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Background:
Anxiety disorders, particularly Generalized Anxiety Disorder (GAD), represent one of the most
prevalent psychiatric conditions globally, significantly impacting quality of life and productivity.
The neuro-endocrine mechanisms underlying anxiety involve hyper-activation of the
hypothalamic–pituitary–adrenal (HPA) axis, cortisol exhaustion, and dysregulation of
neurotransmitters such as GABA and serotonin. Ayurveda describes anxiety in terms of
Chittodvega, a Manas vyadhi involving Vata-prakopa, Rajas-Tamas aggravation, and Oja-kshaya.
Shirodhara is traditionally indicated for disorders of mind and stress-related psychic disturbances.
Aim/Objectives:
To evaluate Shirodhara through modern neuro-hormonal mechanisms and classical Ayurvedic
principles in the management of anxiety disorders and GAD.
Methods:
A narrative review of Ayurvedic treatises (Bruhatrayee, Laghutrayee, Nighantu, Rasashastra
texts) and modern biomedical literature was conducted. Data were extracted from PubMed,
Scopus, Cochrane, and Google Scholar using keywords: Anxiety, GAD, Shirodhara,
neuroendocrine, cortisol, GABA, melatonin, HPA axis.
Key Review Findings: Shirodhara modulates HPA axis activity, decreases cortisol, enhances
GABA and serotonin levels, increases parasympathetic tone, and improves sleep architecture.
Ayurvedically, it pacifies Vata, balances Rajas-Tamas, nourishes Ojas, and stabilizes PranaVyana-Sadhaka Pitta.
Conclusion:
Shirodhara offers a promising integrative therapy for GAD through a dual framework neurohormonal regulation and Ayurvedic mind–body balancing. Further randomized, neurobiochemical studies are required for stronger clinical validation.

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