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Background: Nasya, the administration of medicated oils, ghee, powders or juices through the nose, is one of the five main purification procedures (Panchakarma) of Ayurveda. Classical texts describe the nose as the gateway to the head (Nasa hi shiraso dvaram) and recommend Nasya for disorders above the clavicle, including mental and neurological conditions. Modern pharmaceutical science has established that some substances administered intranasally can reach the brain directly through olfactory and trigeminal pathways, bypassing the blood–brain barrier. Objective: To review the classical concept and practice of Nasya, the modern evidence for nose-to-brain transport, and the clinical evidence relevant to Nasya in neurological and psychiatric conditions. Methods: Narrative review of classical Ayurvedic texts and of pharmaceutical, neuroscience and clinical literature on intranasal delivery to the central nervous system. Results: Classical texts describe several types of Nasya (Virechana, Brimhana, Shamana, Marsha and Pratimarsha) with indications including headache, insomnia, anxiety, Unmada, Apasmara and memory loss. Modern studies show that intranasal administration can deliver peptides, small molecules and biologics to the brain via olfactory and trigeminal nerve pathways, and intranasal medicines are now approved for treatment-resistant depression and seizure clusters. Intranasal insulin has been tested in Alzheimer’s disease. Clinical evidence for Ayurvedic Nasya in mental and neurological disorders is limited to small studies and case series. Conclusion: The classical idea that the nose is a gateway to the head is supported by modern evidence for nose-to-brain delivery. Whether Ayurvedic Nasya formulations exploit this pathway has not yet been tested. Pharmacokinetic studies and controlled clinical trials are needed.

Keywords: Nasya; Panchakarma; nose-to-brain delivery; intranasal; olfactory pathway; Anu Taila; anxiety; neurological disorders