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- Ashwagandha (Withania somnifera, Solanaceae)
- Obsessive-Compulsive Disorder
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Date:
11-30-2016 | HC# 111631-557
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Re: Ashwagandha Root Extract Improves Symptoms of Obsessive-Compulsive Disorder in Patients Taking Selective Serotonin Re-uptake Inhibitors
Jahanbakhsh
SP, Manteghi AA, Emami SA, et al. Evaluation of the efficacy of Withania somnifera (ashwagandha) root
extract in patients with obsessive-compulsive disorder: a randomized
double-blind placebo-controlled trial. Complement
Ther Med. 2016;27:25-29.
Obsessive-compulsive
disorder (OCD), characterized by stressful, repetitive, and intrusive thoughts or
obsessions followed by actions or compulsions, is thought to be linked to a
defect in the serotonergic system. A common treatment is the use of selective
serotonin re-uptake inhibitors (SSRIs), but they are considered only mildly effective,
with 40-60% of patients failing to respond. In Ayurvedic herbal medicine,
ashwagandha (Withania somnifera,
Solanaceae) is considered to be a rejuvenating and revitalizing herb. Its
roots, which are used to enhance mental and physical health, have anxiolytic
and antidepressant properties due to the presence of bioactive glycowithanolides,
and the alkaloids withanine and somniferine are used for nervous disorders.
Animal studies also have shown it to enhance serotonergic transmission. The
goal of this randomized, double-blind, placebo-controlled trial was to verify
the efficacy of ashwagandha root extract as an adjunct therapy to treat the
symptoms of OCD.
Ashwagandha
roots were collected from Saravan in the "Sistan va Baluchestan" Province
in Iran in August 2013. The extract was prepared at the pharmacy lab at the
Faculty of Pharmacy at Mashhad University of Medical Sciences, Iran. The roots
were dried and powdered and then percolated with 70% ethanol. The resulting extract
was then evaporated under pressure and freeze-dried to yield a fine powder and 250-mg
capsules were filled with a mixture of powdered extract (30 mg) and lactose for
the treatment group or lactose only for the placebo group.
The
study was conducted between March 2015 and September 2015 at the Mashhad University
of Medical Sciences. Thirty patients met the following inclusion criteria and
were enrolled in the study: diagnosis of OCD according to the Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition, Text Revision, and adequate treatment with
SSRIs. Patients were randomly assigned to the treatment (n=15; 1 male and 14
females) or placebo (n=15; 2 males and 13 females) group. The treatment regimen
was 4 capsules daily; however, to avoid adverse gastrointestinal effects, the patients
were instructed to take 1 capsule daily and to then increase the dosage by 1
capsule every 4 days. At the end of 6 weeks, the treatment was decreased in the
same manner.
The
severity of OCD symptoms was assessed in all patients using the Yale-Brown
Obsessive Compulsive Scale (Y-BOCS) symptom checklist, a 10-item scale ranging
from 0 (no symptoms) to 40 (extreme symptoms), and was completed for each patient
at baseline and after 6 weeks of study intervention.
From
baseline to the end of the study at 6 weeks, the median Y-BOCS score decreased
from 26 to 14 in the treatment group and from 18 to 16 in the placebo group, a
significant between-group difference (P<0.001). At baseline, 7 patients in
the treatment group and 5 in the placebo group suffered from comorbid anxiety
disorders. The patients in each group were divided into those with comorbid
anxiety disorders and those without, and the reduction of Y-BOCS scores was
compared between those subgroups. In both groups, the reduction of Y-BOCS
scores in patients with comorbid anxiety disorders was not significantly
different from patients without anxiety disorders. No adverse effects were
reported during the study.
According
to the authors, this study is the first attempt to investigate the effect of
ashwagandha root extract in patients with OCD. Acknowledged limitations include
the study's short duration and the lack of a phytochemical analysis of the
extract, which could have helped identify the active ingredients responsible
for the observed beneficial effects. In addition, because only a single dose of
the extract was used, they were unable to determine if the observed
anti-obsessive effects were dose-dependent.
The
authors conclude that "W. somnifera
extract may be beneficial as a safe and effective adjunct to SSRIs in the
treatment of OCD."
—Shari Henson
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