Is Ashwagandha recommended for stress and anxiety?

From the Guidelines

Ashwagandha is not recommended for stress and anxiety management based on the provided evidence. The most recent and highest quality study, 1, suggests that selective serotonin reuptake inhibitors (SSRIs) and venlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), are recommended for social anxiety disorder in adults, with a weak strength of recommendation and low certainty of evidence.

Key Points to Consider

• The provided evidence does not support the use of Ashwagandha for stress and anxiety management.
• The study 1 provides recommendations for pharmacotherapy for social anxiety disorder, but does not mention Ashwagandha as a treatment option.
• Another study, 1, provides recommendations for managing anxiety and depression in adult survivors of cancer, but also does not mention Ashwagandha as a treatment option.

Important Considerations

• When considering treatment options for stress and anxiety, it is essential to prioritize evidence-based recommendations and consult with a healthcare provider.
• While Ashwagandha may be considered a safe and potentially effective herbal supplement for stress and anxiety management in some contexts, the provided evidence does not support its use as a recommended treatment option.
• Patients should consult with a healthcare provider before using any supplements, especially if they are taking medications for other conditions or have underlying health concerns.

From the Research

Ashwagandha and Stress/Anxiety

• Ashwagandha supplementation has been found to significantly reduce anxiety and stress levels in several studies 2, 3, 4.
• A systematic review and meta-analysis of randomized controlled trials found that Ashwagandha supplementation reduced anxiety (SMD: -1.55,95% CI: -2.37, -0.74; p = .005) and stress level (SMD: -1.75; 95% CI: -2.29, -1.22; p = .005) compared to the placebo 2.
• A randomized, double-blind, placebo-controlled study found that Ashwagandha root extract alleviated stress, anxiety, and improved quality of life in healthy adults by modulating stress hormones 3.
• Another study found that Ashwagandha supplementation improved cognitive abilities, reduced cortisol levels, and self-reported mood, stress, food cravings, and anxiety in adults with perceived stress 4.

Mechanism of Action

• The key components of Ashwagandha, including 12 alkaloids and 35 withanolides, have been proven to be beneficial in the treatment of anxiety and stress 5.
• Withanolides and alkaloids have been shown to work as antidepressants and are the main reason Ashwagandha is beneficial for depression, although the mechanism of action is unknown 5.
• Ashwagandha has been found to stimulate the activation of immune system cells, inhibit inflammation, and improve memory in animal experiments 5.

Clinical Implications

• Health care professionals need to be aware of the variability in Ashwagandha products, quality controls, reported evidence regarding use, safety profile, and clinical implications in stress reduction 6.
• Clinical trials on Ashwagandha's effectiveness in anxiety-related conditions reveal conflicting results, although many show favorable findings 6.
• Ashwagandha has been found to be a potentially beneficial treatment for depression, with few or no associated adverse events 5.