Herbal medicines in obsessive-compulsive disorder: Pre-clinical and clinical evidence

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Abstract

Background: Obsessive-compulsive disorder (OCD) is a chronic and debilitating neuropsychiatric disorder characterized by recurrent obsessions and compulsions that significantly impair quality of life and daily functioning. Although cognitive behavioural therapy (CBT) and pharmacotherapy remain the mainstay of treatment, many patients experience incomplete response, relapse, or adverse effects associated with long-term therapy. Consequently, increasing attention has been directed toward herbal medicines and phytochemicals as potential alternative or adjunctive therapeutic approaches for OCD. Objective: This review summarizes the available evidence regarding herbal medicines and phytoconstituents investigated for OCD, with emphasis on their therapeutic potential, proposed mechanisms of action, and findings from preclinical and clinical studies.Methods: Relevant articles were retrieved from PubMed, Scopus, Web of Science, Open Access Journals, and Google Scholar up to 31st December 2025 using keywords including “obsessive-compulsive disorder”, “OCD”, “medicinal plants”, “herbal medicine”, and “phytomedicine”. Discussion: Clinical studies, particularly randomized controlled trials, suggest that Crocus sativus, Withania somnifera, Valeriana officinalis, and Echium amoenum may reduce OCD symptom severity, primarily assessed using Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores. Preclinical studies further demonstrated anti-obsessive effects of several medicinal plants through modulation of serotonergic, dopaminergic, and glutamatergic pathways, along with antioxidant, anti-inflammatory, and neuroprotective activities. However, the current evidence remains limited by small sample sizes, short follow-up duration, lack of replication studies, and methodological heterogeneity involving variations in herbal preparations, dosages, and study designs. In addition, mechanisms related to immune regulation, neuroinflammation, oxidative stress, and gut–brain interactions remain insufficiently explored. Conclusions: Herbal medicines demonstrate promising therapeutic potential in OCD management; however, the existing clinical evidence remains insufficient to support routine clinical use. Future research should prioritize large double-blind randomized controlled trials with standardized herbal formulations, longer follow-up periods, and comprehensive safety evaluation, along with mechanistic studies investigating immune, inflammatory, and gut–brain pathways involved in OCD pathophysiology.

Keywords

obsessive-compulsive disorder / phytoconstituents / pre-clinical study / bioactive compounds / clinical trials / cognitive-behavioural therapy

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