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*Anacyclus pyrethrum*, commonly known as pellitory or Akarkara, is a medicinal plant in the Asteraceae family native to North Africa and the Mediterranean. It is traditionally utilized for its neuroprotective, analgesic, and anti-inflammatory properties. Recent clinical research has investigated its potential in managing opioid use disorder (OUD) by mitigating withdrawal symptoms such as anxiety, depression, and oxidative stress. The plant's therapeutic effects are primarily attributed to its rich content of alkylamides, particularly pellitorine, as well as phenolic acids and flavonoids. These bioactive compounds are hypothesized to modulate the opioid, GABAergic, and dopaminergic systems. Furthermore, *Anacyclus pyrethrum* has demonstrated the ability to restore gut microbiota diversity and density following opioid-induced dysbiosis and to reduce elevated cortisol levels associated with withdrawal stress.
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