Potential Utility of Adjunctive Withania somnifera in Schizophrenia Treatment

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WSE treatment may be useful in addressing symptom exacerbation in schizophrenia and schizoaffective disorder.

Adjunctive treatment with a standardized extract of Withania somnifera (WSE) may be effective in reducing psychopathology and stress in patients with schizophrenia or schizoaffective disorder, according to research published in the Journal of Clinical Psychiatry.

Patients with schizophrenia or schizoaffective disorder reporting a recent exacerbation of symptoms were randomly assigned to adjunctive WSE at 1000 mg/d (n=33) or placebo (n=33) for 12 weeks. Patients maintained their current antipsychotic medication regimen throughout the study period. As a primary outcome, researchers assessed change from baseline on the Positive and Negative Syndrome Scale (PANSS) in both treatment groups. In addition, stress levels and inflammatory indices were analyzed per the Perceived Stress Scale and levels of S100 calcium-binding protein B (S100B) and C-reactive protein (CRP), respectively.

Compared with placebo, WSE was associated with significantly greater reductions in PANSS negative (P =.001), general (P =.003), and total (P =.001) symptoms, although not positive symptoms. In a similar fashion, WSE treatment was associated with more significantly reduced stress levels compared with placebo (P =.022). WSE was associated with lower levels of CRP and S100B compared with placebo, although the effect was not significant. During the study course, 9 patients (27.3%) in the placebo group reported an increase in antipsychotic drug dose or an additional drug being added to their regimen compared with just 2 patients (6.1%) in the WSE group (P =.044). Reported adverse effects included somnolence, epigastric discomfort, and loose stools, although there were no statistically significant differences in adverse effect incidence between treatment groups.

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Although the data are preliminary, these findings suggest that adjunctive WSE treatment may be useful in addressing symptom exacerbation in schizophrenia and schizoaffective disorder. Future studies should include an extended course of WSE to assess the long-term effects of this adjunctive treatment method.

Disclosures: Dr Chengappa stated that the University of Pittsburgh is pursuing intellectual property protection for the technology discussed in this article.


Chengappa KNR, Brar JS, Gannon JM, et al. Adjunctive use of a standardized extract of Withania somnifera (ashwagandha) to treat symptom exacerbation in schizophrenia: a randomized, double-blind, placebo-controlled study. J Clin Psychiatry. 2018;79(5):17m11826.