Efficacy and Safety of Saffron and Ashwagandha for Stress-Related Mental Health Outcomes: A Systematic Review of Randomized Controlled Trials.

In 30 seconds

This PRISMA-compliant systematic review synthesised randomised controlled trial evidence on saffron and ashwagandha for stress-related mental health outcomes. It included 31 RCTs among 34 eligible studies. Saffron showed efficacy for depression, anxiety and sleep; ashwagandha showed efficacy for anxiety, stress and sleep. For ashwagandha, pooled cortisol reduction was -3.27 µg/dL. Risk of bias was low in 10 of 31 trials, and GRADE certainty was moderate at best. The review found no RCTs of either plant for burnout or posttraumatic stress disorder.

Key findings

• Saffron showed efficacy for depression in 10 RCTs, anxiety in 9 RCTs and sleep in 8 RCTs, at 15-30 mg/day standardized extract.
• Ashwagandha showed efficacy for anxiety in 10 RCTs, stress in 8 RCTs and sleep in 3 RCTs; pooled cortisol reduction was -3.27 µg/dL.
• Risk of bias was low in 10 of 31 trials; GRADE certainty was moderate at best.
• No RCTs assessed either plant for burnout or posttraumatic stress disorder.

Why it matters

The review brings together trial evidence for two commonly studied medicinal plants across several mental health outcomes, while making clear that confidence in the findings is limited. The absence of trials for burnout and posttraumatic stress disorder is particularly relevant: proposed biological mechanisms do not substitute for clinical evidence, and these outcomes remain priorities for well-designed studies.

What to keep in mind

Risk of bias was low in only 10 of 31 trials, and GRADE certainty was moderate at best. No RCTs addressed burnout or posttraumatic stress disorder.