Ashwagandha vs Rhodiola
Which is better for stress and anxiety?
Awaiting clinical review. This comparison is built from sourced entries but has not yet been signed off by a pharmacist or clinician.
Short answer
Pick ashwagandha for anxiety: it is rated Moderate on two meta-analyses (Hamilton Anxiety scores 2.19 and 3.52 points below placebo), whereas rhodiola's anxiety evidence is Limited, resting on uncontrolled studies and traditional use. The trade-off is safety: ashwagandha has rare liver injury reports and thyroid, sedative and immunosuppressant cautions. For stress rather than anxiety, neither is well supported, since both are rated Limited and reviews of ashwagandha disagree on perceived stress.
Two meta-analyses: Hamilton Anxiety scores 2.19 and 3.52 points lower than placebo
Traditional stress remedy: no placebo-controlled anxiety data, and its interactions are Monitor-level
Side by side
| Attribute | Ashwagandha | Rhodiola |
|---|---|---|
| Evidence for stress and anxiety | Moderate (anxiety symptoms) | Limited (stress and mild anxiety symptoms) |
| Best for | Anxiety and sleep | Stress-related fatigue |
| How fast | 4+ weeks | 4+ weeks |
| Typical form | Root extract, 250–600 mg a day | Ethanol extract, 144–400 mg daily |
| Main caution | Rare liver injury; avoid in pregnancy | Not for pregnancy; check with antidepressant use |
| Safe in pregnancy? | NCCIH advises avoiding it | Not established; EU regulator advises against |
| Thyroid medication | Possible interaction; ask first | No interaction recorded |
| Antidepressants | No interaction recorded | Rare agitation reports; ask first |
Which should you pick?
Choose Ashwagandha if
- anxiety is your main problem and you want the option with meta-analytic support
- you are not pregnant, have no thyroid, autoimmune or liver condition and no surgery planned
- you can judge it over about 8 weeks, the length most trials ran
Choose Rhodiola if
- your main complaint is stress-related tiredness rather than anxiety
- ashwagandha's liver, thyroid or autoimmune cautions rule it out for you
- you are not pregnant, not on an antidepressant or losartan, and can judge it over about four weeks
Questions people ask
Can I take ashwagandha and rhodiola together?
No interaction between the two is recorded, and neither entry reviews taking them together. Both list sedatives (ashwagandha at Caution, rhodiola at Monitor) and blood pressure medicines (both Monitor), and both advise against use in pregnancy, so combining them adds cautions rather than removing any.
Which is better for anxiety, ashwagandha or rhodiola?
Ashwagandha has the stronger evidence: a meta-analysis of 9 trials (558 people) and a later one of 15 trials (873 people) both found lower Hamilton Anxiety scores than placebo, though NCCIH still calls the findings inconclusive. Rhodiola's anxiety data come from an uncontrolled study of 80 mildly anxious people and a 10-person pilot, neither with a placebo group.
Do either of them lower stress?
The evidence is Limited for both. Reviews of ashwagandha disagree: some found lower Perceived Stress Scale scores, while a review of 6 trials found lower cortisol but no significant effect on perceived stress. The EU regulator recognises rhodiola for stress symptoms such as fatigue and exhaustion on traditional use alone.
Which has the more serious safety warnings?
Ashwagandha. It has been linked to rare liver injury, and NCCIH advises against it in pregnancy, autoimmune conditions and before surgery. Rhodiola's interaction rows are all Monitor-level, based on isolated reports of agitation, serotonin syndrome or extra sedation, and one study of losartan; the EU regulator says no clinically relevant interactions have been observed.
Sources
- Systematic review Velan A, Venugopal V, Balakrishnan A, et al. Effects of Ashwagandha (Withania Somnifera) on stress and anxiety: A systematic review and meta-analysis. Explore (NY). 2024;20(6):103062.
- Systematic review Bachour G, Samir A, Haddad S, et al. Effects of Ashwagandha Supplements on Cortisol, Stress, and Anxiety Levels in Adults: A Systematic Review and Meta-Analysis. BJPsych Open. 2025.
- Systematic review Albalawi AA, et al. Dual impact of Ashwagandha: Significant cortisol reduction but no effects on perceived stress - A systematic review and meta-analysis. Nutrition and Health. 2025;31(4):1395-1408.
- Regulator / government health agency National Center for Complementary and Integrative Health (NCCIH). Ashwagandha: Usefulness and Safety.
- Case series Björnsson HK, Björnsson ES, Avula B, et al. Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int. 2020;40(4):825-829.
- Regulator assessment European Medicines Agency HMPC. Assessment report on Rhodiola rosea L., rhizoma et radix (EMA/HMPC/24186/2023). 2024.