Whathelpswithstress.

Frequently asked

Practical answers to the questions readers most often arrive with.

• How fast does ashwagandha work for stress?+

  Most RCTs report measurable decreases in perceived stress and cortisol at 4–8 weeks of daily 300–600 mg. Some people notice a softer baseline within 1–2 weeks; the cortisol effect lags subjective relief.
• Which adaptogen for chronic vs acute stress?+

  For chronic, run-down stress: ashwagandha or holy basil, built up over 4–8 weeks. For acute or anticipatory stress (stage-fright pattern): L-theanine 200 mg or box breathing, both work within 30–60 minutes. Rhodiola sits between, useful for the 'drained' presentations.
• Can I take ashwagandha with antidepressants?+

  There is no documented major interaction, but ashwagandha's mild thyroid-stimulating effect and CNS activity warrant a conversation with your prescriber, especially on SSRIs or MAOIs. Check the free interaction reference for your specific medication.
• Sauna: how often and how hot for stress?+

  The Laukkanen 2015 cohort data showed a dose-response: 4–7 sessions per week of 15–20 minutes at 80–95 °C were associated with the largest mortality and cardiovascular benefits. One session per week did less. Most people do best starting at three per week and building up.
• Are adaptogens safe long-term?+

  Most adaptogens used in clinical trials for 8–12 weeks show good safety profiles. Long-term (multi-year) data is limited. A conservative pattern: 8-week cycles with 2-week breaks, or 5-on / 2-off weekly. Avoid in pregnancy.
• How does saffron compare to fluoxetine for mild depression?+

  The Tóth 2019 Planta Med meta-analysis (23 RCTs, n=1,499) found standardised saffron extract at 30 mg/day was significantly more effective than placebo and similar in efficacy to first-line antidepressants (fluoxetine, citalopram, imipramine) for mild-to-moderate depression over 6–12 weeks. For severe depression, pharmaceutical first-line is still indicated.
• What is Silexan and is it different from inhaled lavender?+

  Yes, distinct preparation. Silexan (WS 1265, marketed as Lasea) is a standardised oral lavender oil preparation registered as a medicinal product in Germany and Austria for subthreshold and generalised anxiety. The head-to-head non-inferiority RCT (Woelk 2010) compared it directly with lorazepam 0.5 mg/day in GAD with non-inferior results and no dependence signal. Distinct from inhaled aromatherapy and from generic lavender oil capsules.
• St. John's wort and the contraceptive pill: what's the risk?+

  Major. Hyperforin is a potent inducer of CYP3A4 and P-glycoprotein, which lowers blood levels of combined oral contraceptives: breakthrough bleeding and contraceptive failure are documented. Use barrier contraception in parallel or pick a different antidepressant approach. The same interaction profile affects warfarin, ciclosporin, tacrolimus, anti-HIV protease inhibitors, digoxin and many other drugs.
• Why is kava restricted in Europe?+

  A cluster of hepatotoxicity reports in the early 2000s led to bans in several markets. Subsequent investigation linked most cases to alcohol- or acetone-extracted preparations of aerial parts, not the traditional water-extracted noble root. Sale is currently restricted or banned in Germany, France, Switzerland and the UK. Where legal, only noble-cultivar water root extract is the lower-risk form.
• What's the evidence for SAMe vs SSRIs?+

  Sarris 2010 Am J Psychiatry RCT: SAMe 800 mg twice daily added to SSRI in non-responders produced significantly higher HAM-D response (36%) and remission (26%) vs placebo over 6 weeks. AHRQ 2003 systematic review found effects comparable to imipramine and escitalopram in monotherapy. Watch for mania in bipolar disorder: contraindicated.