used in both Traditional Chinese Medicine and in Ayurveda as a treatment for epilepsy and related conditions; in Ayurvedic medicine specifically, a remedy known as Skullcap Ramayana #16 includes skullcap along with 18 other healing plants to treat epilepsy, insomnia, tremors, muscle spasms, neuralgia, neurosis, and nervous headaches. 

One study done on rats with pilocarpine-induced epileptic seizures found that baicalin, a flavone found in Scutellaria species, is indeed antiapoptotic, antioxidant, anticonvulsant, and neuroprotective. Rats who were pre-treated with baicalin exhibited delayed onset of limbic seizures and status epilepticus, as well as reduced mortality due to seizures. Baicalin was also found to reverse certain neurological effects of pilocarpine; it improved levels of glutathione and reduced lipid peroxidation and nitrite content in the hippocampus. Administration of baicalin also prevented neuronal cell loss, degeneration, and apoptosis as a result of pilocarpine-induced seizures. As such, the researchers concluded that baicalin, and thus Scutellaria plants, may be an important treatment option for the reduction of seizures and seizure-induced brain damage.

Another animal study observed the effects of 4 different Scutellaria species in the treatment of seizures and epilepsy; the species studied were Scutellaria brevebracteata, Scutellaria galericulata, Scutellaria megalapsis, and Scutellaria orientalis. In this study, seizures were induced by the administration of pentylenetetrazol. The rats were given methanolic extracts of each of the Scutellaria plants dissolved in saline, which was then administered intraperitoneally. A 200mg/kg dose of Scutellaria methanolic extract was given each day for 5 days before pentylenetetrazol administration. In the rats who received Scutellaria extracts, the latency to myoclonic and tonic-clonic convulsions was prolonged. The animals who received Scutellaria also generally exhibited fewer seizures than the control group.

The anticonvulsant effects of skullcap are thought to stem from the plant’s ability to bind with the GABA-a benzodiazepine receptors in the brain and nervous system, as well as the herb’s general interactions with the GABAergic system outside of benzodiazepine receptors. Specifically, baicalein is the main compound in skullcap that interacts with benzodiazepine receptors, while wogonin acts directly as anticonvulsant through neuronal involvement with the GABAergic system. 

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Scutellaria for Problems in Babies and Children

Teething Tea for Babies with Scutellaria lateriflora

Scutellaria lateriflora and Scutellaria baicalensis have both historically been used to treat teething in infants of all ages (at age-appropriate doses). These two herbs can be utilized in a few different ways to relieve pain from teething and problems with tooth eruption, including as tea, a teething rub for the gums, as a tincture, or as a homeopathic remedy. Indeed, skullcap is included in many, many natural teething formulations for babies and young children, and this herb combines well with certain other herbs for relieve not only of teething pain, but also of the symptoms that frequently accompany teething, such as fever, gastrointestinal complaints, general irritability, and more.

Although you can use Scutellaria baicalensis for babies, Scutellaria lateriflora is the better option since this particular herb has a better documented history of use as a teething herb for babies. Also, it tends to be a bit gentler, making it a better option especially for younger infants. That being said, if all you have available is Scutellaria baicalensis, feel free to try this herb, but consider cutting the dose in half at first until you know how your baby responds to this tea.

Below is a recipe for 1 serving of Teething Tea for babies: 

• German Chamomile (Matricaria chamomilla) - 1-2 teaspoons of dried flowers OR 1-2 teabags 
  • NOTE: (McCormick is an easy-to-find and affordable chamomile tea brand that contains the correct type of chamomile; always make sure you’re using GERMAN chamomile and not ROMAN chamomile, which is the very different and unrelated Anthemis nobilis)
• American Skullcap (Scutellaria lateriflora) - 1 teaspoon of dried flowers 
• Catnip (Nepeta cataria) - 1 teaspoon of dried leaves
• Clove (Syzygium aromaticum) - 3 crushed, whole cloves OR ¼ teaspoon of group cloves
  • NOTE: Cloves can produce a very powerful flavor that may be unpalatable to some children. This is also a potent medicine, so don’t be fooled by clove’s common use in the kitchen. Start with 1 clove or a small sprinkle of ground cloves if you’re treating an especially young infant, or omit entirely if you find that your child doesn’t like the flavor (rubbing diluted clove essential oil on the gums is also an option for teething pain relief).
• Passionflower (Passiflora incarnata) - ⅛ teaspoon of passionflower powder
• Lemon Balm (Melissa officinalis) - 1 teaspoon of dried herb
• Licorice Root (Gychyrizzia glabra) - ⅛ teaspoon of powder
  • NOTE: Older infants and toddlers who like to chew on things during teething may also like to chew on licorice sticks, since these are sweet and can help relieve pain from teething (if your child is not adept at eating and chewing yet, make sure to supervise the chewing of licorice root sticks to prevent accidental choking). Licorice root is also excellent for gastrointestinal issues and general inflammation and can combat teething symptoms on a few levels. 
• Lavender (Lavandula officinalis) - ½ teaspoon of dried herb OR a few leaves of fresh lavender (lavender doesn’t necessarily relieve teething pain, however it can help soothe the nervous system in a general way and may relieve irritability, distress, and anxiety that can arise during teething; it can also help improve sleep quantity and quality).

To prepare this tea, combine all of the herbs above in a small saucepan. Add 10-12 ounces of clean, fresh water, and turn the stove on low. Cover and let simmer for 10-15 minutes, then turn off the stove and let the tea cool. Strain, then give directly to the child in a bottle or sippy cup (depending on their age). Infants under 6 months of age can be given small doses via a dropper on an as-needed basis (tea is, of course, water-based, and children under 6 months of age should not consume water in excess; small quantities are unlikely to be harmful, however, especially if you’re administering tea to treat a specific health issue). In babies between 6-9 months of age, give half of this tea in the morning or early afternoon and another half in the evening before bed (or overnight instead of milk to relieve pain or discomfort during the night). In children over 9 months of age, the full dose of tea can be given at one time if desired.

Add Grade A organic maple syrup, raw honey, or stevia/monk fruit drops to sweeten the tea. Maple syrup or raw honey (in children over 1 year of age) can be good choices in situations where the child isn’t eating much due to an upset stomach since these can add in some extra calories during the day, as well as add a little bit of extra nutritional value to this tea. 

If your child prefers it, you may choose to soak a washcloth in some of this tea and then freeze the cloth. Then, your child can chew on this cloth, and will receive small amounts of the tea internally while also getting some relief from chewing on the cold cloth (keep in mind, however, that some children may like this and some may not).

Scutellaria lateriflora Homeopathic Remedies for Problematic Dentition

A study conducted in 1998 confirmed that a homeopathic remedy consisting of Belladonna 30CH, Chamomilla 30CH, and Scutellaria D6 was more effective in resolving teething problems in babies than placebo. 30 infants were included in this study, and the 15 babies who received this homeopathic complex were found to have fewer signs and symptoms of teething, and those signs and symptoms that did still show up were less severe than those seen in the other 15 infants who received a placebo. 

A different formulation produced by Newton Homeopathics for the treatment of teething pains, sleeplessness, colic, and inconsolable crying contains the following homeopathic medicines and Schuessler Tissue Salts in equal proportions (I have included some more information as to what each remedy is used for according to the Homeopathic Materia Medica so that parents can decide which remedies would suit their children best): 

• Chamomilla 6x and/or 15x - Diarrhea due to/during teething; Distress caused by teething; Peevishness, restlessness, or colic caused by other diseases or health issues
• Valeriana officinalis 6x - Used to relieve sleeplessness; Relieves oversensitivity; Treats infants who vomit large clumps of curdled milk after nursing or who have thin, watery diarrhea with visible, white clumps of milk, especially when these symptoms are accompanied by violent screaming
• Aconitum napellus 15x - Used to relieve hot, inflamed gums; also used to treat jaw pain and tension
• Apis mellifica 15x - Used to treat gum inflammation, diarrhea, constipation, and abdominal tenderness
• Baptisia tinctoria 15x - Used to treat soreness of the gums due to teething/toothache; Can treat sores and ulcers on the gums; Treats chronic GI problems that lead to foul smelling bowel movements or frequent belching
• Belladonna 15x - Treats colic; Use when teething pain is relieved by biting
• Borax 15x - Treats colic; Use when the mouth is hot and tender and/or when the child cries during nursing; Relieves loose and/or foul smelling stools, especially when these are preceded by colic
• Bryonia 15x - Used for sore mouth (due to teething or other causes), especially when the mucus membranes are dry
• Calcarea carbonica 15x - Teething pain and other teething-related problems; Delayed or difficult dentition; stomach cramps; convulsions without fever
• Calcarea phosphorica 15x - Teething pain and other teething-related problems; Delayed or difficult dentition; Convulsions without fever; Colic
• Chelidonium majus 15x - Treats colic; Right cheek bone feels swollen, but without pain
• Coffea cruda 15x - Used for colic and the treatment of fevers, especially those accompanied by pain or tendency to weep; Relieves oversensitivity
• Collinsonia canadensis 15x - Treats colic and alternation between diarrhea and constipation; Use for constipation caused by intestinal atony
• Colocynthis 15x - Relieves extreme irritability and colic; Stomach ache during teething; When infant has colic, he/she lies on tummy and screams when moved even slightly
• Kreosotum 15x - Treats colic and sleeplessness, especially where child will not sleep unless held close or rocked; Relieves teething-related issues
• Magnesia phosphorica 15x - Teething pain and other teething-related problems; Treats colic, especially extreme, griping colic pain that shoots upward from the stomach; Spasms during teething without fever
• Nux vomica 15x - Treats colic in breastfed infants when the mother has eaten a stimulating food; Swollen, white, and/or bleeding gums
• Podophyllum peltatum 15x - Treats pain that causes the child to want to press their gums together or to chew persistently; Relieves difficult dentition
• Rheum 15x - Treats colic and excessive salivation accompanied by colic or diarrhea; Use in children with foul-smelling diarrhea or those who scream and cry due to colic; Treats difficult dentition
• Scutellaria lateriflora 15x - Treats pain due to colic and general uneasiness; Relieves nervous irritation and teething-provoked spasms in children
• Silicea 15x - Relieves constipation, colic, and teeth cutting pains
• Terebinthina 15x - Treats frequent colic and abdominal distention
• Zingiber officinale 15x - Relieves colic, diarrhea, constipation, and flatulence

While some people may, of course, be able to purchase this exact remedy and use it as-is, other parents may not be able to purchase this product or may prefer to make their own remedy complex for their child. In this case, consider the medicinal applications of each remedy above, and compile a list of remedies that best fit your own child’s individual needs. Give 1 drop or 1 pellet of each of the remedies you choose. For children under age 2, the pellets should be crushed and then dissolved in clean, fresh water (add some stevia drops if needed to improve the flavor). Give these homeopathic remedies separately from food (ideally, wait 30 minutes before and after administration before giving the child food or drinks like juice or milk).

Scutellaria for Chicken Pox

One source recommends the use of skullcap as part of an herbal chicken pox remedy. ¼ to ½ teaspoon of skullcap tincture should be given as needed, along with giving regular baths with either oatmeal, comfrey, burdock root, sea salt, or baking soda. 1-2 drops of German chamomile, tea tree, and/or lavender essential oils can also be added to the bath. After each bath, an herbal healing salve should be applied to treat sores. 

How to Administer Scutellaria

Either the root or the whole plant can be used medicinally with either herb, though in the case of Chinese skullcap, the root is the more commonly used part of the plant. If purchasing the whole Chinese skullcap root, look for a product that is solid, thick, and long. It should ideally be a nice yellow color, and should not have a cortex.

Skullcap’s flavonoids can easily be extracted into water in the form of a tea, decoction, or infusion. Tea prepared using American skullcap specifically is considered to be a very safe and gentle nervine, and can even be used to relieve teething symptoms in infants. In terms of dental health, skullcap can also be valuable as a preventative medicine for gingivitis and periodontal disease since it helps increase collagen production in the gums. 

To brew a tea using dried skullcap herb (not the root), prepare a tea using 1-2 grams of the dried herb and drink up to 3 times per day for adults and teenagers. The tincture should be given at a dose of 2-4mL, 3 times daily in adults. Capsules containing freeze-dried aerial parts of skullcap have been given at a dose of 350mg, 3 times per day for 2 weeks as a treatment for mood problems in adults. 

For babies and children, follow these guidelines to adjust the dose based on the child’s age (when in doubt, start with a dose even lower than that recommended below and work your way up slowly; note, however, that skullcap does have a long history of use in people of all ages, including children, and is generally regarded as being quite safe): 

• 6 months to 1 year - Give 12% of the adult dosage
• 1-2 years - Give 25% of the adult dosage
• 3-7 years - Give 50% of the adult dosage
• 8-12 years - Give 75% of the adult dosage
• 12+ years - Give up to the full adult dosage (unless your child is particularly small for their age, and then consider giving them 75% of the adult dosage to start)

Note that skullcap combines well with passionflower for the treatment of tension and anxiety (this combination can also promote restful sleep), with German chamomile for stomach upset, and with lemon balm for emotional complaints, irritability, or general moodiness.



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