CHITTODVEGA (GENERALISED ANXIETY DISORDER): AYURVEDIC PATHOGENESIS AND EVIDENCE FROM CLINICAL STUDIES
Background: Anxiety disorders are among the most common mental disorders worldwide. In Ayurveda, persistent anxiety is commonly described under the term Chittodvega, derived from Udvega (agitation) listed by Charaka among mental disorders. Ayurvedic management combines internal medicines, external therapies such as Shirodhara and Nasya, and Sattvavajaya. Objective: To describe the Ayurvedic understanding of Chittodvega, compare it with generalised anxiety disorder (GAD), and summarise clinical evidence for Ayurvedic and related interventions. Methods: Narrative review of classical sources and of clinical literature retrieved from PubMed, Google Scholar, DOAJ and AYUSH journals, focusing on controlled trials, systematic reviews and representative Ayurveda clinical studies. Results: Chittodvega is understood as a disorder of Manovaha Srotas in which Vata (especially Prana Vata) and Rajas are aggravated, often with Pitta involvement, leading to fear, worry, restlessness, palpitations and sleep disturbance. This closely matches GAD. Among single herbs, Ashwagandha has the strongest clinical evidence for reducing anxiety and stress, supported by several randomised trials and systematic reviews. Brahmi has supportive evidence from a randomised trial in older adults. Yoga reduces anxiety in randomised trials. Ayurveda studies of Shirodhara, Nasya and classical formulations are mostly small, uncontrolled or single-centre. Conclusion: The Ayurvedic model of Chittodvega is coherent and clinically compatible with GAD. Evidence is promising for Ashwagandha and yoga, but most classical therapies require larger, rigorously designed trials using standard outcome measures such as the Hamilton Anxiety Rating Scale.Keywords: Chittodvega; generalised anxiety disorder; Manovaha Srotas; Ashwagandha; Brahmi; Shirodhara; Medhya Rasayana