Efficacy of Ashwagandha (Withania somnifera) on the Management of Anxiety and Stress in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Abstract
Introduction Ashwagandha (Withania somnifera) is widely used as an adaptogenic herb for managing stress and anxiety; however, current evidence remains inconsistent because of heterogeneity in formulations, dosing regimens, and outcome measures.This systematic review and meta-analysis evaluated the efficacy of Ashwagandha supplementation for reducing stress and anxiety in adults.Methods Three databases, PubMed, Scopus, and EMBASE were searched from the inception to January 6, 2026. Randomized controlled trials (RCTs) enrolling adults (≥18 years) that compared orally administered Ashwagandha with placebo or control and reported quantitative anxiety and/or stress outcomes were included. Two reviewers screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2.0 tool. Random-effects meta-analyses were performed using standardized mean differences (Hedges’ g) with 95% confidence intervals (CIs). Statistical heterogeneity was assessed using the I² statistic, and certainty of evidence was evaluated using the GRADE framework. This systematic review and meta-analysis was registered with PROSPERO (International Prospective Register of Systematic Reviews; Registration ID: CRD420261304132).Results Ten RCTs involving 779 participants, were included. Ashwagandha supplementation significantly reduced anxiety measured using the Hamilton Anxiety Rating Scale compared with control (Hedges’ g = −1.18; 95% CI: −2.10 to −0.26; p = 0.021), although substantial…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 779 participants or records.
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