The effect of adaptogenic plants on stress: A systematic review and meta-analysis

Abstract

Stress is a substantial part of life, however, persistent stress can disturb the hypothalamic–pituitary–adrenal axis leading to different diseases. Adaptogenic herbs are considered to have a stress-relieving effect via decreasing cortisol levels. We assessed the effect of adaptogenic plants on cortisol pathway (cortisol and ACTH levels) and on psychological stress levels of mentally stressed healthy adults, based on the results of randomized controlled trials published until June 25th, 2023. Twenty-five studies on nine adaptogenic herbs - Bacopa monnieri, Eleutherococcus senticosus, Eurycoma longifolia, Gynostemma pentaphyllum, Lepidium peruvianum, Ocimum sanctum, Panax ginseng, Rhodiola rosea and Withania somnifera - were processed in the systematic review. The results on Withania somnifera were meta-analyzed. Significant serum cortisol level decrease (MD = -3.27 ug/dL, 95%CI: −4.62––1.92, p = 0.003) and clinically relevant Perceived Stress Scale (PSS) score decrease were observed in the Withania somnifera-treated group compared to the placebo group after 56 or 60 days treatment.

Keywords

• Stress
• Adaptogens
• Cortisol
• Withania somnifera
• Perceived Stress Scale
• Stress management