Adaptogenic Herbs in Stress-Induced Neuropsychiatric Disorders: Mechanistic Insights, Therapeutic Potential, and Translational Perspectives

Abstract

ABSTRACT Chronic psychological stress is now widely recognised as a precipitating and perpetuating factor in a spectrum of neuropsychiatric conditions, including generalised anxiety disorder, major depressive disorder, post-traumatic stress disorder (PTSD), and stress-related cognitive decline. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, sustained neuroinflammation, heightened oxidative burden in corticolimbic circuits, and disrupted brain-derived neurotrophic factor (BDNF) signalling collectively underpin the transition from adaptive stress responses to frank psychopathology. Adaptogenic herbs, a pharmacologically distinct category of botanical medicines defined by their capacity to enhance non-specific resistance to stressors represent a mechanistically plausible and clinically investigated adjunct to conventional neuropsychiatric pharmacotherapy. This review synthesises current preclinical and clinical evidence for six extensively studied adaptogens: Withania somnifera (ashwagandha), Rhodiola rosea, Panax ginseng, Bacopa monnieri, Eleutherococcus senticosus, and Ocimum sanctum. We examine shared and herb-specific molecular targets encompassing glucocorticoid receptor sensitivity, NF-κB/NLRP3 neuro-immune pathways, Nrf2-mediated antioxidant responses, monoaminergic and GABAergic neurotransmission, and hippocampal neuroplasticity and critically evaluate the translational gap between animal mechanistic work and human randomised controlled trials. Methodological heterogeneity, inconsistent phytochemical standardisation, and under-powered trial designs presently limit definitive efficacy claims; nonetheless, converging evidence supports the therapeutic potential