title: A Breathing-Based Meditation Intervention for Patients With Major Depressive Disorder Following Inadequate Response to Antidepressants: A Randomized Pilot Study.
abstract: To evaluate feasibility, efficacy, and tolerability of Sudarshan Kriya yoga (SKY) as an adjunctive intervention in patients with major depressive disorder (MDD) with inadequate response to antidepressant treatment.
  
  
  
  Patients with MDD (defined by DSM-IV-TR) who were depressed despite ≥ 8 weeks of antidepressant treatment were randomized to SKY or a waitlist control (delayed yoga) arm for 8 weeks. The primary efficacy end point was change in 17-item Hamilton Depression Rating Scale (HDRS-17) total score from baseline to 2 months. The key secondary efficacy end points were change in Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) total scores. Analyses of the intent-to-treat (ITT) and completer sample were performed. The study was conducted at the University of Pennsylvania between October 2014 and December 2015.
  
  
  
  In the ITT sample (n = 25), the SKY arm (n = 13) showed a greater improvement in HDRS-17 total score compared to waitlist control (n = 12) (-9.77 vs 0.50, P = .0032). SKY also showed greater reduction in BDI total score versus waitlist control (-17.23 vs -1.75, P = .0101). Mean changes in BAI total score from baseline were significantly greater for SKY than waitlist (ITT mean difference: -5.19; 95% CI, -0.93 to -9.34; P = .0097; completer mean difference: -6.23; 95% CI, -1.39 to -11.07; P = .0005). No adverse events were reported.
  
  
  
  Results of this randomized, waitlist-controlled pilot study suggest the feasibility and promise of an adjunctive SKY-based intervention for patients with MDD who have not responded to antidepressants.
  
  
  
  ClinicalTrials.gov identifier: NCT02616549.
authors.affiliation: Department of Psychiatry, University of Pennsylvania School of Medicine, 10th Floor, Gates Bldg, 3400 Spruce St, Philadelphia, PA 19104. anup@mail.med.upenn.edu.|Department of Psychiatry, University of Pennsylvania, Philadelphia, USA.
authors.forename: Anup
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, USA.
authors.forename: Marna S
authors.initials: MS
authors.lastname: Barrett
authors.affiliation: Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Cucchiara
authors.affiliation: Division of Geriatric Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Nalaka S
authors.initials: NS
authors.lastname: Gooneratne
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Thase
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D019122:Meditation / Q000523:psychology; D008875:Middle Aged; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D012119:Respiration; D016896:Treatment Outcome; D015013:Yoga / Q000523:psychology; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents