Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review…
This meta-analysis reports an anxiety effect bigger than anything prescription medication achieves, but rates its own evidence as low certainty — what would you want to see before treating that number as real?
Reasonable evidence with real limitations. how we score evidence
Caveat on this rating: An SMD of -1.55 is roughly three times the effect size seen for SSRIs in anxiety trials, which is implausible on its face; combined with I-squared of 93.8% and the authors' own "low certainty" GRADE rating, the pooled number should be read as a summary of a biased literature, not as an estimate of benefit. The great majority of the pooled trials were run on manufacturer-supplied branded extracts.
Ashwagandha is sold in the US as a dietary supplement under the Dietary Supplement Health and Education Act of 1994 (DSHEA).
Pooling 12 randomized trials with 1,002 participants, this meta-analysis reported large reductions in anxiety (standardized mean difference -1.55) and stress (SMD -1.75) versus placebo. The authors themselves rated the certainty of that evidence as low, and the heterogeneity between trials was extreme (I-squared 93.8% for anxiety, 83.1% for stress) — effect sizes that large with disagreement that severe usually reflect small biased trials rather than a real drug effect of a size no prescription anxiolytic has ever matched.
Worth asking
This meta-analysis reports an anxiety effect bigger than anything prescription medication achieves, but rates its own evidence as low certainty — what would you want to see before treating that number as real?
Source
Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta-analysis of randomized controlled trials. — Akhgarjand C, Asoudeh F, Bagheri A, et al. (2022)
Reputable peer-reviewed journal
Read the source: https://doi.org/10.1002/ptr.7598
DOI: 10.1002/ptr.7598
How this was scored
- Study design
- Meta-analysis of randomised trials
- Funding
- Funding not disclosed
- Published in
- Reputable peer-reviewed journal
- Sample size
- 1,002
- Preregistered
- No
- Conflicts disclosed
- No
- Independent of proponent
- not recorded
- 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 "moderate evidence". Reasonable evidence with real limitations. It scores 68 out of 100 on our published rubric. One caveat travels with that badge: An SMD of -1.55 is roughly three times the effect size seen for SSRIs in anxiety trials, which is implausible on its face; combined with I-squared of 93.8% and the authors' own "low certainty" GRADE rating, the pooled number should be read as a summary of a biased literature, not as an estimate of benefit. The great majority of the pooled trials were run on manufacturer-supplied branded extracts. 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?
Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta-analysis of randomized controlled trials. — Akhgarjand C, Asoudeh F, Bagheri A, et al. (2022). Published in: Reputable peer-reviewed journal. DOI: 10.1002/ptr.7598. 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: Funding not disclosed. Independence from the proponent is not recorded. 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.