Samangadi Churna in the management of attention deficit hyperactivity disorder (ADHD): A critical review integrating classical Ayurvedic concepts with contemporary evidence.

Abstract

Background. Attention-deficit/hyperactivity disorder (ADHD) is a common childhood neurodevelopmental disorder marked by persistent inattention and/or hyperactivity–impulsivity affecting daily functioning. Although Ayurveda has not directly described equivalent for ADHD, its manifestations may be explored through concepts such as Unmada, Manas, Buddhi, Manovaha Srotas, and Medhya-Rasayana. Samangadi Churna, a classical Ayurvedic formulation described Kashyapa Samhita, Sutrasthana, Lehaadhyaya. in  containing Samanga, Triphala, Brahmi, Bala, Atibala, and Chitraka, is traditionally administered with Go-Ghrita and Madhu for supporting Medha, Ayu, and Bala. This review critically examines its possible relevance in ADHD management in light of classical Ayurvedic principles and available contemporary evidence.

Objective. To review the classical description, evaluate the potential pharmacological rationale, assess the available contemporary clinical evidence on Samangadi Churna in attention-deficit/hyperactivity disorder (ADHD), and identify directions for future research.

Methods. A narrative review was undertaken following the principles of the SANRA (Scale for the Assessment of Narrative Review Articles) framework. Classical information was obtained from the Kashyapa Samhita; Sutrasthana; lehaadhyaya, while contemporary literature was searched through PubMed/MEDLINE, Google Scholar, and relevant full-text databases. The search employed combinations of the terms “Samangadi Churna,” “Samangadi Leha,” “attention-deficit hyperactivity disorder,” “ADHD”,  “Unmada,” “Medhya-Rasayana,” and “Bacopa monnieri.”

Review summary. ADHD is not described as a distinct disorder in classical Ayurvedic texts; however,its clinical manifestations may be conceptually correlated with Unmada, particularly the disturbance of Dhi, Dhriti, and Smriti associated with Manovibhrama. Within this framework, Samangadi Churna, described in the Kashyapa Samhita, contains Samanga, Triphala, Brahmi, Bala, Atibala, and Chitraka and is administered with Go-Ghrita and Madhu, with classical emphasis on supporting Medha, Ayu, and Bala. Its therapeutic rationale can therefore be viewed within a Medhya–Balya–Rasayana properties. Contemporary evidence, however, is predominantly available for individual ingredients rather than the complete formulation. Bacopa monnieri has demonstrated cognitive and behavioural effects in human studies, including those addressing attention and hyperactivity, whereas Rubia cordifolia, Sida cordifolia, Abutilon indicum, and Plumbago zeylanica are supported mainly by preclinical evidence involving antioxidant, neuroprotective, neurotransmitter-related, and digestive mechanisms. Triphala has also been investigated for antioxidant, anti-inflammatory, and microbiome-related effects. Although the gut–brain axis is increasingly recognised as a potential area of relevance in ADHD, evidence remains evolving. Overall, direct clinical evidence for the efficacy of Samangadi Churna in ADHD requires major clinical trials.

Conclusion. Samangadi Churna demonstrates a rational basis within classical Ayurvedic principles and may have potential through the combined effects of its constituent ingredients. However, current evidence requires more research  to establish its efficacy as a treatment for ADHD. Further research should focus on formulation standardization, pediatric safety, dose optimization, and well-designed randomized controlled trials employing validated ADHD assessment tools.