Background: Mental health disorders contribute substantially to global disability, and many patients experience incomplete remission, adverse effects, or poor adherence with standard pharmacological and psychotherapeutic treatments. Interest is growing in evidence-based integrative approaches, including the adjunctive use of herbal compounds with plausible neurobiological actions.
Methods: This narrative, mechanism-oriented review synthesised clinical and translational evidence on selected herbal agents saffron (Crocus sativus), curcumin, kava (Piper methysticum), oral lavender oil (Silexan), Ashwagandha (Withania somnifera) and Ginkgo biloba used as adjuncts or, in some trials, monotherapies for depressive, anxiety and psychotic-spectrum disorders. Randomised controlled trials, meta-analyses and high-quality reviews were identified through searches of major databases and hand-searching of reference lists. Data on study design, populations, dosing, outcomes, safety and mechanistic findings were qualitatively integrated.
Results: Across depressive disorders, saffron and curcumin produced small-to-moderate improvements in depressive symptoms versus placebo, with saffron showing non-inferiority to fluoxetine in mild-to-moderate major depression and curcumin demonstrating adjunctive benefit when added to antidepressants. In anxiety and stress-related conditions, kava, Silexan and Ashwagandha consistently reduced validated anxiety or stress scores, with Silexan and Ashwagandha showing particularly favourable long-term tolerability. In chronic schizophrenia, adjunctive Ginkgo biloba yielded modest improvements in total and negative symptoms when added to antipsychotics. Across compounds, adverse events were generally mild and comparable to placebo, though concerns remain about kava-related hepatotoxicity and potential herb-drug interactions. Mechanistic evidence converges on monoaminergic modulation, hypothalamic-pituitary-adrenal axis regulation, anti-inflammatory and antioxidant effects, and neurotrophic support.
Conclusion: Standardised herbal compounds can provide modest but clinically relevant adjunctive benefits in depressive and anxiety disorders, with more circumscribed advantages in psychosis. Their most appropriate role is as carefully selected, monitored adjuncts within evidence-based treatment plans rather than as stand-alone alternatives. Larger, longer-term and mechanistically enriched trials are needed to refine dosing, identify responsive subgroups and clarify long-term safety and interaction profiles.
International Journal of Herbal Medicine
Research Journals