Safety and efficacy of Withania somnifera for anxiety and insomnia: Systematic review and meta‐analysis

• Published in: Human psychopharmacology 2024-11, Vol.39 (6), p.e2911-n/a
• Main Authors: Fatima, Kaneez, Malik, Javeria, Muskan, Fariha, Raza, Ghana, Waseem, Areesha, Shahid, Hiba, Jaffery, Syeda Fatima, Khan, Umeed, Zaheer, Muhammad Kashan, Shaikh, Yasmeen, Rashid, Ahmed Mustafa
• Format: Article
• Language: English
• Subjects: Anxiety; Anxiety - drug therapy; Ashwagandha; Clinical trials; herbal medicine; Humans; Insomnia; Latency; mental disorders; Meta-analysis; Phytotherapy; Plant Extracts - adverse effects; Plant Extracts - pharmacology; Plant Extracts - therapeutic use; Randomized Controlled Trials as Topic; Sensitivity analysis; Sleep; Sleep and wakefulness; Sleep disorders; Sleep Initiation and Maintenance Disorders - drug therapy; Treatment Outcome; Withania; Withania somnifera
• ISSN: 0885-6222; 1099-1077; 1099-1077
• DOI: 10.1002/hup.2911

Objective Despite the historical neurological use of Withania somnifera, limited evidence supports its efficacy for conditions like anxiety and insomnia. Given its known anti‐stress properties, this review evaluated its safety and efficacy for anxiety and insomnia. Methods We searched Medline, Cochrane Library, and Google Scholar until August 2023 for randomized controlled trials (RCTs) comparing W. somnifera to placebo in patients with anxiety and/or insomnia. Outcome measures included changes in anxiety levels via the Hamilton Anxiety Scale (HAM‐A), Sleep Onset Latency (SOL), Total Sleep Time (TST), Wake After Sleep Onset (WASO), Total Time in Bed (TIB), Sleep Efficiency (SE), and Pittsburgh Sleep Quality Index (PSQI) score. We utilized a random‐effect model for pooling Mean Differences (MD) with a 95% Confidence Interval (CI). Heterogeneity was assessed through sensitivity and subgroup analysis, and the quality of RCTs was evaluated using the Cochrane revised risk of bias tool. Results Pooled results from five RCTs (n = 254) demonstrated that W. somnifera significantly reduced HAM‐A scores (MD = −5.96; [95% CI −10.34, −1.59]; P = 0.008; I2 = 98%), as well as sleep parameters such as SOL, TST, PSQI, and SE, but not WASO and TIB. Conclusion While W. somnifera extracts yielded promising results, further research with larger sample sizes is needed to confirm its effects on anxiety and insomnia.