Ashwagandha

herb Verified

Specifically for Schizophrenia

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Why it works for Schizophrenia:

Briefly, ashwagandha contains bioactive withanolides and related compounds that have several properties potentially relevant to schizophrenia:

Anti-inflammatory / immunomodulatory — schizophrenia (at least in some patients) has immune-inflammatory dysregulation; ashwagandha modulates cytokines, COX-2 and NF-κB signalling in preclinical models, which may reduce inflammation-linked symptom severity. Psychiatrist.com
Antioxidant / neuroprotective — reduces oxidative stress markers in animal and some human studies (relevant because oxidative stress is implicated in schizophrenia). ScienceDirect
GABAergic and glutamatergic (NMDA) modulation — components of W. somnifera show GABA-like activity and NMDA-modulating effects in preclinical work; this may plausibly help negative symptoms, cognition or stress-related symptoms. Psychiatrist.com
Stress / cortisol reduction (adaptogen effects) — it lowers perceived stress and cortisol in multiple studies; lowering stress can improve general psychopathology and negative symptoms. MDPI

Summary: the proposed biological rationale is an anti-inflammatory / antioxidant / neuromodulatory action plus stress reduction — not a direct antipsychotic effect. That’s why studies have tested it as an adjunct to standard antipsychotic medication. Psychiatrist.com

How to use for Schizophrenia:

The largest controlled trial to date (University of Pittsburgh / J Clin Psychiatry, Chengappa et al., 2018) used a standardized Withania somnifera extract (Sensoril®). Key practical details from that randomized, double-blind, placebo-controlled study:

Formulation used: standardized extract (Sensoril®). (Important — different products vary widely.) Psychiatrist.com
Dosing schedule in the trial: 250 mg twice daily (500 mg/day) for week 1, then titrated to 500 mg twice daily (1,000 mg/day) from week 2 and maintained for a total of 12 weeks (unless tolerability required reduction). Psychiatrist.com
How given: adjunctive to ongoing antipsychotic treatment (participants continued their antipsychotics; the herb was added on top). The trial population were patients experiencing a recent exacerbation of symptoms. Psychiatrist.com
Outcomes measured: PANSS (positive, negative, general, total) and Perceived Stress Scale (PSS); benefit was seen for negative, general and total PANSS and stress, but not positive symptoms. Improvements started around 4 weeks and continued through 12 weeks. Psychiatrist.com

If a clinician were to consider this evidence (not a recommendation to self-treat), the trial protocol gives the clearest, evidence-based regimen: use a standardized extract, start low for 1 week (250 mg BID) then 500 mg BID (1,000 mg/day) as tolerated, and treat for several weeks while monitoring. Psychiatrist.com

Scientific Evidence for Schizophrenia:

Randomized / controlled trials

Chengappa K.N.R. et al., J Clin Psychiatry, 2018 — Adjunctive standardized Withania somnifera extract (Sensoril®) vs placebo in schizophrenia (n=66). Result: adjunctive WSE (1,000 mg/day) produced significantly greater reductions in negative, general and total PANSS scores and reduced perceived stress versus placebo; adverse events were generally mild (somnolence, GI complaints). (Full article / PDF). Psychiatrist.com

Earlier / pilot clinical trials

Agnihotri et al., Indian Journal of Pharmacology, 2013 — small randomized double-blind pilot trial (reported brief in the literature) suggested possible benefit (smaller pilot evidence; see trial summaries). Magistral BR

Physiological / mechanistic & review articles

Review — “Ashwagandha in brain disorders: A review of recent developments” (ScienceDirect / Neuroscience reviews) — summarizes neuroprotective, anti-inflammatory, GABAergic/NMDA effects and clinical data across neuropsychiatric conditions. ScienceDirect
Recent systematic/review articles (MDPI Nutrients, 2025 etc.) — meta-analyses and reviews supporting stress/anxiety and cognitive effects, and summarizing safety data. MDPI

Clinical trial registration & related resources

ClinicalTrials.gov NCT01793935 — trial registry entry for the Chengappa et al. study (provides protocol/registration details). ClinicalTrials

Specific Warnings for Schizophrenia:

Major, evidence-backed warnings

Use only as adjunct — do not stop antipsychotics. The trials added ashwagandha to ongoing antipsychotic therapy. Do not replace prescribed antipsychotics with herbal supplements. (Trial context). Psychiatrist.com
Possible sedation / GI side effects: somnolence, epigastric discomfort, loose stools were reported more often with WSE in the schizophrenia trial. Monitor sedation especially if patient is on benzodiazepines or other sedatives. Psychiatrist.com
Drug interactions: may interact with — and potentiate effects of — sedatives (benzodiazepines, Z-drugs), diabetes medications (can lower blood glucose), antihypertensives, thyroid hormone medications, and immunosuppressants. The National Center for Complementary and Integrative Health (NCCIH) and multiple drug-interaction sources list these interactions. If the patient is on any of these, discuss with prescribing clinicians. NCCIH
Autoimmune / immunosuppressant caution: because ashwagandha has immunomodulatory effects it could interfere with immunosuppressive therapy or exacerbate autoimmune disease — avoid or use with caution under specialist advice. NCCIH
Thyroid effects: ashwagandha may increase thyroid hormone levels in some people; caution if the patient has thyroid disease or is on thyroid medication — monitoring is recommended. NCCIH
Pregnancy & breastfeeding: safety not established — generally avoid in pregnancy and breastfeeding. NCCIH
Perioperative: recommended to stop at least 2 weeks before surgery because of possible interactions with anesthesia and effects on blood pressure/immune function. Nutritional Medicine Institute
Rare reports of psychiatric adverse events / withdrawal-like symptoms: there are case reports of withdrawal and even acute psychosis after stopping long-term ashwagandha use (very rare, anecdotal). This suggests clinicians should ask about herbal use and monitor closely; causality is uncertain but worth noting. ScienceOpen

Practical monitoring advice (based on trial and safety sources)

Baseline review of current meds (antipsychotics, sedatives, antidiabetics, thyroid, immunosuppressants). Psychiatrist.com
If used: monitor sedation, GI symptoms, blood glucose (if diabetic), blood pressure, and thyroid function (if thyroid disease) during treatment. Stop and consult prescriber if new psychosis, worsening mood, severe GI symptoms, or other concerning events. Psychiatrist.com

Back to Schizophrenia

General Information (All Ailments)

Note: You are viewing ailment-specific information above. This section shows the general remedy information for all conditions.

What It Is

Ashwagandha (Withania somnifera) is a medicinal herb traditionally used in Ayurvedic medicine for over 3,000 years. It is sometimes called Indian ginseng or winter cherry, though it’s botanically unrelated to true ginseng. The root and leaf extracts are the primary sources of its active compounds, known as withanolides — natural steroidal lactones thought to be responsible for many of its therapeutic effects.

Ashwagandha is classified as an adaptogen, meaning it helps the body manage stress and maintain physiological balance. It’s available in various forms: powders, capsules, tinctures, teas, and standardized extracts.

How It Works

Ashwagandha’s mechanisms of action are multifaceted and supported by both traditional use and modern research:

Stress Response Modulation

Regulates the hypothalamic-pituitary-adrenal (HPA) axis, which controls the body’s stress response.
Reduces cortisol levels (the main stress hormone), helping mitigate chronic stress, fatigue, and anxiety.

Neuroprotection and Brain Function

Promotes antioxidant activity in the brain, protecting nerve cells from oxidative stress.
May increase levels of acetylcholine and GABA, supporting better focus, memory, and relaxation.

Hormonal and Energy Support

In men, some studies show improved testosterone levels and sperm quality.
Enhances thyroid function in some individuals by stimulating T4 production.
Increases mitochondrial energy production, reducing fatigue and improving endurance.

Anti-inflammatory and Immunomodulatory Effects

Contains withaferin A, which has shown anti-inflammatory effects by inhibiting NF-κB (a key inflammation pathway).
Helps modulate immune activity, potentially balancing overactive or suppressed immune responses.

Why It’s Important

Ashwagandha has gained global attention for its broad spectrum of potential health benefits, including:

Stress and Anxiety Relief: Clinical trials suggest significant reductions in perceived stress and cortisol levels.
Improved Sleep: May promote deeper, more restorative sleep through GABA-mimetic activity.
Cognitive Enhancement: Enhances memory, focus, and information processing speed.
Physical Performance: Boosts muscle strength, VO₂ max, and recovery in athletes.
Hormonal Balance: Supports reproductive and thyroid health in both men and women.
Overall Vitality: Promotes resilience, energy, and mood stability — aligning with its Ayurvedic reputation for rejuvenation (rasayana).

Considerations

While generally well-tolerated, Ashwagandha is not suitable for everyone or in all contexts. Key considerations include:

Dosage

Common clinical dosages range from 300–600 mg/day of standardized extract (with 5% withanolides).
Effects often build over several weeks.

Safety and Side Effects

Mild: Gastrointestinal upset, drowsiness, or headache.
Rare: Allergic reactions or over-stimulation of thyroid hormone.
Avoid very high doses, as these may cause stomach irritation or diarrhea.

Interactions

May potentiate the effects of sedatives, thyroid medications, blood pressure drugs, or immunosuppressants.
Should not be combined with alcohol or other strong adaptogens without guidance.

Who Should Avoid It

Pregnant or breastfeeding women (due to possible uterine stimulation).
Individuals with hyperthyroidism or autoimmune disorders without medical supervision.
Those scheduled for surgery (may interfere with anesthesia or blood pressure).

Quality Matters

Choose extracts standardized to 5% withanolides and tested for contaminants like heavy metals or pesticides.
Reputable brands often use clinically studied extracts such as KSM-66 or Sensoril.

Helps with these conditions

Ashwagandha is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.

Anxiety 0% effective

PTSD 0% effective

Sleep Apnea 0% effective

Alzheimer's 0% effective

Hypothyroidism 0% effective

OCD 0% effective

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Anxiety

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Ashwagandha is an adaptogenic herb whose bioactive compounds (mainly withanolides) appear to modulate the stress response (HPA axis), lower cortisol,...

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