The Anxiolytic Effects of Ashwagandha Supplementation in Adults with Autism Spectrum Disorder and Anxiety

BACKGROUND: The neuroendocrine system activates the hypothalamus-pituitary-adrenal (HPA) axis during stress,1 and individuals with autism spectrum disorder (ASD) may have atypical stress responses linked to HPA axis dysregulation.2 Prolonged activation of this system increases cortisol secretion, the body’s primary stress hormone.3 Withania somnifera (Ashwagandha) is a traditional herbal remedy believed to reduce stress by modulating the HPA axis and lowering cortisol levels.5 HYPOTHESIS: Following four weeks of Ashwagandha supplementation, the treatment group is expected to exhibit reduced cortisol levels, improved Aberrant Behavior Checklist (ABC) scores, and decreased stress-related behaviors, reflecting its anxiolytic effects. METHODS: Forty-two adult participants with ASD and anxiety will be randomized to a Ashwagandha supplementation or placebo control group for a four-week blinded trial. Cortisol and anxiety levels will be measured by random serum cortisol levels and the ABC, respectively. The next phase involves data analysis using paired t-tests, linear regression, and repeated measures analysis to assess group differences. RESULTS: It is expected that participants will show elevated baseline cortisol levels, with no initial group differences in cortisol or ABC scores. Following four-weeks of blinded supplementation, the treatment group is anticipated to show reduced cortisol levels and ABC scores, reflecting decreased anxiety and improvements in stress-induced behaviors, supporting Ashwagandha’s potential anxiolytic effects. CONCLUSIONS: If confirmed, the findings will support Ashwagandha as a natural intervention for reducing stress in adults with ASD and anxiety. If not, results will inform future research on stress, anxiety, and cortisol in this population.