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Background: Schizophrenia is a severe, often chronic mental disorder that affects about 24 million people worldwide. Antipsychotic medicines are effective for positive symptoms but less so for negative and cognitive symptoms, and many patients have residual symptoms and side effects. Ayurveda describes psychotic states under Unmada, with a detailed classification, aetiology and management. Objective: To review the classical concept of Unmada, compare it with schizophrenia spectrum disorders, and evaluate the evidence for Ayurvedic and related interventions as adjuncts to standard care. Methods: Narrative review of Charaka Samhita and Sushruta Samhita and of clinical studies, systematic reviews and trials identified through PubMed, the Cochrane Library and Indian databases. Results: Charaka defines Unmada as disturbance of mind, intellect, consciousness, knowledge, memory, desire, character, behaviour and conduct, and classifies it into Doshaja types and an exogenous (Agantuja) type. These descriptions overlap substantially with schizophrenia and other psychoses. A Cochrane review identified three small Indian trials suggesting possible benefit of Ayurvedic preparations but judged the evidence insufficient. A randomised, placebo-controlled trial found that adjunctive Ashwagandha extract improved symptoms, especially negative symptoms, in patients with acute exacerbation. Yoga as an add-on improves negative symptoms and social functioning in randomised trials. Conclusion: Ayurveda offers a detailed classical framework for psychosis and several promising adjunct interventions. Its role should be adjunctive, alongside antipsychotic medicines and psychosocial care, and requires larger, rigorous trials.

Keywords: Unmada; schizophrenia; psychosis; Ashwagandha; Brahmyadi Yoga; yoga therapy; adjunct therapy