Herbal adaptogens used for stress and anxiety: A narrative review

Stress and anxiety represent widespread public health concerns that adversely affect both mental and physical well-being. Although conventional anxiolytic medications are clinically effective, their long-term use is often limited by adverse effects, risk of dependency, and development of tolerance. Herbal adaptogens have gained considerable attention as potential therapeutic alternatives due to their ability to stabilise physiological responses during stress conditions. This narrative review summarises current scientific evidence on major adaptogenic herbs, including Ashwagandha, Rhodiola, Tulsi, Brahmi, Chamomile, Lemon Balm, Valerian, Skullcap, and Apamarga. Their pharmacological actions primarily involve modulation of the hypothalamic–pituitary–adrenal (HPA) axis, regulation of neurotransmitter systems, and antioxidant mechanisms. Despite promising findings, further efforts toward phytochemical standardisation, clinical validation, and development of advanced drug delivery systems remain essential to optimise their therapeutic effectiveness.