Arumugam · Explore (New York, N.Y.) 2024 · systematic review and meta-analysis · n=9 studies (558 participants)

Effects of Ashwagandha (Withania Somnifera) on stress and anxiety: A systematic review and meta-analysis.

Cited 31 times in the scientific literature.

Level 1 - systematic review of randomized trials

Systematic review and meta-analysis of randomized controlled trials

PubMed 39348746 · doi:10.1016/j.explore.2024.103062 · record verified 2026-08-29

What was done

Systematic review and meta-analysis searching MEDLINE, EMBASE, PubMed, PsychINFO, and Cochrane Library (January 2000 to January 2022) for randomized controlled trials evaluating Ashwagandha (Withania somnifera) formulations on stress and anxiety. Two authors independently extracted subjective and objective outcome measures comparing Ashwagandha to placebo.

What was found

Nine randomized controlled trials with 558 participants were included. Compared to placebo, Ashwagandha significantly reduced: - Perceived Stress Scale (PSS): MD = -4.72 (95% CI = -8.45 to -0.99) - Hamilton Anxiety Scale (HAS): MD = -2.19 (95% CI = -3.83 to -0.55) - Serum cortisol levels: MD = -2.58 (95% CI = -4.99 to -0.16) Four included studies reported mild to moderate adverse events.

Why it matters

This meta-analysis aggregates trial evidence showing Ashwagandha improves both subjective stress and anxiety measures as well as biological cortisol levels. It provides pooled quantitative estimates for clinical evaluation.

Limits

The total sample size across nine studies is small (558 patients). The abstract does not specify dosing, formulation standardization, study durations, units of measurement for cortisol, or long-term safety data.

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