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CC BY 4.0 · J Neuroanaesth Crit Care
DOI: 10.1055/s-0045-1810063
Review Article

Herbal Medicines: The Double-Edged Sword for Brain—A Narrative Update

Ankur Khandelwal 
1   Department of Anaesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences (AIIMS), Guwahati, Assam, India
,
S. Niranjana 
2   Department of Anesthesia and Intensive Care, Khoula Hospital, Muscat, Oman
,
Kalyan Sarma 
3   Department of Radiology, All India Institute of Medical Sciences (AIIMS), Guwahati, Assam, India
,
Masaraf Hussain 
4   Department of Neurology, All India Institute of Medical Sciences (AIIMS), Guwahati, Assam, India
,
Priyadarshi Dikshit 
5   Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Guwahati, Assam, India
,
Gyaninder P. Singh 
6   Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Abstract

Phytochemicals or herbal medicines (HMs) with neuroprotective and nootropic properties are being increasingly utilized in various neurological conditions owing to their antioxidative, anti-inflammatory, and antiapoptotic properties, as well as their role in immune regulation, hormonal regulation, and modulation of neurotransmitters and ion channels. While HMs are often regarded as safe, they are not without risks. The aim of this review was to know the various neurological and non-neurological side effects of long-term consumption of neuroprotective and nootropic phytochemicals. An electronic search was conducted using the following databases from January 2000 to December 2023: PubMed, PubMed Central, Embase, Scopus, and Science Citation Index (Web of Science). Only studies published in the English language were considered. The search used key terms such as “Herbs,” “Phytochemicals,” “India,” “Asia,” “Neuroprotection,” “Neurological diseases,” and “Complications.” The sources included research articles, systematic reviews and meta-analyses, narrative reviews, and editorials. Letters to the editor, commentaries, abstracts only, and unpublished data were excluded. While HMs are increasingly being used therapeutically for various neurological and non-neurological conditions, they also carry the risk of adverse effects due to contamination, adulteration, direct effects of metabolites, herb–drug interactions, interindividual susceptibility, and other factors. In addition, widespread availability, over-the-counter sale, and unsupervised dosing are the key reasons for their unregulated prolonged use. As such, correct identification of HMs and consequent assessment of their toxicological profile are deemed extremely crucial. Neurotoxicity testing for HMs is challenging considering the limitations of traditional methods (morphological, microscopic, and chemical); nevertheless, in the recent years, several novel procedures have been developed. Large studies are warranted to establish the safety profile of consuming HMs either alone or in combination in humans.

Keywords

herbs - neuroprotection - phytochemicals - safety - toxicity


Publikationsverlauf

Artikel online veröffentlicht:
01. August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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