The potential utility of ashwagandha for improving cognitive dysfunction in persons with bipolar or other neurocognitive disorders

Abstract

Bipolar Disorder is a mood disorder that can be quite severe for subgroups of patients, and often such patients manifest deficits in attention, concentration, memory, and executive functions that persist even when they are relatively well. Cognitive concerns can impair daily life functioning and impact employment, education, and interpersonal relationships. Main line treatments for bipolar disorder typically do not address cognitive impairments, and some treatments may actually worsen cognitive deficits. Treatment development for cognitive impairments in bipolar disorder is truly in its infancy; extracts of Ashwagandha (Withania som- nifera) may hold promise as a potential treatment option. The bioactive constituents of Ashwagandha, including withanolides, indosides, Withaferin A, and others, possess anti-inflammatory-immunomodulatory, anti-oxidant, cortisol lowering, antistress, pro-cholinergic, anti-glutamatergic and neuroprotective properties, the very processes that are thought to underlie cognitive impairments not only in in bipolar disorder but also in other psychiatric disorders like schizophrenia and major depression. This chapter reviews this in detail and highlights the preliminary randomized controlled study assessing an extract of Ashwagandha for improving cognition in bipolar disorder. The chapter also explores the potential role of Ashwagandha extracts in the treatment of other neurocognitive disorders, and it concludes by summarizing additional future research needed to realize the potential of this ancient medicinal plant for the treatment of human ailments.