title: Evaluation of the influence of ayurvedic formulation (Ayushman-15) on psychopathology, heart rate variability and stress hormonal level in major depression (Vishada).
abstract: BACKGROUND
  Ayurveda (Indian-complimentary and alternative medicine) is still most sought after in India and has promising potential in management of Vishada [major depressive disorder (MDD)]. But, systematic research is lacking. In this study we evaluated of influence of ayurvedic treatment (Panchakarma and Ayushman-15) on psychopathology, heart rate variability (HRV) and endocrinal parameters in patients with major depression.
  
  
  METHODS
  81 drug naive patients diagnosed as Vishada by ayurvedic physician and MDD according to DSM IV-TR were given ayurvedic Virechana module (therapeutic purgation) and were randomized into two groups. Patients in group A (n=41) received Ayushman-15A while group B (n=40) received Ayushman-15B for two months and Shirodhara (forehead-oil pouring therapy). Patients were assessed with Hamilton Depression Rating Scale (HDRS), Montgomery Asberg Depression Rating Scale (MADRS), Heart Rate Variability (HRV). Cortisol and adrenocorticotropic hormone (ACTH) were estimated at baseline and after ayurvedic therapy. HRV and endocrinal parameters were compared with age and gender matched healthy volunteers.
  
  
  RESULTS
  HRV parameters showed significant sympathetic dominance in patients compared to healthy volunteers. Two months of ayurvedic treatment significantly decreased psychopathology, showed increase in vagal tone, decrease in sympathetic tone and reduced cortisol levels. However, there was no significant difference between groups receiving Ayushman A and B.
  
  
  CONCLUSIONS
  This study provides evidence for antidepressant, cardiac (HRV) and beneficial neuroendocrine modulatory influence of Ayurveda therapy in patients of Vishada (MDD). Further studies are needed to confirm these findings. Greater insight into the neurobiology behind this therapy might provide valuable information about newer drug target.
authors.affiliation: National Ayurveda Dietetics Research Institute, Bangalore, India.
authors.forename: Ramakrishna K
authors.initials: RK
authors.lastname: Kishore
authors.affiliation: National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Hulegar A
authors.initials: HA
authors.lastname: Abhishekh
authors.affiliation: Toronto Western Hospital, Toronto, Canada.
authors.forename: Kaviraja
authors.initials: K
authors.lastname: Udupa
authors.affiliation: National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Jagadisha
authors.initials: J
authors.lastname: Thirthalli
authors.affiliation: Central Council for Research in Ayurvedic Sciences, New Delhi, India.
authors.forename: Gandhidas S
authors.initials: GS
authors.lastname: Lavekar
authors.affiliation: National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Bangalore N
authors.initials: BN
authors.lastname: Gangadhar
authors.affiliation: National Institute of Mental Health and Neurosciences, Bangalore, India.
authors.forename: Trichur R
authors.initials: TR
authors.lastname: Raju
authors.affiliation: National Institute of Mental Health and Neurosciences, Bangalore, India. Electronic address: drsathyaprabha@gmail.com.
authors.forename: Talakad N
authors.initials: TN
authors.lastname: Sathyaprabha
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D000928:Antidepressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008515:Medicine, Ayurvedic; D010936:Plant Extracts / Q000494:pharmacology / Q000627:therapeutic use*; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D010936:Plant Extracts; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone
keywords: Ayurveda; Ayushman; Cortisol; HRV; Major depressive disorder; Vishada