SHIRODHARA: AN ANCIENT AYURVEDIC THERAPY FOR NEUROLOGICAL AND PSYCHOLOGICAL DISORDERS – A COMPREHENSIVE REVIEW

Abstract

Background: Shirodhara, an ancient Ayurvedic therapeutic procedure, involves the continuous pouring of medicated liquids (oil, buttermilk, milk, or decoctions) over the forehead. Traditionally prescribed for manasika (psychological) and nervous system disorders, it is believed to pacify Vata and Pitta doshas, promote relaxation, and harmonize the mind-body complex. In recent decades, Shirodhara has gained global recognition for its potential in managing stress, anxiety, insomnia, hypertension, and neuropsychiatric disorders. Aim: To review the classical principles, mechanisms of action, clinical efficacy, safety, and modern scientific research related to Shirodhara in neurological and psychological disorders. Objectives: To explore the classical Ayurvedic references and therapeutic indications of Shirodhara. To analyze its proposed mechanisms of action from both Ayurvedic and biomedical perspectives. To review clinical evidence regarding its efficacy and safety in managing neurological and psychological disorders. Materials and Methods: A comprehensive literature review was conducted using classical Ayurvedic texts (Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya), contemporary Ayurvedic treatises, and databases such as PubMed, Scopus, AYUSH Research Portal, DHARA, and Google Scholar. Relevant clinical trials, case reports, and experimental studies published up to 2025 were included. Results: Evidence from classical literature and contemporary studies supports the therapeutic potential of Shirodhara in reducing stress, anxiety, depression, insomnia, headache, and neuroendocrine imbalances. Mechanistically, Shirodhara is proposed to exert calming effects on the hypothalamic-pituitary-adrenal (HPA) axis, regulate autonomic functions, and enhance neurochemical balance. Reported adverse effects are minimal when administered following standard protocols. Conclusion: Shirodhara stands as a promising integrative therapy for a range of neurological and psychological disorders. While classical and preliminary modern evidence is encouraging, further high-quality randomized controlled trials and mechanistic studies are warranted to strengthen the evidence base and standardize clinical practice guidelines.