CHRONOPHARMACOLOGICAL IMPACT OF SPIRITUAL PRACTICES IN THE MANAGEMENT OF GENERALIZED ANXIETY DISORDER (GAD): A SCIENTIFIC AND PHARMACOLOGICAL REVIEW

Generalized anxiety disorder (GAD) is one of the health issues that has not lost its importance in the world despite the incredible progress in the field of pharmaceutical interventions. Compiling evidence in the past two decades has shown that the time of medication intake, in conjunction with psycho-spiritual practices including meditation, prayer, reciting mantras, yogic breathing procedures, and rituals of the circadian rhythm, can be used to upregulate and down-regulate therapeutic effectiveness. The chronopharmacological concepts are synthesized in the current review with recent facts on spiritual activities as a reflection on the manner in which both interrelate to modify neuroendocrine rhythms, autonomic equilibrium, and sensitivity to anti-anxiety pharmacologic intervention. The paper highlights how spiritually based therapies, in conjunction with circadian biology, normalize the dysregulated levels of cortisol, balance sympathetic-parasympathetic rhythms, and improve the activities of serotonergic and GABAergic circuits. The following parts of the paper discuss the pharmacodynamic results with increased sleep structure, lower oxidative stress, and epigenetic changes with sustained spiritual involvement. Combined, the evidence presented supports an integrative theory where the role of spirituality is that of a significant chronobiological controller and not an add-on, thus having the potential to change the course of GAD treatment.