Anxiety Natural Remedies: What Has Actual Evidence (2026)

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The strongest peer-reviewed evidence for natural anxiety relief converges on four interventions: ashwagandha (KSM-66 extract, 27.9% cortisol reduction vs placebo), Silexan lavender oil (HAM-A reduction of 14.1 points vs 9.5 placebo, n=539), magnesium in deficient populations, and L-theanine in acute stress paradigms. Below them, the evidence drops sharply — and most ranked lists conflate the two tiers.

TL;DR — The 4 with real receipts

• Ashwagandha (KSM-66, 300–600 mg/day): 27.9% cortisol reduction vs placebo. 7+ RCTs. Provisionally on WFSBP/CANMAT clinical guidelines.
• Lavender oil Silexan (80–160 mg/day, oral capsule): HAM-A reduction of 14.1 points vs 9.5 placebo (Kasper 2014, n=539). Non-inferior to lorazepam in head-to-head trial. No dependency risk.
• Magnesium (200–400 mg elemental/day): Suggestive evidence in deficient populations. ~48–50% of US adults run below the magnesium EAR.
• L-theanine (200 mg, acute stress): 9+ RCTs. Effect strongest in acute stress paradigms; chronic GAD evidence base is smaller.
• CBD looks compelling (g = -0.92) but 70.3% of the broader literature shows no effect. Read the trial designs, not the headlines.

Type "anxiety natural remedies" into any search engine in 2026 and you will find approximately one million articles listing the same 15–20 interventions, in roughly the same order, with roughly the same level of evidence cited for all of them. Ashwagandha and lemon balm share a bullet. Magnesium and "calm blends" share a column. CBD and passionflower sit side by side, as if the evidence behind each were comparable.

It is not.

The honest version of this list looks nothing like what Healthline, Verywell Mind, and most supplement-brand content farms produce. The honest version separates effect size from "has at least one positive study." It distinguishes between a meta-analysis of 18 RCTs and a single pilot trial with 40 participants. It names the researchers, the journals, and the specific tools used to measure anxiety — because the Hamilton Anxiety Rating Scale (HAM-A) and a self-reported stress questionnaire are not interchangeable. And it tells you what the National Center for Complementary and Integrative Health (NCCIH) actually says, which is often more cautious than the supplement aisle implies.

This transmission ranks 18 commonly recommended interventions using three criteria: number of randomized controlled trials (RCTs), reported effect size, and side-effect penalty. The tiers are evidence-based, not editorial.

How did we rank these natural anxiety remedies?

Every intervention in this transmission was evaluated against the same three-question framework:

Question 1 — How many RCTs? A single positive study does not establish efficacy. We required at least two independent RCTs or one published meta-analysis before placing an intervention in Tier S or Tier A.

Question 2 — What is the effect size? We use standardized effect sizes where reported: Hedges' g, Cohen's d, or percent HAM-A reduction relative to placebo. As a rough benchmark: g < 0.3 is small; 0.3–0.5 is moderate; > 0.5 is large. Interventions with only small effects against placebo, regardless of p-value, fall to Tier B or below.

Question 3 — What is the side-effect profile? An intervention with real efficacy but serious harm risk (liver failure, drug interaction) is penalized downward. An intervention with a clean safety profile at standard doses gets a neutral rating.

This is not a definitive clinical trial — it is an evidence synthesis. The clinical picture changes with dosage, delivery method, individual biology, and comorbidities. Consult a physician before combining any supplement with anxiolytic medications.

Which natural anxiety remedies have the strongest RCT support?

Ashwagandha (Withania somnifera, KSM-66 extract) has the deepest RCT record of any herbal anxiolytic. The foundational study is Chandrasekhar et al. (2012), published in the Indian Journal of Psychological Medicine: a double-blind, placebo-controlled trial of 64 adults with chronic stress, using KSM-66 extract at 300 mg twice daily for 60 days. The treated group showed a 27.9% reduction in serum cortisol compared to placebo, with concurrent reductions on the perceived stress scale and anxiety inventory.

"A high-concentration full-spectrum extract of Ashwagandha root safely and effectively improves an individual's resistance towards stress and thereby improves self-assessed quality of life."

Lopresti et al. (2019), published in Medicine (Baltimore), extended the picture with 240 mg daily over eight weeks in healthy adults, finding significant reductions in anxiety and morning cortisol. A 2022 systematic review and meta-analysis in PLOS ONE that covered seven independent RCTs consistently showed reduced anxiety scores versus placebo. Notably, the World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Treatments (CANMAT) have provisionally included ashwagandha in their treatment guidelines for generalized anxiety disorder — a signal that the evidence has crossed a threshold that working clinicians take seriously.

"Ashwagandha supplementation was associated with significant reductions in scores on all the stress-assessment measures."

The NCCIH's official position as of 2024: "evidence is unclear about ashwagandha's effects on anxiety." That is technically true. It is also true that this is NCCIH's standard framing for any supplement that hasn't yet cleared FDA-level trial infrastructure — not a statement that the evidence is absent. Read the primary studies, not the summary.

Ashwagandha has a clean short-term safety profile. Rare cases of liver injury have been reported and warrant caution at high doses or with prolonged use beyond 90 days.

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Magnesium is not a supplement in the conventional sense — it is an essential mineral that approximately 50% of American adults do not consume at adequate levels, according to National Health and Nutrition Examination Survey data. That deficiency matters: magnesium regulates NMDA receptor activity and modulates the hypothalamic-pituitary-adrenal (HPA) axis, both of which are implicated in anxiety pathophysiology.

Boyle, Lawton, and Dye (2017), published in Nutrients, conducted the first systematic review of magnesium supplementation for anxiety: 18 studies, all recruiting participants with existing anxiety vulnerability (mild anxiety, PMS, postpartum, hypertension). The review found "suggestive" evidence of benefit — particularly for mild anxiety and PMS-related anxiety — but flagged that most studies combined magnesium with other ingredients, complicating the attribution.

"Existing evidence is suggestive of a beneficial effect of magnesium on subjective anxiety in anxiety vulnerable samples."

The effect is cleaner when the baseline population is genuinely deficient. Standard dose in trials: 200–400 mg/day of elemental magnesium (glycinate or citrate forms have better absorption than oxide). Side effects at standard doses: loose stool at the high end; otherwise well-tolerated. No clinically significant drug interactions at supplement doses.

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L-theanine, an amino acid concentrated in green tea leaves, has a specific and well-characterized neurological mechanism: it increases alpha brain-wave activity and modulates GABA, serotonin, and dopamine pathways at doses of 100–400 mg. The Williams et al. (2019) systematic review in Plant Foods for Human Nutrition, covering nine RCTs of pure L-theanine supplementation, found statistically significant reductions in stress and anxiety in populations exposed to acute stressors.

"L-theanine may assist in the reduction of stress and anxiety in people exposed to stressful conditions."

A 2024 systematic review by Moshfeghinia et al., covering 11 RCTs in BMC Psychiatry, found L-theanine significantly reduced anxiety symptoms more effectively than placebo in diagnosed anxiety disorders. The caveat: most trials use 200 mg doses in acute stress paradigms, not chronic GAD. The chronic-use evidence base is smaller. Safety profile: clean. No documented serious adverse events at doses up to 900 mg/day.

What natural anxiety remedies have moderate evidence?

Lavender oil (Silexan, 80 mg oral capsule) is the most pharmaceutical-grade herbal anxiolytic with the strongest trial infrastructure. Kasper et al. (2014) ran a 10-week, double-blind, randomized trial with 539 adults with generalized anxiety disorder, published in the International Journal of Neuropsychopharmacology. The primary outcome: HAM-A total score reduction.

"Silexan at 160 mg/day produced HAM-A reductions of 14.1 points versus 9.5 points for placebo. At 80 mg/day, the reduction was 12.8 points — both superior to placebo at p < 0.01."

Read that again. At the 160 mg dose, 60.3% of participants achieved greater than 50% reduction in HAM-A scores, compared to 37.8% on placebo. That is a response rate competitive with first-line pharmaceutical anxiolytics. Earlier Kasper trials (2010) directly compared Silexan 80 mg to lorazepam and found equivalent HAM-A reduction. The mechanism is distinct from benzodiazepines: Silexan acts via voltage-dependent calcium channels, not GABA-A receptors, which means no dependency, no rebound anxiety, no abuse potential.

"In comparison with lorazepam, Silexan showed non-inferiority in reducing anxiety symptoms with a comparable clinical profile."

The catch: Silexan is a specific standardized extract (manufactured by Schwabe Pharmaceuticals). Lavender essential oil diffused into a room, lavender-scented candles, and topical lavender preparations do not have this evidence base. They are not the same thing. This conflation is the most common error in wellness content about lavender.

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Saffron (Crocus sativus, 30 mg/day) has an emerging RCT record primarily in depression, with anxiety as a secondary outcome. Lopresti and Drummond's 2014 systematic review in Human Psychopharmacology covered saffron's psychopharmacological effects, and a subsequent 2019 meta-analysis found a large effect size versus placebo for anxiety symptoms (Hedges' g = 0.95, p = 0.006).

"Saffron had large treatment effects compared to placebo and, when compared with antidepressant medications, had similar antidepressant efficacy."

The effect size looks impressive. The database is smaller than ashwagandha's. Most trials are also short (6–8 weeks) and conducted in populations with comorbid depression. Saffron at typical doses (30 mg/day of standardized extract) is safe; at very high doses (above 5 g), it carries uterotonic risk and should be avoided in pregnancy.

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Passionflower (Passiflora incarnata) has the weakest foundation of the Tier A entries. A 2007 Cochrane review identified only two qualifying RCTs with 198 total participants. One trial found passionflower equivalent to oxazepam (a benzodiazepine) for generalized anxiety — with the notable advantage of fewer impairment-of-job-performance complaints. But two trials is not a sufficient evidence base to draw firm conclusions.

"There is insufficient evidence to draw definitive conclusions from the existing evidence. Further randomized controlled trials are needed."

That is the Cochrane conclusion: insufficient. Not ineffective — insufficient. Worth monitoring; not worth confident recommendation without more trials.

Does CBD work for anxiety? What about kava?

CBD (cannabidiol) is perhaps the most over-marketed intervention on this list. A 2024 systematic review published in Psychiatry Research screened 1,550 articles and found eight eligible RCTs with 316 participants; the meta-analytic effect size was Hedges' g = -0.92.

"CBD showed a substantial significant impact on anxiety with a considerable effect size; however, limitations including small sample sizes and single-dose designs substantially constrain interpretation."

That effect size number looks strong. It is not what it appears. Three critical limitations suppress confidence: first, most qualifying trials administered a single dose in an acute stress paradigm — not a chronic treatment. Second, 70.3% of observations across the broader CBD literature showed no effect on anxiety outcomes. Third, risk-of-bias assessment was high across studies: allocation concealment, blinding of outcome assessors, and intention-to-treat analysis were all inadequate in the majority of included trials.

The commercial CBD market compounds these problems. Labeling is inconsistent. Actual CBD content frequently diverges from stated content. Delivery method (sublingual, oral, inhaled) produces different bioavailability curves. There is no clinical-grade standardization analogous to Silexan. The evidence that exists is promising enough to justify further research — not confident enough to justify the current market enthusiasm.

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Kava (Piper methysticum) has a non-trivial RCT record for anxiety: a 2003 Cochrane review found kava superior to placebo across 12 trials. The anxiolytic effect is real — kavalactones modulate GABA-A receptors and voltage-gated sodium channels.

The problem is the liver. The NCCIH's warning is unambiguous: kava has been linked to rare but serious liver injury, including cases of liver failure requiring transplantation and at least one death. The mechanism is not fully understood — it may involve cytochrome P450 inhibition, contamination with hepatotoxic plant parts, or individual genetic susceptibility. Germany, Canada, Switzerland, and the UK have all issued regulatory restrictions.

"Kava has been linked to rare cases of liver damage, some of which have been serious or fatal."

The evidence for efficacy is real. The side-effect penalty is severe. Until a hepatotoxicity-safe formulation is standardized and replicated, kava sits in Tier B — not because it doesn't work, but because the risk-benefit calculation is unresolved.

Which natural anxiety remedies are over-marketed?

Here is where most wellness content fails completely.

Tier C: weak or inconsistent evidence. Valerian, chamomile, and oral GABA supplements each have at least some positive trials — but the effect sizes are small, the trial quality is poor, or the evidence base is too thin to generalize. Valerian for anxiety: a 4-week pilot study found no significant difference from placebo on anxiety scales. Chamomile: a 2024 systematic review of 10 clinical trials found that nine reported positive effects, but all involved small samples, short durations, and inconsistent research designs. Oral GABA: the fundamental issue is the blood-brain barrier — orally ingested GABA has poor CNS penetration, and trials are largely pre-registered but not yet published or are confounded by combination products.

Tier D: no real RCT support but heavily marketed. This tier includes holy basil (tulsi), lemon balm at typical supplement doses (150–300 mg), and most "calm blend" products. Lemon balm has one small positive RCT (n=18, single dose, stress model). Holy basil has animal studies and one open-label human trial. These are sold as anxiolytics in every supplement store in America. The labeling is not fraudulent in the strict legal sense — "supports calm" is not the same as "reduces anxiety per HAM-A criteria." But the gap between what is implied and what the evidence shows is wide.

Which natural anxiety remedy has the best evidence-to-safety ratio?

Rank	Intervention	RCT support	Effect size vs. placebo	Side-effect risk
1	Ashwagandha (KSM-66, 300–600 mg/d)	7+ RCTs, meta-analyses	Large (HAM-A -28% cortisol)	Low (rare liver cases at high dose)
2	Lavender oil Silexan (80–160 mg/d)	5+ RCTs	Large (HAM-A -14 pts vs. -9.5 placebo)	Low (no dependence)
3	Magnesium (200–400 mg elemental/d)	18 studies (meta-analysis)	Small-moderate (vulnerable populations)	Low (loose stool at high dose)
4	L-theanine (200–400 mg/d)	9+ RCTs	Moderate (acute stress populations)	Very low
5	Saffron (30 mg/d standardized)	5+ RCTs	Large (g = 0.95 vs. placebo)	Low (avoid in pregnancy at high doses)
6	Passionflower	2 RCTs	Moderate (vs. oxazepam equivalent)	Low
7	CBD (oral, standardized)	8 RCTs	Unclear (g = -0.92 with high bias)	Low (drug interactions possible)
8	Kava	12 RCTs	Moderate-large	High (hepatotoxicity)
9	Chamomile	10 trials	Small-moderate	Low
10	Valerian	Multiple trials	Inconsistent / small	Low
11–18	Holy basil, lemon balm, GABA supps, calm blends	0–1 weak trials	Negligible	Low

Lifestyle parallel track. Two non-supplement interventions outperform most supplements on both effect size and evidence depth.

Hofmann et al. (2010), published in the Journal of Consulting and Clinical Psychology, conducted a meta-analysis of 39 mindfulness-based therapy studies with 1,140 participants and found moderate effect sizes for anxiety reduction across clinical conditions.

"Mindfulness-based therapy was moderately effective for improving anxiety and mood symptoms from pre- to post-treatment."

Stubbs et al. (2017), a meta-analysis in Psychiatry Research covering six RCTs with 262 adults, found that exercise significantly decreased anxiety symptoms more than control conditions (standardized mean difference = -0.58, 95% CI: -1.0 to -0.76, p = 0.02).

"Exercise significantly decreased anxiety symptoms with a moderate effect size in people with anxiety and stress-related disorders."

Neither mindfulness nor exercise appears on most supplement-focused "natural anxiety remedies" lists. Both have deeper evidence than most things that do.

Why do most "natural anxiety remedies" lists get it wrong?

The core failure of mainstream wellness content on anxiety is a category error: conflating "has at least one positive study" with "has evidence for efficacy."

A single positive RCT with 40 participants can generate a statistically significant result by chance, by inadequate blinding, by placebo response inflation, or by selective outcome reporting. Publication bias amplifies the problem — negative trials are less likely to be published, so the visible evidence base skews positive across the board.

The second failure is conflating forms. Silexan is not aromatherapy lavender. KSM-66 is not generic ashwagandha root powder. Saffron at 30 mg standardized extract is not a pinch of saffron in your dinner. Dose, standardization, and delivery method are not secondary details — they are the variables that determine whether a compound does what the trial found. Most supplement products sold under these names are not manufactured to trial specifications. This is the gap the supplement industry has structured its entire marketing around, and it is the gap that most ranked lists fail to close.

"Most published research findings are false" — the foundational paper on statistical power, publication bias, and replication failures in biomedical research.

The third failure is ignoring the counterfactual: what is the comparator? Several interventions in Tier S or Tier A perform at levels comparable to low-dose pharmaceutical anxiolytics in head-to-head trials. That is significant clinical information that wellness content systematically buries, perhaps because it sounds too bold, and pharma-critical content avoids, perhaps because it sounds too alternative.

What we can say. What we can't.

We can say: Ashwagandha (KSM-66), lavender oil Silexan (80 mg), and magnesium supplementation in deficient populations have the strongest peer-reviewed evidence bases for anxiety reduction among commonly recommended natural interventions.

We can say: L-theanine and saffron have emerging, promising evidence, particularly for acute stress and mild-to-moderate anxiety.

We can say: CBD's effect sizes look compelling in the existing small-sample literature, but the trial quality is insufficient to support confident clinical recommendation as of 2026.

We can say: Kava works. It also carries real hepatotoxicity risk that the trial record on efficacy does not resolve.

We can't say: any of these are replacements for CBT, exercise, or evidence-based pharmacotherapy in moderate-to-severe generalized anxiety disorder. The interventions with the deepest evidence base across all interventions — pharmacological or otherwise — remain CBT and, for certain populations, SSRIs.

We can't say: the absence of evidence for lemon balm, holy basil, or calm blends means they are inert. It means the trials have not been done at sufficient scale or rigor to know.

We can't say: these rankings hold across all populations, anxiety subtypes, or delivery mechanisms. The evidence is almost entirely from adults without severe psychiatric comorbidities. Panic disorder, social anxiety disorder, PTSD, and OCD have different pharmacodynamics and different evidence bases.

For a deeper look at the ashwagandha evidence specifically or magnesium's role in sleep and cognition, those transmissions run the primary studies in detail.

One million people a month search "anxiety natural remedies." Most will find lists that do not separate Silexan from aromatherapy, ashwagandha from holy basil, or "suggestive evidence in vulnerable populations" from "replicated large effect size across seven trials." The search results they get are shaped by what ranks, not what's true.

There is a pattern here that appears across different domains of human physiology research. The Wim Hof evidence follows the same shape: real peer-reviewed effect, clean mechanism, absent from clinical practice — because no patent means no funding means no infrastructure to move evidence into standard care. Supplement anxiety research is the same story at a smaller scale.

The question worth sitting with: if the peer review on ashwagandha and lavender Silexan is strong enough to inform WFSBP clinical guidelines — the same organizations that set pharmaceutical prescribing standards — why does the mainstream anxiety content ecosystem continue ranking them on the same tier as products with no human trial data at all?

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FAQ

What is the most evidence-backed natural anxiety remedy?

Ashwagandha (KSM-66 extract, 300–600 mg/day) has the deepest RCT record of any herbal anxiolytic — 7+ independent trials, a 27.9% cortisol reduction vs placebo in the foundational Chandrasekhar 2012 study, and provisional inclusion in WFSBP and CANMAT clinical guidelines. Lavender oil Silexan is the only herbal intervention with a pharmaceutical-grade head-to-head trial against a benzodiazepine (lorazepam), showing equivalent efficacy with no dependency risk.

Does CBD work for anxiety?

The existing 8-trial meta-analytic literature reports a Hedges' g of -0.92 for CBD vs placebo (Skelton et al. 2024) — which looks substantial. Three problems suppress confidence: most trials administered a single dose in an acute stress paradigm rather than chronic treatment; 70.3% of observations in the broader CBD literature showed no effect on anxiety outcomes; and risk-of-bias was high across studies. As of 2026, the evidence is promising enough to justify further research — not to support clinical recommendation.

How much ashwagandha should you take for anxiety?

Trials with the strongest evidence use KSM-66 root extract at 300 mg twice daily (600 mg total) for 60 days. The 2022 PLOS ONE meta-analysis covered seven independent RCTs all showing benefit at 300–600 mg/day. Dose, extract standardization, and manufacturer matter: KSM-66 is a standardized proprietary extract; generic ashwagandha root powder is not the same product and does not carry the same trial record.

Is Silexan lavender oil really as effective as lorazepam?

Yes, in the Kasper et al. 2010 Phytomedicine trial — a multi-center, double-blind randomized study comparing Silexan 80 mg directly to lorazepam in adults with generalized anxiety disorder, the two were non-inferior on HAM-A reduction. The 2014 Kasper trial (n=539) further showed 60.3% of participants on 160 mg Silexan achieved >50% HAM-A score reduction. The mechanism differs from benzodiazepines — Silexan acts on voltage-dependent calcium channels, not GABA-A receptors, which means no dependency, no rebound, no abuse potential.

Are magnesium supplements effective for anxiety?

The 2017 Boyle, Lawton & Dye systematic review of 18 studies found "suggestive" evidence of benefit — specifically in populations with existing anxiety vulnerability (mild anxiety, PMS, postpartum). The effect concentrates in genuinely deficient individuals; approximately 48–50% of US adults consume below the magnesium estimated average requirement. Forms matter: glycinate and citrate show better bioavailability than oxide. At standard doses (200–400 mg elemental/day), magnesium has no clinically significant drug interactions and a clean safety profile.

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Sources

• Chandrasekhar, K., Kapoor, J., Anishetty, S. (2012). A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian Journal of Psychological Medicine, 34(3), 255–262.
• Lopresti, A.L., Smith, S.J., Malvi, H., Kodgule, R. (2019). An investigation into the stress-relieving and pharmacological actions of an ashwagandha extract. Medicine (Baltimore), 98(37).
• Boyle, N.B., Lawton, C., Dye, L. (2017). The effects of magnesium supplementation on subjective anxiety and stress — a systematic review. Nutrients, 9(5), 429.
• Williams, J.L., Everett, J.M., D'Cunha, N.M., et al. (2019). The effects of green tea amino acid L-theanine consumption on the ability to manage stress and anxiety levels: a systematic review. Plant Foods for Human Nutrition, 75(1), 12–23.
• Moshfeghinia, R., et al. (2024). The effects of L-theanine supplementation on the outcomes of patients with mental disorders: a systematic review. BMC Psychiatry.
• Kasper, S., Gastpar, M., Müller, W.E., et al. (2014). Lavender oil preparation Silexan is effective in generalized anxiety disorder — a randomized, double-blind comparison to placebo and paroxetine. International Journal of Neuropsychopharmacology, 17(6), 859–869.
• Kasper, S., Gastpar, M., Müller, W.E., et al. (2010). A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. Phytomedicine, 17(2), 94–99.
• Lopresti, A.L., Drummond, P.D. (2014). Saffron (Crocus sativus) for depression: a systematic review of clinical studies and examination of underlying antidepressant mechanisms of action. Human Psychopharmacology: Clinical and Experimental, 29(6), 517–527.
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• NCCIH — National Center for Complementary and Integrative Health. (2024). Ashwagandha: Usefulness and Safety. U.S. Department of Health and Human Services.
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