Published Paper Details:

Withania somnifera (ashwagandha) is an Ayurvedic adaptogen increasingly studied for stress/anxiety reduction and potential neuroprotective effects. This review critically examines phytochemistry, mechanisms, clinical evidence in stress and anxiety, preclinical and clinical evidence relevant to neurodegenerative disorders, and safety signals. Methods: We searched PubMed/PMC, ClinicalTrials.gov and major journals for randomized clinical trials, systematic reviews, preclinical neuroprotection studies and safety reports up to 2025. Selected high-quality RCTs, systematic reviews and mechanistic papers were prioritized. Results: Multiple RCTs and meta-analyses report reductions in perceived stress/anxiety and cortisol with ashwagandha extracts (typical doses 225-600 mg/day) versus placebo; effect sizes vary and risk of bias exists in several trials. Preclinical studies show antioxidant, anti-inflammatory, modulation of HPA axis and direct neuronal effects of withanolides; some withanolides cross the blood-brain barrier and show benefit in animal models of Alzheimer's and Parkinson's disease. Safety data is generally favorable in short trials, but recent case series and pharmacovigilance reports describe rare herb-associated liver injury and possible thyroid effects. Conclusions: Evidence supports ashwagandha's anxiolytic and stress-reducing potential; neuroprotective findings are promising but largely preclinical with limited human data. Larger, standardized, long-term clinical trials and rigorous pharmacovigilance are needed before recommending ashwagandha routinely for neurodegenerative disorders.