Does ashwagandha affect specific mental health conditions?

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Ashwagandha’s potential to moderate the HPA axis, as well as GABAergic and serotonergic activity, may explain at least some of its proposed effects on mental health, but more research is needed to better understand the underlying mechanisms.[1] In a rodent study, ashwagandha promoted social interaction and attenuated the negative effects of prolonged isolation on social function in rats.[2] It is not clear whether the same effects might be seen in humans, but this could be a well-timed avenue for further research to explore. Ashwagandha’s anti-stress effects seem to be related to corticosterone signaling and suppression of neuronal excitation (through modulating nNOS and glutamate signaling) in response to stress. It may also exert some anxiety-reducing effects secondary to the anti-stress properties, via serotonergic and GABAergic signaling. Even lower doses of ashwagandha appear to potentiate the effects of any GABAergic anxiolytic, including alcohol consumption.[3][4][5][6][7][8][9][2][10] In human trials, reduced anxiety has been observed with doses starting at 300 mg, daily up to 12,000 mg/day of ashwagandha over periods ranging from 4–8 weeks. For general stress reduction that hasn’t reached the point of anxiety, 300–600 mg daily appears to be sufficient. [11][12][13][14][15][16][17]

In animal studies, ashwagandha appears to exert antidepressant effects on its own with a potency comparable to antidepressant medication.[18][2][19] In human studies, 200–400 mg of ashwagandha daily over the course of 30–60 days reduced symptoms of depression in participants with elevated levels of stress.[20][21]

Ashwagandha may also be helpful in mitigating the signs and symptoms associated with other psychological conditions such as schizophrenia, bipolar disorder, and/or obsessive compulsive disorder. However, more evidence is needed to establish whether any clear effect exists for these specific conditions.[22][23][24][25]

References
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9.^Dawson TM, Bredt DS, Fotuhi M, Hwang PM, Snyder SHNitric oxide synthase and neuronal NADPH diaphorase are identical in brain and peripheral tissues.Proc Natl Acad Sci U S A.(1991-Sep-01)
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12.^Zhang W, Yan Y, Wu Y, Yang H, Zhu P, Yan F, Zhao R, Tian P, Wang T, Fan Q, Su ZMedicinal herbs for the treatment of anxiety: A systematic review and network meta-analysis.Pharmacol Res.(2022-May)
14.^Cooley K, Szczurko O, Perri D, Mills EJ, Bernhardt B, Zhou Q, Seely DNaturopathic care for anxiety: a randomized controlled trial ISRCTN78958974PLoS One.(2009 Aug 31)
15.^Andrade C, Aswath A, Chaturvedi SK, Srinivasa M, Raguram RA double-blind, placebo-controlled evaluation of the anxiolytic efficacy ff an ethanolic extract of withania somniferaIndian J Psychiatry.(2000 Jul)
17.^Sarris J, Ravindran A, Yatham LN, Marx W, Rucklidge JJ, McIntyre RS, Akhondzadeh S, Benedetti F, Caneo C, Cramer H, Cribb L, de Manincor M, Dean O, Deslandes AC, Freeman MP, Gangadhar B, Harvey BH, Kasper S, Lake J, Lopresti A, Lu L, Metri NJ, Mischoulon D, Ng CH, Nishi D, Rahimi R, Seedat S, Sinclair J, Su KP, Zhang ZJ, Berk MClinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce.World J Biol Psychiatry.(2022-Jul)
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21.^A Remenapp, K Coyle, T Orange, T Lynch, D Hooper, S Hooper, K Conway, H A HausenblasEfficacy of Withania somnifera supplementation on adult's cognition and moodJ Ayurveda Integr Med.(2021 Nov 25)
22.^Çakici N, van Beveren NJM, Judge-Hundal G, Koola MM, Sommer IECAn update on the efficacy of anti-inflammatory agents for patients with schizophrenia: a meta-analysis.Psychol Med.(2019-Oct)
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25.^Daphna JoelCurrent animal models of obsessive compulsive disorder: a critical reviewProg Neuropsychopharmacol Biol Psychiatry.(2006 May)