Ayurveda management of Major Depressive Disorder: A case study

Add on effect of Whole System Ayurveda protocol in suboptimal controlled Primary Hypothyroidism - A randomized controlled trial

BACKGROUND

Primary hypothyroidism (PH) is a common chronic life style disorder. Whole system Ayurveda protocol on PH (WSAPH) is explored for it's possible complimentary role in the management of suboptimal controlled PH on stable levothyroxine therapy.

OBJECTIVE

To evaluate the efficacy of whole system Ayurveda protocol on Primary hypothyroidism with suboptimal response to stable levothyroxine therapy.

MATERIAL AND METHODS

Study was a randomized controlled trial. Total 46 known patients of suboptimal response to stable levothyroxine therapy, age group 20-60 years of either sex participated in the study. They were randomly placed in two groups, Group KG received Kanchanara guggulu two tablets of 500 mg each, thrice a day with water and group WSAPH was on whole system Ayurveda protocol for primary hypothyroidism (WSAPH). Interventions were for 60 days. Assessments were done through various parameters like Thyroid profiles (TSH, T3, T4, Free T4), Weight, BMI, Skin fold thickness (SFT), Body fat index (BFI), Waist hip ratio (WHR), Lipid profile, Zulewskis clinical score for hypothyroidism (ZUL), WHO Quality of Life- BREF (WHOQOL-BREF), Clinical Global Improvement scales (CGI). Clinical assessments were done on every 15th day and biochemical were done before and after interventions.

RESULTS

Study showed that WSAPH group produced significant outcome improvement compared to KG group in TSH (p = 0.02), weight (p = 0.02), SFT (p = 0.04), BFI (p = 0.01), WHOQOL-BREF (p = 0.004) and ZUL (p = 0.02). Both the group showed improvements in BMI, WHR, BFI, SFT, WHOQOL-BREF, ZUL, CGI scales. Effect size was medium in TSH, weight, BFI, SFT and ZUL.

CONCLUSION

WSAPH was effective in management of PH and normalized TSH and ZUL scores in patients with suboptimal response to stable levothyroxine therapy. Further studies are needed.

Efficacy of whole system ayurveda management protocol in major depressive disorder- A randomized controlled clinical trial

BACKGROUND

Major Depressive Disorder (MDD) is one of the common depressive disorder. MDD has high comorbidity and has greater implications on quality of life. Whole system Ayurveda management protocol (WSAP) is explored for it's possible role in management of MDD.

OBJECTIVE

To evaluate the efficacy of Whole system Ayurveda management protocol on Major Depressive Disorder.

MATERIAL AND METHODS

Study was a randomized controlled trial. Total 50 patients of MDD meeting the DSM V criteria, age group 20-70 years of either sex participated in the study. They were randomly divided into two groups, control group received Escitalopram 10 mg twice a day and Ayurveda group was on WSAP. Interventions were for 60 days. Assessments were done through various clinical parameters like Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Brief psychiatric rating scale (BPRS), Pittsburgh Sleep Quality Index (PSQI), WHO Quality of Life- BREF (WHOQOL-BREF), Clinical Global Improvement scale (CGI), UKU Side effect scale. Assessments during intervention was on every 15th day.

RESULTS

Study showed that Ayurveda group produced significant outcome improvement compared to control group in HDRS (p = 0.01), HARS (p = 0.03), PSQI (p = 0.03), WHOQOL-Bref (p < 0.001) and UKU side effect scale (p = 0.02). Both the group showed improvements in all the parameters except in WHOQOL-Bref where Ayurveda group only showed improvements (p < 0.001). Effect size showed large effect in WHOQOL-Bref. Mild side effects were reported in control group and none in Ayurveda group.

CONCLUSION

WSAP was effective in management of MDD and had better side effect profile. Further studies needed.

Current Therapeutic Strategies for the Management of Benzodiazepine (BZD) Withdrawal Syndrome: A Review

Benzodiazepines are commonly prescribed drugs for numerous indications such as epilepsy, anti-anxiety, sleep aids, sedatives, and hypnotics. Although the well-tolerated effects of benzodiazepine are seen in many clinical instances, the severity of side effects reduces its quantifiable use. Benzodiazepines, which are medically useful but theoretically unsafe, are frequently recommended by medical practitioners for psychotic patients but have misuse and dependence liabilities. It is impelled as a debateable topic globally about which no one talks. These drugs are also known as silent killers because abruptly stopping them can result in tremors, muscle spasticity, and life-frightening seizures. These drugs are beneficial as well as risky. Nonclinical treatment is simple and well suited and provides support for patients suffering from side effects generated by benzodiazepine withdrawal. This review mainly focuses on antipsychotic drugs and their mechanisms, mortality, withdrawal, abuse, and management via clinical and nonclinical therapies.

Comparative assessment of the information available on the treatment of depression over websites in English and Hindi language

Background

The study aimed to perform a cross-sectional comparative assessment of the content and quality of information available on the treatment of depression over websites in English and Hindi language.

Materials and Methods

We screened the first 50 links obtained on searching for depression treatment on Google, and selected 72 (44 in English; 28 in Hindi) websites. They were evaluated for coverage of different aspects of depression, quality of treatments mentioned, esthetics, and interactivity.

Results

A significantly lesser number of Hindi websites discussed the minimum duration of treatment needed for a depressive episode (36% vs. 79%), possible side effects of treatment (18% vs. 77%), discussed suicidality in depression explicitly (25% vs. 57%), or recommended consultation with a mental health professional (11% vs. 43%). English websites more commonly mentioned psychotherapy (86% vs. 64%), electroconvulsive therapy (64% vs. 21%), and social support measures (59% vs. 32%) for depression treatment. Whereas, Hindi websites more commonly mentioned Ayurvedic/herbal medicines (46% vs. 16%), and yoga (29% vs. 4%) for treatment. Lastly, the esthetics score for English websites was significantly higher than for Hindi websites. A significantly greater number of Hindi websites were owned by commercial entities.

Conclusion

This is the first study to systematically compare online information on depression treatment in English and Hindi language websites, and identify areas for further improvement in the overall quality of online information in Hindi. There is a need for the creation of credible and accessible online resources in regional languages like Hindi for the promotion of depression literacy among the general public by government and non-profit professional organizations.

Efficacy of whole system ayurveda protocol in irritable bowel syndrome – A Randomized controlled clinical trial

BACKGROUND

Irritable bowel syndrome (IBS) is one of the clinically challenging disorders. It has a significant effect on health, cost and quality of life. Ayurveda management through whole system approach in IBS is explored.

OBJECTIVE

To evaluate the efficacy of whole system Ayurveda approach in IBS.

METHODS

The present trial is a randomized controlled parallel group study. 48 patients diagnosed as IBS (Rome IV Criteria) between the age group of 20-60 yrs were recruited in the study. Patients were randomly divided into 2 groups. KC group intervened with Kalingadi Churna 3 gm twice a day, before food with buttermilk. WS group intervened with whole system ayurveda protocol (WSAP). Duration of intervention was 60 days with follow up on every 15th day. Assessments were through various clinical measures like IBS Symptom Severity Score (IBS-SSS), IBS Adequate Relief (IBS-AR), Gastrointestinal symptom rating scale (GSRS), IBS-VAS, Complete Spontaneous Bowel Movements (CSBMs), Bristol Stool Form (BSF), Hamilton Anxiety Rating Scale (HARS), Hamilton Depression Rating Scale (HDRS), IBS quality of life (IBS-QoL) at every follow up. Hemoglobin, Erythrocyte sedimentation rate and stool examination was conducted at pre and post study.

RESULTS

Study showed that WS group had significant improvement compared to KC group in IBS-SSS, IBS-AR, IBS-VAS, CSBM, BSF-Diarrhea and BSF-Constipation. Both groups were comparable in GSRS, HARS, HDRS and IBS-QOL. Blood and stool parameters assessments showed comparable improvements in both the groups. Within group significant improvements in all the clinical assessment scales were observed in both the groups.

CONCLUSION

WSAP was effective in management of IBS (IBS constipation and IBS diarrhea). Improvements were observed in abdominal pain, stool frequency, consistency and adequate relief.

Effect of insomnia in the major depressive disorder

Background

People with sleep problems are more likely to have mental disorders. This study aimed to assess the effect of insomnia on the prognosis of patients with major depressive disorder (MDD).

Methods

We divided the patients into three groups according to the Insomnia Severity Index (ISI) scores. In addition, we compared the results of the Hamilton Depression Scale (HAMD) and Symptom Checklist-90 (SCL-90) scores. We evaluated the effect of insomnia at the 2nd, 4th, and 8th-week follow-up on the prognosis of MDD.

Results

Fifty-five patients between 19 and 58 years old, with a diagnosis of MDD via the Structured Clinical Interview for the Diagnostic and Statistical Manual-5 (DSM-5). The ISI scores of the moderate and severe group decreased significantly (P < 0.05) in the 2nd week compared to the baseline. The HAMD scores in all groups improved significantly in the 2nd week.

Conclusions

This study was inspired to assess insomnia as a comorbid disorder for patients with MDD, which may bring poor treatment consequences.

Ratrijagarana night wakefulness and its impact on Manasika Bhava mental characteristics among industrial workers: A descriptive cross-sectional study

Nidra (sleep), Ahara (food) and Brahmacharya (abstinence) are the three sub-pillars of health and alterations in these basic pillars of health can lead to mortality and morbidity. Among these, Nidra has a critical role in the biological and psychological functioning of the body. The circadian rhythm is the physiological machinery that controls and regulates physiological activities throughout the 24 hours in conjunction with the day and night. The synchronicity of the circadian rhythm and adequate sleep is essential for maintaining normal physical and mental health. This study, therefore, was undertaken as a descriptive cross-sectional survey to evaluate the impact of Ratrijagarana (night wakefulness) on Manasika Bhava (mental characteristics) among industrial workers aged between 19 and 25 years from both genders. Maniasika Bhavas were assessed using Manasa Bhava Pariksha (MBP), a 20 item questionnaire. The results indicate a substantial change in Mana (non-distracted mind), Chinta (anxiety/worry), Dhairyam (courage), Harsha (joy), Veeryam (energy), Shraddha (desire), Medha (intelligence), Avasthaana (stability of mind), Vignyaana (knowledge), Sanjna (recognition), and Smriti (memory). Among these, Sanjna, Medha and Mana and Veeryam are most affected, with positive ranks scoring 115, 107 and 104. Vignyaana, (χ2₍₆₎ = 162.031; p = .001) Veerya (χ2₍₄₎ = 12.688; p = .013) and Shraddha (χ2₍₆₎ = 12.558; p = .05) also showed significant association with sleeping hours per day. These encouranging results need further corroboration through future studies with larger sample size and diverse populations.