Comparing the therapeutic potential of Drakshadi Kashaya against Mrudweekadi kashaya as adjunct to a multimodal Ayurveda approach in alcohol dependence: A parallel-arm randomized controlled study

Abstract BACKGROUND: Alcohol dependence, referred to as Madatyaya in Ayurveda, is a condition marked by compulsive alcohol consumption, leading to physical, psychological, and social harm. Prolonged drinking causes Dosha imbalance, depleting Dhatus (~body tissues) and Ojas . Madatyaya (alcohol dependence) manifests as intoxication with symptoms like confusion, nausea, and liver dysfunction. Ayurvedic management focuses on detoxification through Ayurvedic medications, dietary modifications, and mental stabilization through Yoga, Pranayama , and Satwavajaya Chikitsa (counseling), offering a holistic approach to recovery. OBJECTIVE: To compare the efficacy of Drakshadi kashaya and Mrudweekadi kashaya as adjuncts to a multimodal Ayurvedic approach in reducing alcohol dependence symptoms and improving liver function in adults with alcohol use disorder. MATERIALS AND METHODS: This was a randomized, parallel-arm, open-label clinical trial conducted at the Department of Ayurveda, KLE Ayurveda Hospital and Research Center, over a period of 30 days. Participants aged between 20 and 50 years who met the inclusion criteria were enrolled and randomly allocated into two groups of 25 each. Group A received Mrudweekadi kashaya , and Group B received Drakshadi kashaya . Both groups were administered 15 mL of the respective kashaya , three times daily before meals, for 30 consecutive days. Alongside the pharmacological intervention, all participants underwent Ayurvedic supportive therapy comprising Pathya-Apathya (dietary modifications), Yoga practices, and Satwavajaya Chikitsa (Ayurvedic psychological counseling). The primary outcome measures were changes in the alcohol dependence scale scores and Madatyaya Lakshana assessments, recorded at baseline, on the 15th day, and the 30th day. Secondary outcome measures included levels of gamma-glutamyl transferase (GGT) and other liver function test (LFT) parameters, assessed at baseline and on the 30th day. Within-group comparisons were conducted using the paired t -test, while between-group comparisons were analyzed using the unpaired t -test. RESULTS: Both treatment groups exhibited statistically significant improvements ( P < 0.05) in ADS scores, Madatyaya symptoms, GGT, and LFT parameters over the 30-day intervention period. By day 30, Group B ( Drakshadi kashaya ) demonstrated significantly greater improvements in GGT levels, liver enzymes, and reduction in alcohol consumption compared to Group A ( Mrudweekadi kashaya ), with a P value of <0.001. Group A also showed meaningful clinical improvement, though to a lesser extent, with a between-group comparison yielding a P value of 0.0072. CONCLUSIONS: The results of the study suggest that Drakshadi kashaya is a potentially effective Ayurvedic intervention for alcohol dependence, with notable improvements in liver health and alcohol abstinence. Further large-scale studies are recommended to confirm these findings and assess long-term efficacy and safety. CTRI Registration: CTRI/2022/10/046674, Dated: October 20, 2022.