Ashwagandha (Withania somnifera), a revered herb in Ayurvedic medicine, is widely recognized for its adaptogenic properties, aiding in stress and anxiety reduction. While its benefits are well-documented, emerging discussions suggest the need to understand potential withdrawal effects upon discontinuation.
The 2024 paper is built around a remarkable case of a 30-year-old man with a history of generalized anxiety disorder (GAD). To control his symptoms naturally, he started self-treating with Ashwagandha root extract (600 mg/day)—a standard dosage employed in clinical trials—during a period of six months.
During supplementation, the subject showed considerable amelioration of anxiety, irritability, and sleep, and was able to taper off conventional anxiolytics. But when Ashwagandha was suddenly discontinued (without tapering) after the supplementation period, he started manifesting distinct withdrawal-like effects within two days, which were characterized by:
Heightened anxiety and restlessness
Irritability and mood swings
Insomnia and disturbed sleep
Pervasive discomfort and restlessness
Notably, the patient had no recent change in lifestyle, no new medications, and no use of substances that would account for these symptoms. He was otherwise healthy.
The side effects also resolved over the course of 4–5 days, spontaneously without pharmacologic or psychological intervention, also indicating a self-limiting course. His health care providers opined that these effects might indeed be due to Ashwagandha withdrawal—particularly in light of its pharmacologic effect on GABAergic systems, which control mood and sleep.
Authors Tapan and Jyoti Patel highlight that this case is significant because there was no prior clinical record of Ashwagandha withdrawal in peer-reviewed literature, so it was one of the first to bring awareness to potential dependency-like effects from long-term, unsupervised herbal supplementation.
Although the case gives anecdotal information, wider literature on Ashwagandha withdrawal is lacking. The majority of studies have looked at its therapeutic effects. For example, a systematic review and meta-analysis involving nine randomized controlled trials with 558 participants revealed substantial reductions in stress and anxiety levels among Ashwagandha supplement takers. Adverse effects reported were generally mild, such as drowsiness and gastrointestinal distress.
Another study emphasized Ashwagandha's potential in modulating stress hormones like cortisol and enhancing the overall quality of life in healthy adults. The results highlight its effectiveness but not withdrawal effects
Ashwagandha is widely considered safe with minimal side effects in clinical trials.
No established data exists on withdrawal effects.
It has GABA-mimetic properties, which may explain neurochemical rebound symptoms upon cessation.
The case presented highlights the need for health care providers to know about potential withdrawal effects of Ashwagandha, particularly in users with long-term exposure. Patients are to be informed about tapering off the supplement slowly instead of stopping abruptly to reduce the risk of harmful effects.
The article emphasizes the lack of studies on long-term use and withdrawal potential.
Suggests clinicians be aware of possible withdrawal when patients stop taking Ashwagandha.
While Ashwagandha remains an important asset in stress and anxiety management, the present case report emphasizes the need to appreciate its complete pharmacological profile, such as possible withdrawal effects. It is imperative that more studies are conducted to define thorough guidelines regarding its discontinuation to guarantee patient safety and welfare.
Reference:
1. Patel, Tapan, and Jyoti Patel. “Unmasking Potential Withdrawal Effects of Ashwagandha: A Case Report and Review.” Cureus 16, no. 4 (April 18, 2024). https://www.cureus.com/articles/367499-unmasking-potential-withdrawal-effects-of-ashwagandha-a-case-report-and-review.
(Input from various sources)
(Rehash/Sakshi Thakar/MSM)