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Introduction: Unmada (psychosis) is one of the most serious manasika rogas (mental disorders) described in Ayurveda, characterized by disturbances in perception, thought, and behavior due to dosha vitiation and impairment of manas, buddhi, and indriyas. Modern psychiatry describes psychosis as a cluster of disorders including schizophrenia, schizoaffective disorder, and bipolar disorder with psychotic features. Integrating Ayurveda with modern psychiatry may provide novel therapeutic strategies. Methods: A systematic review was conducted using classical Ayurvedic texts (Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya) along with electronic databases such as PubMed, Scopus, and Web of Science. Keywords included Unmada, Ayurveda, psychosis, schizophrenia, manas roga. Inclusion criteria comprised classical references, clinical trials, pharmacological studies, and review articles published between 2000–2024. Studies exclusively focusing on unrelated psychiatric disorders were excluded. Results: Ayurveda describes five types of Unmada (Vataja, Pittaja, Kaphaja, Sannipataja, and Manasika/Agantuja) with distinct clinical features. Classical management includes daivavyapashraya chikitsa (spiritual measures), yukti vyapashraya chikitsa (herbal formulations such as Brahmi, Shankhapushpi, Ashwagandha, Jatamansi), and sattvavajaya chikitsa (counseling, meditation, self-control techniques). Modern studies support the neuroprotective, anxiolytic, antipsychotic, and adaptogenic properties of these herbs. Panchakarma interventions like Shirodhara, Virechana, and Nasya show positive effects in managing psychotic features. Discussion: Ayurvedic approaches emphasize restoring dosha balance and strengthening manas through holistic measures. Modern pharmacological evidence correlates the action of Ayurvedic herbs with modulation of neurotransmitters, antioxidant effects, and stress reduction. However, large-scale randomized controlled trials are lacking. An integrative approach can address gaps in long-term management and reduce side effects of conventional antipsychotics. Conclusion: Ayurvedic management of Unmada offers holistic, individualized care incorporating herbal, psychological, and detoxification therapies. Evidence suggests potential synergy with modern psychiatry, though further robust clinical studies are necessary.

KEYWORDS: Ayurveda; Manas roga; Psychosis; Unmada; Yoga