Clinical Use

Overall, W. somnífera has not undergone significant scientific investigation in humans, therefore much of its use is based on pharmacological effects demonstrated in experimental models or traditional usage. In practice, it is often used in herbal combination treatments. stress adaptation

The pharmacological effects of the herb, which have been well established in animal studies, provide a theoretical basis for its use in situations characterised by stress (Archana & Namasivayam 1999; Bhattacharya & Muruganandam 2003; Dhuley 2000; Grandhi et al 1994).

More specifically, oral administration of an aqueous, standardised extract of W. somnífera (in a dose extrapolated from the human dose) has been found to offer protection against experimentally induced biological, physical and chemical stressors (Rege et al 1999).

In one in-vivo study, plasma Cortisol levels and adrenal weight were significantly lower, while liver weight increased (Kurandikar et al 1986).

To date, controlled studies are unavailable to determine and clarify whether these effects are also significant in humans.

(For more information see 'Clinical note — Allostasis and adaptation to stress' in the Siberian ginseng monograph.)

anxiety

Although controlled studies are lacking, the herb's pharmacological effects, such as its GABA-mimetic activity (Mehta et al 1991) and ability to lower Cortisol levels (Kurandikar et al 1986), provide a theoretical basis for its use in anxiety states. One study used a herbal combination treatment known as Geriforte, which contains primarily W. somnífera. The product was taken by 34 subjects with anxiety neurosis, and after 12 weeks significant reductions in the frequency, duration and intensity of symptoms were observed (Ghosal et al 1990).

anabolic and weight gain promotion

Both animal and human studies have shown significant improvements in weight gain during the growth phase with the use of withania (Sharma et al 1986; Ziauddin et al 1996). It is suspected that an anabolic effect is responsible.

Withania-fortified milk (2 g/dayfor60 days) has been investigated in children and found to induce weight gain, increase total plasma proteins and haemoglobin levels (Venkatraghaven etal 1980). Withania 1374

anaemia

The herb is used in the treatment of iron deficiency anaemia due to its effects on haemopoeisis and natural iron content (Aphale et al 1998; Ziauddin et al 1996). This use has been supported by studies showing increased haemoglobin levels in children, induced by withania.

cancer therapy

Prevention of bone marrow depression Animal studies suggest a potential role for withania as an adjunctive treatment during chemotherapy for the prevention of drug-induced bone marrow depression (Davis & Kuttan 1999; Gupta et al 2001).

The ability to stimulate stem cell proliferation has led to concerns that W. somnífera could reduce cyclophosphamide-induced toxicity and therefore reduce its usefulness in cancer therapy (Davis & Kuttan 1998). However, preliminary animal studies indicate that withania could prove to be a potent and relatively safe radiosensitiser and chemotherapeutic agent (Uma Devi 1996).

drug withdrawal

In animal studies, repeated administration of withania (100 mg/kg) inhibited morphine tolerance and dependence (Kulkarni & Ninan 1997). Based on this observation, and its ability to modulate stress responses in general, withania is used in herbal combination therapy during opiate withdrawal.

arthritis

Withania is traditionally incorporated into herbal combination formulations for symptom relief in osteoarthritis and rheumatoid arthritis. Its documented antiinflammatory and antioxidant activities provide some support for this use, although controlled studies have not established efficacy.

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