The DOI matches its Crossref record; 3 of the 3 references it cites were found in a registry or an index.
Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta‐analysis of randomized controlled trials
Open accessAbstract
Clinical trial studies revealed conflicting results on the effect of Ashwagandha extract on anxiety and stress. Therefore, we aimed to evaluate the effect of Ashwagandha supplementation on anxiety as well as stress. A systematic search was performed in PubMed/Medline, Scopus, and Google Scholar from inception until December 2021. We included randomized clinical trials (RCTs) that investigate the effect of Ashwagandha extract on anxiety and stress. The overall effect size was pooled by random‐effects model and the standardized mean difference (SMD) and 95% confidence interval (CIs) for outcomes were applied. Overall, 12 eligible papers with a total sample size of 1,002 participants and age range between 25 and 48 years were included in the current systematic review and meta‐analysis. We found that Ashwagandha supplementation significantly reduced anxiety (SMD: −1.55, 95% CI: −2.37, −0.74; p = .005; I 2 = 93.8%) and stress level (SMD: −1.75; 95% CI: −2.29, −1.22; p = .005; I 2 = 83.1%) compared to the placebo. Additionally, the non‐linear dose–response analysis indicated a favorable effect of Ashwagandha supplementation on anxiety until 12,000 mg/d and stress at dose of 300–600 mg/d. Finally, we identified that the certainty of the evidence was low for both outcomes. The current systematic review and dose–response meta‐analysis of RCTs revealed a beneficial effect in both stress and anxiety following Ashwagandha supplementation. However, further high‐quality studies are needed to firmly establish the clinical efficacy of the plant.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Conclusive evidence from rigorous, methodologically sound, well-designed, validated, and replicated trials does not exist for the indications for which ashwagandha is used.
“Nonetheless, conclusive evidence from rigorous, methodologically sound, well-designed, validated, and replicated trials does not exist for the aforementioned indications.11–13”
From Ashwagandha-induced liver injury—A case series from India and literature review (2023) · cites this paper as [13]
Citations
Cites
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305 · cited 1×
“We also rated the certainty of evidence using the GRADE approach (Guyatt et al., 2008).”
MethodPaul, S., Chakraborty, S., Anand, U., Dey, S., Nandy, S., Ghorai, M., Saha, S. C., Patil, M. T., Kandimalla, R., Proćków, J., et al. (2021) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2021.112175 · Cited by 306
Neuroprotective Effects of Withania somnifera Dunn. in Hippocampal Sub‐regions of Female Albino Rat
Jain, S., Shukla, S. D., Sharma, K., & Bhatnagar, M. (2001) · Phytotherapy Research · doi:10.1002/ptr.802 · Cited by 101
Flagged first, then by citations
Research works printed but not linked: 43
- Abedon B., 2008, A standardized Withania somnifera extract significantly reduces stress‐related parameters in chronically stressed humans: A double‐blind, randomized, placebo‐controlled study, Jana, 11, 51
- Ahmed R., 2017, Holistic approach in the management of depression: A review, Journal of Integrated Community Health, 6, 10
- 10.12659/MSM.882608 · DOI
- Andrade C., 2000, A double‐blind, placebo‐controlled evaluation of the anxiolytic efficacy ff an ethanolic extract of Withania somnifera, Indian Journal of Psychiatry, 42, 295
- 10.1007/s11064-009-9987-7 · DOI
- 10.1016/S0944-7113(00)80030-6 · DOI · Paper page
- 10.1002/9781119558378 · DOI · Paper page
- 10.4103/0253-7176.106022 · DOI
- 10.1371/journal.pone.0257843 · DOI
- 10.4088/JCP.13m08413 · DOI
- 10.4088/JCP.17m11826 · DOI
- 10.1177/2156587216641830 · DOI
- Edition F., 2013, Diagnostic and statistical manual of mental disorders, American Psychiatric Association, 21, 591
- Gannon J. M., 2019, Effects of a standardized extract of Withania somnifera (Ashwagandha) on depression and anxiety symptoms in persons with schizophrenia participating in a randomized, placebo‐controlled clinical trial, Annals of Clinical Psychiatry, 31, 123
- 10.4103/0019-5545.102424 · DOI · Paper page
- 10.4103/2249-4863.109934 · DOI · Paper page
- Griffin C. E., 2013, Benzodiazepine pharmacology and central nervous system–mediated effects, The Ochsner Journal, 13, 214
- 10.1136/bmj.d5928 · DOI · Paper page
- 10.3389/fnins.2018.00562 · DOI
- Khyati S., 2013, A randomized double blind placebo controlled study of ashwagandha on generalized anxiety disorder, International Ayurvedic Medical Journal, 1, 1
- 10.1016/bs.vh.2016.09.004 · DOI
- Kumar V., 2015, Chemistry and pharmacology of Withania somnifera: An update, CELLMED, 5, 1.1
- Langade D., 2019, Efficacy and safety of Ashwagandha (Withania somnifera) root extract in insomnia and anxiety: A double‐blind, randomized, placebo‐controlled study, Cureus, 11, e5797
- 10.1016/j.jep.2020.113276 · DOI
- 10.1016/j.hermed.2021.100434 · DOI
- 10.1097/MD.0000000000017186 · DOI · Paper page
- Mediratta P., 2001, Development of differential tolerance to the sedative and anti‐stress effects on benzodiazepines, Indian Journal of Physiology and Pharmacology, 45, 111
- Mehta A., 1991, Pharmacological effects of Withania somnifera root extract on GABAA receptor complex, The Indian Journal of Medical Research, 94, 312
- 10.1016/j.ijsu.2010.02.007 · DOI · Paper page
- 10.1002/ptr.7200 · DOI
- 10.1080/10408398.2019.1678012 · DOI
- 10.1007/s00394-020-02204-5 · DOI
- Nemeroff C. B., 2003, The role of GABA in the pathophysiology and treatment of anxiety disorders, Psychopharmacology Bulletin, 37, 133
- 10.1007/978-3-319-28155-1_23 · DOI
- 10.2174/157488409789375311 · DOI
- 10.1089/acm.2014.0177 · DOI
- Provino R., 2010, The role of adaptogens in stress management, Australian Journal of Medical Herbalism, 22, 41
- Salve J., 2019, Adaptogenic and anxiolytic effects of ashwagandha root extract in healthy adults: A double‐blind, randomized, placebo‐controlled clinical study, Cureus, 11, e6466
- Selye H., 1956, The stress of life
- Singh G., 2010, Biological activities of Withania somnifera, Annals of Biological Research, 1, 56
- 10.1016/j.jep.2021.113929 · DOI
- 10.1111/bph.14943 · DOI
- 10.1016/j.jep.2020.112876 · DOI
Cited by
Sorted by citations
Ashwagandha-induced liver injury—A case series from India and literature review
Philips, C. A., Valsan, A., Theruvath, A. H., Ravindran, R., Oommen, T. T., Rajesh, S., Bishnu, S., Augustine, P., & India, O. B. O. T. L. R. C. (2023) · Hepatology Communications · doi:10.1097/hc9.0000000000000270 · Cited by 62
Metadata
- Authors
- Akhgarjand, C., Asoudeh, F., Bagheri, A., Kalantar, Z., Vahabi, Z., Shab‐bidar, S., Rezvani, H., & Djafarian, K.
- Affiliations
- Tehran University of Medical Sciences (IR)
- Roozbeh Hospital (IR)
- Taleghani General Hospital (IR)
- Corresponding author
- Djafarian, Kurosh
- ORCID
- Venue
- Phytotherapy Research
- Publisher
- Wiley
- Published
- 2022-08-25
- Volume
- 36
- Issue
- 11
- Pages
- 4115-4124
- ISSN
- 0951-418X (ISSN-L)
- 1099-1573
- OpenAlex
- W4293217615
- Cited by
- 93
- References
- 3
- Citations by year
- 2026: 25 · 2025: 23 · 2024: 26 · 2023: 18 · 2022: 1
- FWCI
- 3.56
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Locations
- Phytotherapy Research (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Phytochemicals and Medicinal Plants
- Health Sciences › Medicine › Complementary and alternative medicine › Medicinal Plant Extracts Effects
- Health Sciences › Medicine › Complementary and alternative medicine › Medicinal Plants and Bioactive Compounds
- Keywords
- Withania somnifera, anxiety, stress, herbal supplementation, dose-response relationship, adaptogens
- MeSH terms
- Adult, Anxiety, Anxiety Disorders, Humans, Middle Aged, Plant Extracts, Randomized Controlled Trials as Topic, Dietary Supplements, Withania
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
