Fixed-drug eruption caused by ashwagandha (Withania somnifera): a widely used Ayurvedic drug. This means they can cause drug-drug interactions, and they can have all the usual side effects and risks that pharmaceutical can have. Anyone with upcoming surgery should stop using ashwagandha at least two weeks prior. J Diet Suppl. St. John's wort can cause a buildup of serotonin in the body when taken with antidepressants. Ahmad MK, Mahdi AA, Shukla KK, et al. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Effects of Withania somnifera in patients of schizophrenia: a randomized, double blind, placebo controlled pilot trial study. Ghosal S, Lal J, Srivastava R, and et al. Select a condition to view a list of vitamins. Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. Ireland PJ, Hardy T, Burt AD, Donnelly MC. 1988;26(11):877-882. It is commonly used for stress. Ashwagandha and other dietary supplements should never replace standard medicine or care. These supplements may contain similar active ingredients or have potential uses that are like those of ashwagandha. It also covers possible side effects of the herb, interactions, dosage information, and guidance regarding selecting ashwagandha supplements. Choudhary, M. I., Nawaz, S. A., ul-Haq, Z., Lodhi, M. A., Ghayur, M. N., Jalil, S., Riaz, N., Yousuf, S., Malik, A., Gilani, A. H., and ur-Rahman, A. Withanolides, a new class of natural cholinesterase inhibitors with calcium antagonistic properties. View abstract. A systematic review and meta-analysis of randomized controlled trials. Byetta, Trulicity, Ozempic, Rybelsus, Bydureron, Victoza, Mounjaro), Sulfonylureas (e.g. drugs for diabetes and blood pressure). J Atten Disord 2010;14:281-91. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. However, SSRIs don't work for everyone, and other antidepressants work via different pathways in your body. Dongre S, Langade D, Bhattacharyya S. Efficacy and safety of ashwagandha (withania somnifera) root extract in improving sexual function in women: a pilot study. . No supplement is intended to treat, cure, or prevent disease. lisinopril, captopril, benazepril, quinapril), ARBs (e.g. Health Sci Rep 2022;5(4):e741. View abstract. This information may not fit your specific health circumstances. If you're taking antidepressants and vitamins at the same time, be aware of the ingredients in your vitamin supplements. 2017;14(6):599-612. doi:10.1080/19390211.2017.1284970, Tiwari S, Gupta SK, Pathak AK. Withania somnifera extract. J Funct Morphol Kinesiol. Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs. Notably, ashwagandha doses typically do not exceed 1,000 milligrams per day for up to 12 weeks. A variety of of vitamins and nutritional supplements have been shown to help treat depression. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. This article provides a review of the potential uses of ashwagandha. 2012;7(9):e44419. Efficacy and safety evaluation of ayurvedic treatment (ashwagandha powder and sidh makardhwaj) in rheumatoid arthritis patients: a pilot perspective study. Pusec CM, Wolsky R, Llerena C, Sura P. A Case of Supplement-Induced Hepatitis. Is this an emergency? The drug interactions listed above are not all of the possible interactions or adverse effects. Kumar G, Srivastava A, Sharma SK, Rao TD, Gupta YK. Front Pharmacol 2022;13:901710. There is animal research that suggests that ashwagandha may lower systolic and diastolic blood pressure, putting people who take blood pressure-lowering medication at risk for hypotension,. Cancer Lett 2000;148:9-17. Biswal BM, Sulaiman SA, Ismail HC, Zakaria H, Musa KI. View abstract. PLoS One 2021;16(9):e0257843. Holistic Medicine 42 years experience. National Library of Medicines list As an adaptogen, helping the body resist physiological and psychological stress, Steroidal lactones (withanolides, withaferins), GLP-1 Agonists (e.g. Efficacy of Withania somnifera supplementation on adult's cognition and mood. In general, Ashwagandha is thought to be safe when used in moderate amounts. doi:10.7759/cureus.5797, Cheah KL, Norhayati MN, Husniati Yaacob L, Abdul Rahman R. Effect of ashwagandha (Withania somnifera) extract on sleep: a systematic review and meta-analysis. However, there is concern that herbs like ashwagandha may have interactions that have not yet been identified. This is according to a recent review of case studies of liver damage caused by ashwagandha. Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian, pharmacist, or healthcare provider. According to a December 2012 study in the Journal of Medicine and Life, SSRIs are primarily the recommended treatment for depression. Some herbal supplements with antidepressant properties are safe to consume alongside medications. However, there is concern that herbs like ashwagandha may have interactions that have . View abstract. Therefore,it could theoretically increase the risk of hypoglycemia (i.e. Am J Drug Alcohol Abuse 2009;35(1):1-11. View abstract. 2020;40(4):825-829. Cureus. Neurol India 2009;57:166-71. Sometimes, these supplements are stand-alone products or multivitamins; in other cases, they are mixed in with healthy food products, like spirulina, chlorella or herbal products. It may also interact with medications for these conditions. Ashwagandha's leaves contain a compound that causes sleep induction and is used for treating insomnia. Talk with a healthcare provider about the right ashwagandha dosage for your needs. According to an August 2016 study in the Complementary Therapies in Medicine Journal, taking ashwagandha with antidepressants like SSRIs can be a safe, effective and healthy way of supporting your mental health. Learn about the uses and potential benefits of Ashwagandha including dosage guidelines, side effects, interactions and safety/efficacy ratings. A recent study looked at the health claims and safety of ashwagandha and found that the herb has shown anticancer, anti-inflammatory, heart-protective, liver-protective, and immunomodulatory (able to change the immune system) actions. However, tyramine-rich foods like cheeses, beer and other fermented products are dangerous for people taking MAOIs. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Choudhary D, Bhattacharyya S, Joshi K. Body weight management in adults under chronic stress through treatment with ashwagandha root extract: a double-blind, randomized, placebo-controlled trial. Of the 58 participants in the study, those who took ashwagandha had reduced levels of cortisol (a stress hormone) as well as lower perceived stress scores by the end of the eight-week study. However, some other statins do not seem to be affected by grapefruit juice, including pravastatin (Pravachol), fluvastatin (Lescol) and rosuvastatin (Crestor). Staff, Cotellic With Turmeric And Black Pepper Interaction. 2019;98(37):e17186. First and foremost, I want to point out this it can tricky to determine whether or not a dietary/herbal supplement will interact with prescription drugs due to a general lack of studies on the matter. View abstract. This includes: As with many other herbs and supplements, ashwagandha has a risk of side effects. J Evid Based Complementary Altern Med. Nevertheless, be sure to talk to your doctor before adding on ashwagandha to blood pressure medicine, such as: Ashwagandha might increase the effects and adverse effects of thyroid hormone drugs. View abstract. There is little evidence for its use as an "adaptogen." Ashwagandha contains chemicals that. Safety studies have not been performed on these populations, so it's best to avoid using ashwagandha altogether while pregnant or breastfeeding. J Ethnopharmacol. 2021;57:102642. doi:10.1016/j.ctim.2020.102642, Bjrnsson HK, Bjrnsson ES, Avula B, et al. A study compared ashwagandha to a placebo to determine whether the herb would have a positive effect on insomnia. Salve J, Pate S, Debnath K, Langade D. Adaptogenic and anxiolytic effects of ashwagandha root extract in healthy adults: A double-blind, randomized, placebo-controlled clinical study. 8-16-1995;95(1-2):189-193. Association of l-DOPA with recovery following Ayurveda medication in Parkinson's Disease. View abstract. Taking ashwagandha along with medications that lower blood pressure might cause blood pressure to go too low. J Diet Suppl. Ahumada F, Aspee F, Wikman G, Hancke J. Withania somnifera exract. O'Connor J, Lindsay K, Baker C, Kirby J, Hutchins A, Harris M. The impact of ashwagandha on stress, sleep quality, and food cravings in college students: quantitative analysis of a double-blind randomized control trial. Katz M, Levine AA, Kol-Degani H, Kav-Venaki L. A compound herbal preparation (CHP) in the treatment of children with ADHD: a randomized controlled trial. Ashwagandha may interact with certain drugs by enhancing or negating their actions. According to one study that examined ashwagandha's effect on athletics, ashwagandha may improve both endurance and recovery in healthy adult athletes. Taking it with drugs that increase levels of thyroid hormone (e.g. Additionally, a pilot study looked at ashwagandha's effects on people with mild cognitive impairment. Dasgupta A, Peterson A, Wells A, Actor JK. As with many other herbal supplements, little research is available on possible interactions. These side effects are usually experienced on higher doses. Although ashwagandha is mainly considered safe, side effects may be possible. Next Steps to Take, Understanding Your Childs Life With ADHD. Effect of Withania somnifera (Ashwagandha) on the development of chemotherapy-induced fatigue and quality of life in breast cancer patients. Just be sure to choose a supplement from a reputable manufacturer and follow the . The roots can be used topically as a poult. Gastrointestinal side effects including nausea, vomiting and diarrhoea. View abstract. However, these results have not been proven in humans. Effect of Asian ginseng, Siberian ginseng, and Indian ayurvedic medicine Ashwagandha on serum digoxin measurement by Digoxin III, a new digoxin immunoassay. Take extra care driving and doing tasks that you need to be alert for while taking this product. Some vitamins and supplements can interfere with blood-thinning blood pressure drugs, Dr. Glatter says. Bhattacharya SK, Satyan KS, Ghosal S. Antioxidant activity of glycowithanolides from Withania somnifera. Ashwagandha side effects. As this is a relatively new area of research, more vigorous studies are needed. Ashwagandha (Withania somnifera) is a natural herb used for centuries in Ayurveda. J.Altern.Complement Med. It may also interact with other herbs, supplements, and even foods. Ashwagandha may also contain withanolides, which are thought to have anti-inflammatory and antioxidant properties. Safety of ashwagandha root extract: a randomized, placebo-controlled, study in healthy volunteers. People who are pregnant or breastfeeding should not use ashwagandha. J Med Food 2022. J Clin Lab Anal 2008;22:295-301. 2013;74(11):1076-83. Therapeutic Research Faculty 2020. Since you don't mention any drugs in your question, we'll list some of the potential interactions below. After 60 days, participants who took ashwagandha reported lower levels of stress and were also found to have reduced cortisol levels. Hydroxyzine has moderate interactions with at least 207 different drugs. You can mix other nonessential amino acids and antidepressants without any issues. At the end of the study, significant improvements in general memory and immediate memory were seen in the ashwagandha group. Vaishnavi, K., Saxena, N., Shah, N., Singh, R., Manjunath, K., Uthayakumar, M., Kanaujia, S. P., Kaul, S. C., Sekar, K., and Wadhwa, R. Differential activities of the two closely related withanolides, Withaferin A and Withanone: bioinformatics and experimental evidences. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version. Read more: 15 Celebrities Who Struggle With Anxiety and Depression. Devi, P. U., Sharada, A. C., and Solomon, F. E. Antitumor and radiosensitizing effects of Withania somnifera (Ashwagandha) on a transplantable mouse tumor, Sarcoma-180. Effect of standardized root extract of ashwagandha (Withania somnifera) on well-being and sexual performance in adult males: a randomized controlled trial. J Ayurveda Integr Med. Go to the ER right away. Effect of a medicinal plant (Passiflora incarnataL) on sleep. This product may cause you to be sleepy. Some people may need to avoid taking Ashwagandha, however, including those who: Dietary supplements are not regulated like drugs in the United States, meaning the Food and Drug Administration (FDA) does not approve them for safety and effectiveness before products are marketed. Talk with a healthcare provider about which herb or supplement may be best for you. Medicine (Baltimore). 1998;60(2):173-178. Indian J Exp Biol 2000;38:607-9. This information does not endorse any treatments or medications as safe, effective, or approved for treating a . The herb has been proven to interact with many other drugs, the interaction with SSRI (selective serotonin reuptake inhibitor) or Benzodiazepines are not proven scientifically. J Neurol Sci 2000;176:124-7. You can also connect with Dr. Brian Staiger on LinkedIn. Be sure to tell your doctor that you take this product if you are scheduled for surgery or tests. The news available in this regard in . Guerrero FA, Medina GM. Gopal S, Ajgaonkar A, Kanchi P, et al. This includes people who have had a transplant, are on chemo, or have an autoimmune disease. Ultimately, the supplements and foods you can . Food Chem.Toxicol. In this investigation, participants took either a placebo or 240 milligrams per day of ashwagandha extract. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. By Brittany Lubeck, RD These include drugs like thyroid desiccated, levothyroxine, or liotrix. Ashwagandha is not naturally found in foods, which means the only way to get it is through supplements. CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. 2017;10(3):96-100. doi:10.5935/1984-0063.20170018. View abstract. In the study, participants received either a placebo or 600 milligrams per day of ashwagandha for eight weeks. Some products may not mix well with other drugs or natural products. View abstract. Indian J Exp Biol. I have it on my medical HelloPharmacist View abstract. Jahanbakhsh SP, Manteghi AA, Emami SA, Mahyari S, et al. Chronic stress increases cortisol levels, leading to lower levels of T3 and T4. Ashwagandha can react with certain medications and supplements you may already take, and result in adverse effects. However, you should not stop taking any prescribed medication. It is recommended that people with hormone-sensitive prostate cancer avoid using ashwagandha out of an abundance of caution. Does Ambien Cause Withdrawal Symptoms After Stopping? Participants of this study received either a placebo or 300 milligrams of ashwagandha twice per day for eight weeks. Taking ashwagandha with sedative medications might cause breathing problems and/or too much sleepiness. View abstract. Durg S, Bavage S, Shivaram SB. 1965;9(1):9-15. Int.J.Crude Drug Res. Compared to those who took the placebo, participants who took ashwagandha were found to have better visual memory, learning, and attention. In this randomized, double-blind, placebo-controlled trial, 125 adult participants were randomized to either 300 milligrams per day of ashwagandha sustained release or a placebo for 90 days. Take extra care if you are taking drugs to help with your thyroid. Researchers of the study believed that these results were due to the ability of ashwagandha to moderate the body's stress response. According to their lab study, withanone may interfere with DNA, leading to liver damage. View abstract. Some but not all ashwagandha supplements are organic. View abstract. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. Who Shouldn't Take Ashwagandha? Moderate 623 Interactions; Unknown 2123 Interactions; Interaction Rating Key. Nonetheless, additional large-scale, long-term studies would strengthen these findings. Cureus 2022;14(10):e30433. Cheah KL, Norhayati MN, Husniati Yaacob L, Abdul Rahman R. Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis. 2021;6(1):20. doi:10.3390/jfmk6010020, Langade D, Kanchi S, Salve J, Debnath K, Ambegaokar D. Efficacy and safety of ashwagandha (Withania somnifera) root extract in insomnia and anxiety: a double-blind, randomized, placebo-controlled study. 2022;15(9):1067-1080. doi:10.1080/17512433.2022.2121699, Salve J, Pate S, Debnath K, Langade D. Adaptogenic and anxiolytic effects of Ashwagandha root extract in healthy adults: a double-blind, randomized, placebo-controlled clinical study. Do note that ashwagandha itself does not . Commonly prescribed SSRIs include sertraline (brand name Zoloft), paroxetine (Paxil), fluoxetine (Prozac) and citalopram (Celexa). Hence, be cautious if taking these medications and want to take Ashwagandha also. Studies on immunomodulatory activity of Withania somnifera (Ashwagandha) extracts in experimental immune inflammation. Indian J Exp Biol 1997;35:236-9. Feel free to send him an email at Hello@HelloPharmacist.com! Khattak, S., Saeed, Ur Rehman, Shah, H. U., Khan, T., and Ahmad, M. In vitro enzyme inhibition activities of crude ethanolic extracts derived from medicinal plants of Pakistan. Herbal supplements, like St. John's wort or garcinia cambogia, are much more likely to affect the functionality of your antidepressants compared to vitamins or mineral tablets. In rare cases, the use of ashwagandha may lead to liver damage. 2004;42(12):2015-2020. The effect of standardized ashwagandha extract (35% withanolide glycosides) on fatigue, vitality and associated steroid hormonal systems in healthy aging, overweight men (40 to 70 years of age; BMI, 25 to 35) was investigated via a 16-week, double-blind, randomized, placebo-controlled crossover trial (N=57). In our latest question and answer, the pharmacist discusses whether or not ashwagandha supplements interact with prescription drugs. View abstract. All rights reserved. 2021 Feb 11;6(1):20. doi: 10.3390/jfmk6010020. Serotonin syndrome can even result in death. PLoS One 2009;4:e6628. View abstract. View abstract. Ashwagandha supplements are meant to be taken every day. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Read our. Effects of L-Theanine administration on stress-related symptoms and cognitive functions in healthy adults: a randomized controlled trial. Doses higher than that may interact with lexapro, or produce more pronounced effects. They should also be kept from direct sunlight and stored in their original bottle or container. After 30 days, those who took either dose of ashwagandha self-reported positive effects on their anxiety. Deshpande A, Irani N, Balkrishnan R, Benny IR. J Clin Psychiatry. Archana R, Namasivayam A. Antistressor effect of Withania somnifera. Do not use this product if you are pregnant or plan to become pregnant soon. View abstract. Study participants were randomized to receive a placebo, 225 milligrams per day of ashwagandha, or 400 milligrams per day of ashwagandha for 30 days. View abstract. This holds true for ashwagandha. Ashwagandha has not been well studied in regard to potential interactions with prescription medication. Cureus 2022;14(10):e30787. The body naturally produces thyroid hormones. Medically reviewed by Drugs.com. It may cause you to become sleepy or drowsy. The ashwagandha root extract has been used for thousands of years as an herbal remedy in Ayurveda, the ancient Indian medical system. According to an April 2016 review in the Journal of Psychiatry, several nutrients are involved in healthy brain activity. WebMD does not provide medical advice, diagnosis or treatment. Indian J Pharmacol. Mild Interactions of hydroxyzine include: ashwagandha; brimonidine; eucalyptus; nettle; sage; siberian ginseng; This information does not contain all possible interactions or adverse effects. View abstract. Ashwagandha has mild interactions with at least 29 different drugs. This means not enough is known about either the safety or effectiveness of taking daily ashwagandha for an extended period of time. These are: In addition to these commonly prescribed antidepressants, there are other central nervous system drugs with antidepressant effects, like antipsychotics, as well as herbs and supplements that have natural antidepressant properties. For more information on drug interactions, visit the RxList Drug Interaction Checker. As with many other herbal supplements, little research is available on possible interactions. Upton R, ed. 2013;12(4):312-22. Which is why it might lead to sleepiness and drowsiness with medications such as Wellburtin. The best time to take ashwagandha is at the time that works best for you. View abstract. Liver Int. Complement Ther Med. Kumar S, Bouic PJ, Rosenkranz B. Ashwagandha might lower blood sugar levels. There are no vitamins contraindicated for consumption with antidepressants, but you should be cautious about consuming a mixture of supplements. Be sure to let your doctor know if you plan on adding ashwagandha to your medication list so you can be appropriately monitored. Certain antidepressants may not be compatible with herbs or other natural ingredients in these products. Kulkarni, S. K. and Dhir, A. Withania somnifera: an Indian ginseng. Use birth control you can trust while taking this product. Herbal supplements can strongly affect the body. Cent.Nerv.Syst.Agents Med.Chem. Hi, I was recommended to take ashwagandha. View abstract. The liver damage never progressed to liver failure, and most cases were resolved within five months. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat. It's important to keep all supplements out of reach of small children and pets who may accidentally ingest more than they should. Deocaris, C. C., Widodo, N., Wadhwa, R., and Kaul, S. C. Merger of ayurveda and tissue culture-based functional genomics: inspirations from systems biology. 2020;12(4):1119. Ashwagandha may be able to help with insomnia. View abstract. Ashwagandha has no known moderate interactions with any drugs. 2020;10(11):e01760. Although side effects do not always occur, you may experience drowsiness, stomach pain, or loose stools when taking ashwagandha. Clinical Evaluation of the Spermatogenic Activity of the Root Extract of Ashwagandha (Withania somnifera) in Oligospermic Males: A Pilot Study. Does Ashwagandha Interact With Any Medications? 1965;9(3):127-136. Effect of Indian Ayurvedic medicine Ashwagandha on measurement of serum digoxin and 11 commonly monitored drugs using immunoassays: study of protein binding and interaction with Digibind. Assessment of Withania somnifera root extract efficacy in patients with generalized anxiety disorder: A randomized double-blind placebo-controlled trial. 2021;2:72-81. doi:10.1016/j.crtox.2021.02.002. If you're interested in taking a nutritional supplement to support your treatment for depression, talk to your doctor so you can find the one that works best for you and doesn't affect your antidepressants. glipizide, glyburide, glimepride), SGLT2 Inhibitors (e.g. Therefore, before using this product, tell your doctor or pharmacist of all the . A 2020 case study examined five adults who had experienced signs of hepatotoxicity, or toxicity to the liver, after using ashwagandha in varying doses. According to the Cleveland Clinic, there are six different types of medications commonly used to treat depression. Indian J Psychol Med. Most reported drug interactions are based on the potential additive effectswhen combined with certain drugs (e.g. Ashwagandha interferes with immunoassay measurements of digoxin, a medication primarily used for treating congestive heart failure and abnormal heart rhythms. J Med Food 2022. Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? One study, published in Phytotherapy Research, reported that ashwagandha supplementation reduced blood sugar and A1c levels, although this was a relatively small study. low blood sugar). 1985;23(4):177-183. Malviya, N., Jain, S., Gupta, V. B., and Vyas, S. Recent studies on aphrodisiac herbs for the management of male sexual dysfunction--a review. Anbalagan, K. and Sadique, J. Dietary supplements: what you need to know. Its effects on arterial blood pressure in anaesthetized dogs. Herb-drug interactions. No, Ashwagandha does not possess any qualities that cause it to be habit forming, and the risk of forming an addiction to Ashwagandha is little to none. Studies are inconclusive, but ashwagandha may have immune-stimulating properties. Curr Clin Pharmacol. Never start, stop or otherwise change your therapy before speaking with your provider. Is It Safe To Take Keflex (Cephalexin) With Birth Control? Again, be sure to talk to your doctor about adding ashwagandha to immunosuppressant drugs. View abstract. 2020;40(4):825-829. doi:10.1111/liv.14393, Siddiqui S, Ahmed N, Goswami M, Chakrabarty A, Chowdhury G. DNA damage by withanone as a potential cause of liver toxicity observed for herbal products ofWithania somnifera(ashwagandha). Therefore, it should be used cautiously with drugs used to treat diabetes, including: Just like with potential interactions between ashwagandha and diabetes drugs, there may be a potential issue with drugs used to treat high blood pressure as studies show ashwagandha mayhave blood-pressure-lowering effects. Dhuley, J. N. Therapeutic efficacy of Ashwagandha against experimental aspergillosis in mice. Hello! 2019;98(37):e17186. Curr Sports Med Rep. 2017;16(4):230-239. doi:10.1249/JSR.0000000000000385. Baker C, Kirby JB, O'Connor J, Lindsay KG, Hutchins A, Harris M. The perceived impact of ashwagandha on stress, sleep quality, energy, and mental clarity for college students: qualitative analysis of a double-blind randomized control trial.
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