title: The influence of Hatha yoga as an add-on treatment in major depression on hypothalamic-pituitary-adrenal-axis activity: a randomized trial.
abstract: OBJECTIVE
  The impact of Hatha yoga as add-on treatment to quetiapine fumarate extended release (QXR) or escitalopram (ESC) in depressed patients on hypothalamic-pituitary-adrenal (HPA) axis activity was assessed.
  
  
  METHODS
  60 inpatients suffering from major depressive disorder (MDD) according to DSM-IV were randomized for a 5 week treatment with Yoga or not (control group) and with either QXR (300 mg/day) or ESC (10 mg/day). Serial dexamethasone/corticotropin releasing hormone (DEX/CRH) tests were performed to assess HPA axis function. The Hamilton Depression Rating Scale (21-HAMD) was used weekly.
  
  
  RESULTS
  A more pronounced down regulation of the HPA axis activity due to yoga could not be detected. The stepwise long term cortisol reduction was seen in both medication groups, irrespectively of yoga add-on treatment. In addition, cortisol improvers in week 1 of therapy (reduction in cortisol peak value within the DEX/CRH test) reached significant greater amelioration of depressive symptoms after 5 weeks.
  
  
  CONCLUSIONS
  Our results suggest that antidepressant agents down regulate HPA axis function to a greater extent than additional Hatha yoga treatment. Moreover, an early reduction of HPA system hyperactivity after one week of pharmacological treatment seems to raise the possibility of a favorable treatment response.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Regensburg, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany. Electronic address: nina.sarubin@med.uni-muenchen.de.
authors.forename: Nina
authors.initials: N
authors.lastname: Sarubin
authors.affiliation: Department of Psychiatry and Psychotherapy, University Regensburg, Germany; Max-Planck-Institute of Psychiatry, Munich, Germany.
authors.forename: Caroline
authors.initials: C
authors.lastname: Nothdurfter
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.
authors.forename: Cornelius
authors.initials: C
authors.lastname: Schüle
authors.affiliation: Department of Psychiatry and Psychotherapy, University Regensburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Lieb
authors.affiliation: Max-Planck-Institute of Psychiatry, Munich, Germany.
authors.forename: Manfred
authors.initials: M
authors.lastname: Uhr
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Born
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.
authors.forename: Ricarda
authors.initials: R
authors.lastname: Zimmermannc
authors.affiliation: Department of Psychology/Statistics and Evaluation, Ludwig-Maximilian-University, Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Bühner
authors.affiliation: Department of Psychiatry and Psychotherapy, University Regensburg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Konopka
authors.affiliation: Department of Psychiatry and Psychotherapy, University Regensburg, Germany; Max-Planck-Institute of Psychiatry, Munich, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Rupprecht
authors.affiliation: Department of Psychiatry and Psychotherapy, University Regensburg, Germany.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Baghai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D019540:Area Under Curve; D015283:Citalopram / Q000627:therapeutic use; D003346:Corticotropin-Releasing Hormone / Q000097:blood; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000534:rehabilitation*; D003907:Dexamethasone; D003987:Dibenzothiazepines / Q000627:therapeutic use; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D052580:Muscle Stretching Exercises / Q000379:methods*; D017063:Outcome Assessment, Health Care; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D000069348:Quetiapine Fumarate; D015013:Yoga; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D003987:Dibenzothiazepines; D015283:Citalopram; D000069348:Quetiapine Fumarate; D003907:Dexamethasone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone
keywords: Cortisol; DEX/CRH-test; Depression; Escitalopram; Quetiapine; Yoga