Pooling five randomized trials (n = 254), a meta-analysis found that ashwagandha lowered Hamilton Anxiety scores by 5.96 points more than placebo, with very high variation between trials.
Adults with anxiety and/or insomnia · Outcome: HAM-A; sleep measures
Confidence applies to this claim and context.
AttentionNot assessedNo current independent attention assessment
EvidenceNo mapped studiesNo reviewed experiment families currently mapped
ConfidenceNot assessedFor: Pooling five randomized trials (n = 254), a meta-analysis found that ashwagandha lowered Hamilton Anxiety scores by 5.96 points more than placebo, with very high variation between trials.. No current reviewed confidence assessment for this claim.
The GapAttention not measured
Attention describes reviewed public attention, evidence shows study types, and confidence applies only to the stated claim. There is no overall score.
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Why we checked it
Attention is high but down from a summer peak. English Wikipedia's Withania somnifera article had 43,775 views in September 2026, down from 63,001 in July. PubMed added 19 records on ashwagandha in the 30 days to Oct 11 2026.
Here's where it actually stands
Ashwagandha (Withania somnifera) is a plant used in traditional Indian medicine. In the US its extracts are sold as dietary supplements, often marketed for stress and sleep. The FDA does not approve supplements before sale, and no ashwagandha drug is approved. Small trials suggest it may lower anxiety scores and slightly improve sleep. Most trials are short, and the extracts differ. Rare cases of liver injury have been reported, some severe. In one case series, three people with existing liver disease died.
What we know
Pooling five randomized trials (n = 254), a meta-analysis found that ashwagandha lowered Hamilton Anxiety scores by 5.96 points more than placebo, with very high variation between trials.
What we don't know
Does ashwagandha reliably reduce anxiety or improve sleep, and is it safe long term?
Claims
Pooling five randomized trials (n = 254), a meta-analysis found that ashwagandha lowered Hamilton Anxiety scores by 5.96 points more than placebo, with very high variation between trials. · headlineAdults with anxiety and/or insomnia · Outcome: HAM-A; sleep measuresConfidence: Not assessed · source checked
Would change this claim: If a large, registered trial with a standardized extract confirms an anxiety or sleep benefit, we would upgrade the opening.
Source: Safety and efficacy of Withania somnifera for anxiety and insomnia: Systematic review and meta-analysis. · PMID 39083548 · Hum Psychopharmacol · Abstract, Results: five RCTs (n = 254); HAM-A MD -5.96 (-10.34, -1.59); I2 = 98% · Verify ↗
A meta-analysis of five randomized trials (400 participants) found a small benefit of ashwagandha extract on overall sleep. The authors said data on serious adverse effects were limited.Adults, with or without insomnia · Outcome: Overall sleepConfidence: Not assessed · source checkedSource: Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis. · PMID 34559859 · PLoS One · Abstract, Results: five RCTs, 400 participants; SMD -0.59 (-0.75 to -0.42); Conclusion: data on serious adverse effects limited · Verify ↗
A review of 14 trials in people with mental disorders (360 treated, 353 controls) found improvements in anxiety; the depression result did not hold up in all analyses, and trials were small and varied.People with mental disorders, mostly anxiety disorders · Outcome: Anxiety, depression, stress, sleep; safetyConfidence: Not assessed · source checkedSource: The effect of Withania somnifera (Ashwagandha) on mental health symptoms in individuals with mental disorders: systematic review and meta-analysis. · PMID 41140145 · BJPsych Open · Abstract, Results: fourteen studies, 360 vs 353; anxiety effect confirmed by Bayesian analysis but not depression; no significant difference in safety and tolerability · Verify ↗
Case reports describe liver injury linked to ashwagandha. Five cases from Iceland and the US recovered over months. In an Indian series of 8 single-ingredient cases, all 3 patients who developed liver failure on top of existing liver disease died.Case reports and series (Iceland, US DILIN, India) · Outcome: Liver injury pattern and outcomeConfidence: Not assessed · source checkedSource: Ashwagandha-induced liver injury-A case series from India and literature review. · PMID 37756041 · Hepatol Commun · 31991029: five cases, jaundice, no hepatic failure, tests normalized in 1-5 months; 37756041: 8 single-ingredient cases of 23; 3 with acute-on-chronic liver failure, all 3 died · Verify ↗Source: Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. · PMID 31991029 · Liver Int · 31991029: five cases, jaundice, no hepatic failure, tests normalized in 1-5 months; 37756041: 8 single-ingredient cases of 23; 3 with acute-on-chronic liver failure, all 3 died · Verify ↗
In the largest randomized trial so far (1,002 adults with stress and anxiety, 8 weeks), there were no serious adverse events, and liver, kidney and blood tests did not differ from placebo. The trial was too short and too small to rule out rare liver injury.Adults 18-65 with reported stress and anxiety (multinational) · Outcome: Safety laboratory tests; adverse eventsConfidence: Not assessed · source checkedSource: Safety of 8-Week Administration With Ashwagandha (Withania somnifera) Root Extract in Adults With Stress and Anxiety: Findings From a Prospective, Randomized, Multi-Center, Double-Blinded, Placebo-Controlled Study. · PMID 41943502 · Phytother Res · Abstract: n = 1002; no serious adverse events; AEs 5.6% vs 9.2%; no significant changes in liver function tests, renal markers or hematological parameters · Verify ↗
Mapped studies / experiment families
One experiment counts once, even with several registrations or publications. Counts above describe the headline claim.
No reviewed experiment families mapped yet.
Studies & active trials
Only papers and registered trials an editor reviewed for this page. Being listed is not a finding; the claims above say what they show.
The effect of Withania somnifera (Ashwagandha) on mental health symptoms in individuals with mental disorders: systematic review and meta-analysis.PMID 41140145 · DOI 10.1192/bjo.2025.10885Study · Published · Oct 27, 2025 · BJPsych OpenOpen source ↗
Ashwagandha-induced liver injury-A case series from India and literature review.PMID 37756041 · DOI 10.1097/HC9.0000000000000270Study · Published · Oct 1, 2023 · Hepatol CommunOpen source ↗
Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network.PMID 31991029 · DOI 10.1111/liv.14393Study · Published · Liver IntOpen source ↗
Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis.PMID 34559859 · DOI 10.1371/journal.pone.0257843Study · Published · PLoS OneOpen source ↗
Safety and efficacy of Withania somnifera for anxiety and insomnia: Systematic review and meta-analysis.PMID 39083548 · DOI 10.1002/hup.2911Study · Published · Hum PsychopharmacolOpen source ↗
Safety of 8-Week Administration With Ashwagandha (Withania somnifera) Root Extract in Adults With Stress and Anxiety: Findings From a Prospective, Randomized, Multi-Center, Double-Blinded, Placebo-Controlled Study.PMID 41943502 · DOI 10.1002/ptr.70315Study · Published · Phytother ResOpen source ↗
Effect of Ashwagandha Root Extract on Stress, Anxiety, and Sleep Quality in Adults Experiencing Minority StressNCT NCT07441070Trial · Recruiting · Apr 27, 2026 · SF Research Institute, Inc.Open registry record ↗
What would change our mind
If a large, registered trial with a standardized extract confirms an anxiety or sleep benefit, we would upgrade the opening.
If an FDA or NIH safety review quantifies the liver-injury risk, we would add it.
Effect of Ashwagandha Root Extract on Stress, Anxiety, and Sleep Quality in Adults Experiencing Minority StressSF Research Institute, Inc. · checked Oct 11, 2026 · NCT NCT07441070; status:RECRUITING; primary completion 2026-07-30 (estimated)
Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network.Liver Int · checked Oct 11, 2026 · PMID 31991029; DOI 10.1111/liv.14393
Ashwagandha-induced liver injury-A case series from India and literature review.Hepatol Commun · checked Oct 11, 2026 · PMID 37756041; DOI 10.1097/HC9.0000000000000270
Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis.PLoS One · checked Oct 11, 2026 · PMID 34559859; DOI 10.1371/journal.pone.0257843
Safety and efficacy of Withania somnifera for anxiety and insomnia: Systematic review and meta-analysis.Hum Psychopharmacol · checked Oct 11, 2026 · PMID 39083548; DOI 10.1002/hup.2911
Safety of 8-Week Administration With Ashwagandha (Withania somnifera) Root Extract in Adults With Stress and Anxiety: Findings From a Prospective, Randomized, Multi-Center, Double-Blinded, Placebo-Controlled Study.Phytother Res · checked Oct 11, 2026 · PMID 41943502; DOI 10.1002/ptr.70315
The effect of Withania somnifera (Ashwagandha) on mental health symptoms in individuals with mental disorders: systematic review and meta-analysis.BJPsych Open · checked Oct 11, 2026 · PMID 41140145; DOI 10.1192/bjo.2025.10885
Does ashwagandha reliably reduce anxiety or improve sleep, and is it safe long term?
Pooled trials are small, short and highly variable; long-term safety data are limited.
What would answer it: Larger registered randomized trials with standardized extracts lasting several months, reporting liver tests.
Not settled. Pooled small trials suggest lower anxiety scores and a small sleep benefit, but the trials are short and use different extracts. Known: rare but sometimes severe liver injury has been linked to ashwagandha products. A large 8-week trial found no liver-test differences from placebo, but rare reactions would not show up in a study of that size and length.