Abstract
Depression among older adults is an increasing public health concern, particularly in resource-constrained settings such as Nigeria, where access to specialized psychiatric care remains limited and conventional antidepressant therapy may be complicated by polypharmacy and adverse effects. This study explores the potential of a combined herbal formulation containing equal proportions of Ashwagandha (Withania somnifera), Rhodiola (Rhodiola rosea), Chamomile (Matricaria recutita), and Saffron (Crocus sativus) as an adjunct to outpatient management of mild to moderate geriatric depression. A pilot observational study was conducted in outpatient clinics in Lagos, Nigeria, involving 60 participants aged 65 years and above who received the herbal formulation alongside routine counseling for eight weeks. Outcomes were assessed using the Geriatric Depression Scale (GDS), Pittsburgh Sleep Quality Index (PSQI), Zarit Burden Interview (ZBI), and measures of functional independence. The findings show a 33.5% reduction in GDS scores, a 37.7% improvement in PSQI scores, a 33.6% reduction in caregiver burden, and a 15.7% increase in functional independence over the intervention period. Reported adverse events were mild and transient, consisting primarily of gastrointestinal discomfort and dizziness, suggesting acceptable short-term tolerability within the study population. These findings indicate that the combined herbal formulation, when used alongside routine counseling, may have potential as a culturally acceptable and comparatively accessible adjunctive approach for managing geriatric depression in resource-limited outpatient settings. However, given the observational pilot design, the findings should be interpreted as preliminary rather than causal evidence of efficacy. The study contributes to emerging research on integrative approaches to geriatric mental healthcare in Nigeria and highlights the need for adequately powered randomized controlled trials to evaluate efficacy, safety, and long-term outcomes before broader clinical or policy integration is considered.