This herb (spelled schisandra or schizandra) has an ancient history of use in China, where it is called wu wei zi, or five flavored fruit, because of it is said to possess the five flavors of classical Chinese medicine: sour, bitter, sweet, salty, and pungent. Because of this, it is held in high regard in the Chinese materia medica and is still widely used in traditional Chinese medicine today. In the first century classic herbal compendium, the Divine Husbandman’s Classic of the Materia Medica (Shen Nong Ben Cao Jing), schisandra is classified among the superior medicines, purported to “prolong the years of life without aging,” increase energy (qi), treat fatigue, emaciation and langor, act as a male sexual tonic, and treat asthma. It was also considered antihepatotoxic, antidiabetic, antitussive, and is a sedative, tonic, and treatment for cholera. In combination with other herbs, its applications become much broader. The fruit is considered highly astringent, and is therefore used for a variety of secretory excesses, including night sweats, chronic diarrhea, and in males, spermatorrhea. Official indications for the fruit include diabetes, frequent urination, night sweats, chronic cough, and dyspnea. Schisandra was introduced from Eastern Russia into Europe in the 1850s. Since the 1950s, research in the former Soviet Union has focused on its potential uses as an adaptogen, primarily to enhance concentration and increase endurance, and its use is integrated into conventional medical and pharmacy practice in Russia. The primary active ingredients are lignans. It is official in the pharmacopoeias of China, Japan, Korea, and Russia. Current research has focused on its effects in treating diabetes and liver damage related to hepatic disease, for example, hepatitis. Hepatoprotective, antioxidant, antiproli-ferative and chemopreventive, anti-inflammatory, cardioprotective, and antimicrobial effects have all been demonstrated in in vivo and in vitro studies. Hepatoprotective and performance / endurance enhancing effects have been demonstrated in human clinical studies. Research into Schisandra’s use as an adaptogen was inspired by its traditional Chinese medicine use as a tonic for debility. Numerous clinical trials conducted in the 1950s showed improvement in activities requiring concentration, coordination, and endurance, a reduction in fatigue, and an increase in accuracy and work quality. Uncontrolled trials suggest general improvements in mental efficiency in humans, with associated improvement in vision and hearing and skin receptor sensitivity. Animal models have demonstrated adaptogenic effects, including increased renal and gonadal RNA, glycogen and enzyme levels in older models (rabbits) compared with younger animals. In a double-blind, placebo-controlled RCT involving race and show-jump horses, treatment with schisandra reduced heart rate, respiratory frequency, and lactate levels, and increased plasma glucose and performance. Treated horses also completed the race faster than controls. Similar results demonstrating enhanced performance and recovery after exercise have been found in other studies involving racehorses. In an in vivo study with phenobarbital, ethanol, and ether intraperitoneal administration of schisandra reduced sleeping time, suggesting antidepressant activity. Several other studies have also suggested antidepressant activity, both in animal and human clinical models. One rat study showed a significant increase in dopamine and its metabolites in the rat brain. Stimulating effects on the CNS have been reported, including restlessness, increased aggressiveness, and insomnia at higher doses. Increased resistance to heat and frostbite have both been demonstrated, suggesting the ability of the herb to increase response to environmental stressors. Schisandra is considered to have a high safety profile, and appears to be entirely free of toxicity when used in the recommended dosage range. No clinical reports of overdosage in humans have been identified. According to TCM, schisandra should not be used in cases of excess heat, or in the early stages of a rash or cough. Patients with high gastric acidity or peptic ulcers may experience exacerbation. It is also considered contraindicated in patients with epilepsy, hypertension, and intracranial pressure. Side effects may include restlessness, insomnia, and dyspnea. Schisandra may increase uterine contractility, and is used in traditional Chinese medicine to induce or promote prolonged labor; therefore, its use is not recommended during pregnancy.