Ayurvedic Herbs for Anxiety: A Review of the Research

Which Ayurvedic herbs help with anxiety? Ashwagandha is the only one with a substantial body of trials, and those trials point toward lower anxiety scores than placebo, but the certainty is low. Brahmi and tulsi have far less evidence, and other traditional calming herbs have almost none in human trials. Herbs are one part of Ayurveda, which also uses routine, diet and body therapies. This review focuses on the herbs themselves, what the studies found, and the safety questions worth asking.

What the studies looked at

Ayurveda traditionally groups several of these herbs as rasayana, preparations meant to restore and strengthen. Modern research has tested only a few of them as standardized extracts, usually against placebo. A 2026 systematic review mapped 49 controlled studies of 20 Ayurvedic herbal ingredients for cognition, stress, sleep and mental health symptoms, and found the evidence concentrated in two plants: brahmi for cognition and ashwagandha for stress and sleep.

Ashwagandha (Withania somnifera) has been pooled repeatedly. A 2014 systematic review in the Journal of Alternative and Complementary Medicine screened 62 abstracts and found five human trials. Later reviews grew: 12 trials with 1,002 participants in a 2022 meta-analysis, nine trials with 558 participants in a 2024 review, and five trials with 254 people with anxiety or insomnia in another 2024 review. A 2025 review in BJPsych Open looked only at people with mental health disorders, mostly anxiety disorders: 14 studies, 360 people on ashwagandha and 353 controls, a median dose of 600 mg a day and a median follow-up of eight weeks.

Brahmi (Bacopa monnieri) has fewer anxiety studies. A 2008 randomized trial gave 300 mg a day or placebo for 12 weeks to 54 adults aged 65 or older without dementia, measuring memory, attention, anxiety and depression. A 2013 crossover study gave 17 healthy volunteers single doses before a stressful multitasking test. Tulsi, or holy basil, appears in a 2017 systematic review of 24 human studies across several health areas, including psychological stress.

What they found

The 2014 review found that all five ashwagandha trials reported greater improvement than the comparison on anxiety or stress scales. Two of three placebo-controlled trials using the Hamilton Anxiety Scale showed a significant benefit, and the third came close. In one trial, Beck Anxiety Inventory scores fell 56.5 percent with naturopathic care including ashwagandha, against 30.5 percent with psychotherapy. In another, perceived stress scores fell 44 percent with ashwagandha and 5.5 percent with placebo.

The later pooled reviews agree on direction. The 2022 review found reductions in anxiety (standardized mean difference -1.55) and stress (-1.75) compared with placebo. The 2024 Explore review found lower Hamilton Anxiety scores (a mean difference of 2.19 points), lower perceived stress and lower cortisol. The other 2024 review found Hamilton scores about six points lower, along with better sleep onset and sleep quality. In the 2025 BJPsych Open review, the anxiety benefit held after removing outlier trials (-1.13) and in a second statistical model, though the depression result did not.

For brahmi, the 2008 trial found that combined anxiety scores fell over 12 weeks with brahmi and rose with placebo, and memory recall improved; anxiety was not the main outcome. The 2013 study found some mood benefits and lower cortisol after brahmi, and its authors called for a larger replication. A meta-analysis of nine brahmi trials found faster attention but did not assess anxiety. The 2017 tulsi review reported favorable outcomes in all 24 studies, with no significant adverse events. For traditional calming herbs such as jatamansi and shankhpushpi, we found no controlled human anxiety trials in the sources reviewed here.

How strong the evidence is

For ashwagandha, the signal is consistent in direction but weak in certainty. The 2014 review judged every included trial to be at unclear or high risk of bias, with designs too varied to pool. The 2022 meta-analysis rated certainty low for both anxiety and stress, with very high inconsistency between trials. The 2024 review limited to anxiety and insomnia found similar inconsistency. The 2025 review cited the small number of studies, large differences between them and outlier effects.

Some pooled effects are very large for a supplement, and large effects from small trials can reflect small-study bias rather than a strong herb. Most trials are short and test specific standardized extracts, so results may not apply to other products or to longer use.

Brahmi and tulsi evidence is weaker. Brahmi anxiety data come from a few small trials where anxiety was secondary, and the tulsi review's uniformly favorable results across varied, small studies call for caution rather than confidence. The 2026 review of Ayurvedic herbs concluded that confidence in effect sizes remains limited by heterogeneity, small-study effects and reporting quality.

Limits and open questions

Long-term safety is the largest gap. Case series from Iceland and the US Drug-Induced Liver Injury Network, and a 2023 series from India, describe ashwagandha-linked liver injury, typically cholestatic (affecting bile flow), appearing weeks into use. A 2026 scoping review counted 25 published cases: most recovered after stopping, one needed a liver transplant, and three people with existing cirrhosis died. Chemical testing in the Indian series found no contamination, which points to the herb itself.

Thyroid effects are a second concern. A small 2014 analysis within a trial found thyroxine rose in three people taking ashwagandha, and a 2022 case report described thyrotoxicosis with a rapid heart rhythm in a woman who had used it for two years. Product quality is a third: a 2008 JAMA study found lead, mercury or arsenic in 20.7 percent of Ayurvedic medicines bought online. Drug interactions remain uncertain, with mixed laboratory findings and no good human studies.

What this means in practice

If you live with mild anxiety or everyday stress, ashwagandha is the Ayurvedic herb with the most research behind it, and it is reasonable to discuss it with a clinician. Do not use it if you have liver disease, and get advice first if you are pregnant, have a thyroid condition or take regular medicines. Choose products with independent testing for contaminants, and stop and seek care if you notice yellowing skin or eyes or persistent itching. For the wider Ayurvedic approach, see our guide to Ayurveda for stress.

Herbs are not a substitute for care of an anxiety disorder. If anxiety is persistent or disabling, a doctor or mental health professional can help, and herbs can be discussed alongside that care. Learn more about plant-based approaches in our herbal medicine guide, or find a practitioner in the Gyfts directory.