Medicinal herbs for the treatment of anxiety: A systematic review and network meta-analysis.
The best network meta-analysis puts ashwagandha's anxiety benefit somewhere between almost nothing and about 10 points on a clinical scale — is that uncertain a bet worth taking before we try something with firmer evidence?
Well-supported by good-quality research. how we score evidence
Caveat on this rating: The credible interval runs from -9.70 to -0.17, meaning the true effect could be near zero; the ashwagandha estimate rests on a handful of small trials, most of which were supplied or funded by extract manufacturers. The analysis was conducted at the Beijing Research Institute of Chinese Medicine, an institution with an institutional interest in herbal medicine generally, though its funding came from the university and Chinese national science programmes rather than from any supplement company.
Ashwagandha is sold in the US as a dietary supplement under the Dietary Supplement Health and Education Act of 1994 (DSHEA).
A Bayesian network meta-analysis of 29 randomized trials covering 12 medicinal herbs in adults with diagnosed or subthreshold anxiety found Withania somnifera reduced Hamilton Anxiety Scale scores by 4.90 points (95% credible interval -9.70 to -0.17) — an estimate whose lower bound almost touches zero, drawn from trials the authors explicitly flagged as "limited by their small sample sizes." The authors' overall verdict was that all these results "should be considered preliminary because of the unconvincing sample sizes, together with the potential effectiveness of placebos."
Worth asking
The best network meta-analysis puts ashwagandha's anxiety benefit somewhere between almost nothing and about 10 points on a clinical scale — is that uncertain a bet worth taking before we try something with firmer evidence?
Source
Medicinal herbs for the treatment of anxiety: A systematic review and network meta-analysis. — Zhang W, Yan Y, Wu Y, et al. (2022)
Reputable peer-reviewed journal
Read the source: https://doi.org/10.1016/j.phrs.2022.106204
DOI: 10.1016/j.phrs.2022.106204
How this was scored
- Study design
- Meta-analysis of randomised trials
- Funding
- Independently funded
- Published in
- Reputable peer-reviewed journal
- Sample size
- not recorded
- Preregistered
- No
- Conflicts disclosed
- No
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Where we put this study in context
Questions
How strong is the evidence behind this?
Resolv rates this source "strong evidence". Well-supported by good-quality research. It scores 80 out of 100 on our published rubric. One caveat travels with that badge: The credible interval runs from -9.70 to -0.17, meaning the true effect could be near zero; the ashwagandha estimate rests on a handful of small trials, most of which were supplied or funded by extract manufacturers. The analysis was conducted at the Beijing Research Institute of Chinese Medicine, an institution with an institutional interest in herbal medicine generally, though its funding came from the university and Chinese national science programmes rather than from any supplement company. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Medicinal herbs for the treatment of anxiety: A systematic review and network meta-analysis. — Zhang W, Yan Y, Wu Y, et al. (2022). Published in: Reputable peer-reviewed journal. DOI: 10.1016/j.phrs.2022.106204. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Meta-analysis of randomised trials. Funding: Independently funded. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is ashwagandha, withania somnifera, ksm-66, sensoril, shoden, indian ginseng, winter cherry, ashwagandha root extract FDA approved for this use?
No. Its current status is: Not FDA-evaluated for this use. Ashwagandha is sold in the US as a dietary supplement under the Dietary Supplement Health and Education Act of 1994 (DSHEA).
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.