Adaptogens vs Prescription Treatments for Anxiety and Depression
What the research says about adaptogens such as ashwagandha and rhodiola next to prescription treatment for anxiety and depression, and why no one should switch or stop medicine on their own.
Content last updated . This page has not been medically reviewed.
Safety first. Supplements can cause side effects and interact with medicines. Read mushroom safety and interactions before you use any mushroom product.
If you are in crisis or thinking about suicide, call or text 988 (Suicide & Crisis Lifeline, US). In a life-threatening situation, call 911. [1]
Do not stop or change a prescribed medicine on your own. NIMH says people should not stop taking a prescribed medication, even if they are feeling better, without the help of a health care provider. [1] If you are wondering about adding or swapping in an adaptogen, ask the prescriber or pharmacist first.
This page lays out, side by side, what the sources we read say about adaptogens and about prescription treatment for anxiety and depression. It is information, not a recommendation to use or avoid either, and it is not a comparison of which is "stronger".
What prescription treatment is, in NIMH's words
Antidepressants are medications used to treat depression, and health care providers may prescribe them for other conditions such as anxiety, pain and insomnia. [1] NIMH also says people respond to medications in different ways and it may take several tries to find the one that works best with the fewest side effects. [1] Medicines are one part of care; therapy is another (see therapy for anxiety and stress).What research on adaptogens found
| Question | What the source found | Evidence label |
|---|---|---|
| Ashwagandha (Withania somnifera) and anxiety, stress, mood | A 2025 meta-analysis pooled 14 randomized trials (360 treated, 353 controls); anxiety disorders were the main diagnosis and median follow-up was 8 weeks. [2] It reported benefit for anxiety, depression, stress and sleep quality, but noted small numbers, substantial heterogeneity and outlier effects, and the benefit was confirmed for anxiety but not for depression in the Bayesian analysis. [2] | Promising but limited (anxiety); insufficient evidence (depression) |
| NIH view of ashwagandha | Some preparations may be effective for insomnia and stress, but evidence is unclear about anxiety. [3] | Mixed |
| Rhodiola (Rhodiola rosea) versus sertraline | One 57-person trial in mild to moderate major depression gave a standardized rhodiola extract, sertraline or placebo for 12 weeks. [4] Changes did not differ significantly between groups; the drop in depression score was numerically larger with sertraline, and more people on sertraline reported side effects (63.2%, versus 30.0% for rhodiola). [4] | Preliminary; one small trial |
| NIH view of rhodiola | NIH says we have not learned enough to say whether rhodiola is useful for any health-related purpose. [5] | Insufficient evidence |
Notes on reading the table. The ashwagandha review looked at many extracts and was not a head-to-head with a drug. The rhodiola trial's authors concluded it produced less antidepressant effect than sertraline but was better tolerated. [4] One small trial does not settle the question for anyone, and a result for one extract does not carry to another. For fuller write-ups see ashwagandha for stress and anxiety and rhodiola for fatigue, stress and mood.
Head-to-head evidence, and what is missing
Proper evidence not found for trials comparing ashwagandha directly with an anti-anxiety medicine or antidepressant in the sources we read. We searched PubMed for that comparison and found no usable trial. The only direct comparison we found is the single rhodiola versus sertraline trial above. The EU's herbal committee also said the adaptogen term is not accepted in the pharmacological and clinical terminology commonly used in the EU. [6]Who should get care first
Persistent low mood, constant worry, or trouble functioning deserves an evaluation. See anxiety disorders, adaptogens and mental health conditions and mental health crisis and natural remedies.Frequently asked questions
Can ashwagandha replace my antidepressant or anxiety medicine?
The sources we read do not say that, and NIMH says not to stop a prescribed medicine without a health care provider. [1] Talk to the prescriber.
Did a trial show rhodiola works as well as sertraline?
No. In one 57-person trial, the numerical improvement was larger with sertraline, and the differences between groups were not statistically significant. The authors said rhodiola produced less antidepressant effect but fewer adverse events. [4]
Is ashwagandha proven for anxiety?
No. NIH calls the evidence unclear for anxiety. [3] A 2025 meta-analysis found benefit in small, variable trials and called for replication. [2]
Can I take an adaptogen with an SSRI?
Proper evidence not found in the sources we read. NIMH names St. John's wort as a serotonin-syndrome risk with antidepressants. [1] Ask the prescriber or pharmacist before combining anything.
Where do I get help right now?
In the US, call or text 988, or call 911 in a life-threatening situation. [1]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Interactions and safety
- Antidepressants and supplements. NIMH says combining antidepressants with supplements that act on the serotonin system, such as St. John's wort, can cause a rare but life-threatening illness called serotonin syndrome. [1] St. John's wort is not an adaptogen in this library. Proper evidence not found, in the sources we read, for an interaction between ashwagandha or rhodiola and SSRIs, so do not read that as proof of safety. See supplements and antidepressants.
- Ashwagandha. NIH says it may interact with sedatives and anticonvulsants, among other medicines, may cause drowsiness, and has been linked to rare liver injury. [3] It should be avoided in pregnancy and while breastfeeding. [3]
- Under 25. NIMH notes that children, teenagers and young adults under 25 may have more suicidal thoughts on antidepressants, especially early on. [1] That is a reason for close follow-up with the prescriber, not for self-treatment.
- Tell every clinician and pharmacist about the supplements you use. [7]
References
- NIMH, Mental Health Medications. Read 2026-10-23.
- BJPsych Open 2025, Withania somnifera for mental health symptoms: systematic review and meta-analysis. Read 2026-10-23.
- NCCIH, Ashwagandha: Usefulness and Safety. Read 2026-10-23.
- Mao et al., Phytomedicine 2015, Rhodiola rosea versus sertraline for major depressive disorder. Read 2026-10-23.
- NCCIH, Rhodiola. Read 2026-10-23.
- EMA (HMPC), Reflection paper on the adaptogenic concept (2008). Read 2026-10-23.
- NCCIH, Using Dietary Supplements Wisely. Read 2026-10-23.