Experimental evaluation of antidepressant effect of Vacha (Acorus calamus) in animal models of depression

Ondansetron attenuates cisplatin-induced behavioral and cognitive impairment through downregulation of NOD-like receptor inflammasome pathway

Cisplatin is an effective and commonly used chemotherapeutic drug; however, its use is accompanied by several adverse effects, including chemobrain. Ondansetron is a 5-HT3 antagonist, commonly used in prophylactic against chemotherapy-induced nausea and vomiting. Moreover, it has been identified as a novel neuroprotective agent in different animal models. However, its protective role against chemotherapy-induced chemobrain has not been investigated. The current study was the first study that explored the potential neuroprotective effect of ondansetron against cisplatin-induced chemobrain in rats. Cisplatin (5 mg/Kg) was injected intraperitoneally, once weekly, for 4 weeks with the daily administration of ondansetron (0.5 and 1 mg/Kg). Compared to the cisplatin-treated group, ondansetron administration showed a significant decrease in the latency time and a significant increase in ambulation, rearing, and grooming frequency in the open field test (OFT). Moreover, a significant improvement in the latency time in the rotarod and passive avoidance tests, following ondansetron administration. In addition, ondansetron treatment increased the percentage of alternation in the Y-maze test. Also, ondansetron showed a remarkable enhancement in the biochemical parameters in the hippocampus. It increased the acetylcholine (Ach) level and decreased the level of the acetylcholine esterase enzyme (AchE). Ondansetron significantly decreased interleukin-1β (Il-1β), tumor necrosis factor-alpha (TNF-α), toll-like receptor-4 (TLR-4), NOD-like receptor-3 (NLRP3) inflammasome as well as caspase-1 and caspase-3 levels. Furthermore, ondansetron significantly decreased the levels of copper transporter-1(CTR1) expression in the hippocampus. Collectively, these findings suggest that ondansetron may exhibit a neuroprotective and therapeutic activity against cisplatin-induced chemobrain.

Clotrimazole ameliorates chronic mild stress-induced depressive-like behavior in rats; crosstalk between the HPA, NLRP3 inflammasome, and Wnt/β-catenin pathways

Depression is a major emotional disorder that has a detrimental effect on quality of life. The chronic mild stress (CMS)-depression model was adopted in rats to evaluate the neurotherapeutic effect of Clotrimazole (CLO) and investigate the possible mechanisms of its antidepressant action via its impact on the hypothalamic pituitary adrenal (HPA) axis and the stress hormone, cortisol. It was found that azole antifungals affect steroidogenesis and the HPA axis. Behavioral, histopathological, inflammatory, and apoptotic pathways were assessed. Serum cortisol, inflammasome biomarkers, hippocampal NLRP3, caspase-1, and IL-18, and the canonical Wnt/β-catenin neurogenesis biomarkers, Wnt3a, and non-phosphorylated β-catenin levels were also determined. Different stressors were applied for 28 days to produce depressive-like symptoms, and CLO was administered at a daily dose of 30 mg/kg body weight. Subsequently, behavioral and biochemical tests were carried out to assess the depressive-like phenotype in rats. Stressed rats showed increased immobility time in the forced swimming test (FST), decreased grooming time in the splash test (ST), increased serum cortisol levels, increased inflammasome biomarkers, and decreased neurogenesis. However, administration of CLO produced significant antidepressant-like effects in rats, which were accompanied by a significant decrease in immobility time in FST, an increase in grooming time in ST, a decrease in serum cortisol level, a decrease in inflammasome biomarkers, and an increase in neurogenesis biomarkers. The antidepressant mechanism of CLO involves the HPA axis and the anti-inflammatory effect, followed by neurogenesis pathway activation. Therefore, CLO may have the potential to be a novel antidepressant candidate.

Ayurveda management of Major Depressive Disorder: A case study

Major Depressive disorder (MDD) is a chronic, episodic disorder which manifests with disturbance in mood, interest, cognition and vegetative symptoms. It has major impact on the quality of life of the patients, by affecting their physical, mental, personal, social, and spiritual wellbeing. Vishada and avasada represents minor depressive episodes and MDD can be equated to Kaphaja Unmada.

Current case presented with sadness, worthlessness, helplessness, death wishes, disturbed sleep and was diagnosed as MDD as per DSM V criteria. Ayurveda diagnosis was Kaphaja Unmada involving kapha-dominant vata and tama dosha. Mental examination revealed derangement of mana (mind), buddhi (intellect), smruti (memory), bhakti (desire), sheela (temperament), chesta (psychomotor activity) and achara (conduct) components. Patient was Avara Satwa. Management was planned with integrative treatment comprising of Yukti vypasharaya (pharmacological), Satwawajaya (counselling) and daiwivyapashraya (spiritual-based techniques). Management was with snehapana (internal oleation), virechana (gut cleansing), sarvanga abhyanga (massage of whole body with medicated oil) followed by bashpa sweda (steam therapy to whole body), shirodhara (dripping of medicated oil on fore head), shiropichu (transcranial drug administration by placing cotton pad dipped in medicated oil), katibasti (holding of medicated oil in well-prepared from dough), satwavajaya chikitsa, and daiwi vyapashraya chikitsa. Conventional psychopharmacological interventions taken since last year were tapered and discontinued. Treatment continued for 352 days which included 13 days of hospitalized treatment and follow-ups. Intervention outcome showed reduction in Hamilton depression Rating scores from 31 to 6. Patient's self-assessed worry reduced from 16 h/day to 2 h/day, self-assessed daily relaxed state improved from ½ hour/day to 14 h/day. Patient showed complete remission by 180th day of intervention. Improvements sustained even during the non-interventional observation period. Thus, the Ayurvedic integrative management showed efficacy in management of MDD.

Role of Vacha (Acorus calamus Linn.) in Neurological and Metabolic Disorders: Evidence from Ethnopharmacology, Phytochemistry, Pharmacology and Clinical Study

Vacha (Acorus calamus Linn. (Acoraceae)) is a traditional Indian medicinal herb, which is practiced to treat a wide range of health ailments, including neurological, gastrointestinal, respiratory, metabolic, kidney, and liver disorders. The purpose of this paper is to provide a comprehensive up-to-date report on its ethnomedicinal use, phytochemistry, and pharmacotherapeutic potential, while identifying potential areas for further research. To date, 145 constituents have been isolated from this herb and identified, including phenylpropanoids, sesquiterpenoids, and monoterpenes. Compelling evidence is suggestive of the biopotential of its various extracts and active constituents in several metabolic and neurological disorders, such as anticonvulsant, antidepressant, antihypertensive, anti-inflammatory, immunomodulatory, neuroprotective, cardioprotective, and anti-obesity effects. The present extensive literature survey is expected to provide insights into the involvement of several signaling pathways and oxidative mechanisms that can mitigate oxidative stress, and other indirect mechanisms modulated by active biomolecules of A. calamus to improve neurological and metabolic disorders.