Research - Depression
Therapeutic Duration and Extent Affect the Effect of Moxibustion on Depression-Like Behaviour in Rats via Regulating the Brain Tryptophan Transport and Metabolism
Hao Li,1 Lan Sang,2 Xing Xia,1 Ruirui Zhao,1 Mingyue Wang,1 Xiaofei Hou,1Jiawei Xiong,1 Tiemin Cao,1 Xiaoquan Liu,2 and Jian
Moxibustion has been widely accepted as an alternative therapy for major depressive disease (MDD). However, the efficacy of moxibustion treatment on MDD is highly variable because of its irregular operation. This study was designed to investigate how therapeutic duration and extent influence the anti-depression effect of moxibustion and the underlying mechanism involved. Rats with lipopolysaccharide-induced depression-like behavior were treated by moxibustion treatment. The anti-depression effect was determined by forced swimming test and open field test. Tryptophan (Trp) transport and its metabolism to serotonin (5-HT) and kynurenine (Kyn) were evaluated to explore the anti-depression mechanism. The results showed that moxibustion treatment could alleviate the depression-like behavior in rats. Trp transport and 5-HT generation were significantly increased, and the Trp-Kyn pathway was moderately inhibited by moxibustion. Prolonged therapy could be beneficial to the anti-depression effect by promoting the brain uptake of Trp and shifting the Trp metabolism to 5-HT. An enhanced therapeutic extent could increase 5-HT generation. In conclusion, this study determined that the anti-depression effect of moxibustion involves improved Trp transport and metabolism. The therapeutic duration benefits antidepressant effects, but the complex influence of the therapeutic extent on moxibustion efficacy requires further studies.
Source : Journal Evidence Based Complementary and Alternative Medicine
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Sodium and potassium excretion predict increased depression in urban adolescents
Sylvie Mrug Catheryn Orihuela Michal Mrug Paul W. Sanders
This study examined the prospective role of urinary sodium and potassium excretion in depressive symptoms among urban, low‐income adolescents, and whether these relationships vary by gender. A total of 84 urban adolescents (mean age 13.36 years; 50% male; 95% African American) self‐reported on their depressive symptoms at baseline and 1.5 years later. At baseline, the youth also completed a 12‐h (overnight) urine collection at home which was used to measure sodium and potassium excretion. After adjusting for baseline depressive symptoms, age, BMI percentile, and pubertal development, greater sodium excretion and lower potassium excretion predicted more severe depressive symptoms at follow‐up, with no significant gender differences. The results suggest that consumption of foods high in sodium and low in potassium contributes to the development of depressive symptoms in early adolescence, and that diet is a modifiable risk factor for adolescent depression. Interventions focusing on diet may improve mental health in urban adolescents.
Source : The Physiological Society
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Clinical EFT (Emotional Freedom Techniques) Improves Multiple Physiological Markers of Health
Donna Bach, ND, Gary Groesbeck, BCIA, Peta Stapleton, PhD
Emotional Freedom Technique (EFT) is an evidence-based self-help therapeutic method and over 100 studies demonstrate its efficacy. However, information about the physiological effects of EFT is limited. The current study sought to elucidate EFTs mechanisms of action across the central nervous system (CNS) by measuring heart rate variability (HRV) and heart coherence (HC); the circulatory system using resting heart rate (RHR) and blood pressure (BP); the endocrine system using cortisol, and the immune system using salivary immunoglobulin A (SigA). The second aim was to measure psychological symptoms. Participants (N = 203) were enrolled in a 4-day training workshop held in different locations. At one workshop (n = 31), participants also received comprehensive physiological testing. Posttest, significant declines were found in anxiety (−40%), depression (−35%), posttraumatic stress disorder (−32%), pain (−57%), and cravings (−74%), all P < .000. Happiness increased (+31%, P = .000) as did SigA (+113%, P = .017). Significant improvements were found in RHR (−8%, P = .001), cortisol (−37%, P < .000), systolic BP (−6%, P = .001), and diastolic BP (−8%, P < .000). Positive trends were observed for HRV and HC and gains were maintained on follow-up, indicating EFT results in positive health effects as well as increased mental well-being
Source : Journal of Evidence Based Integrative Medicine
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An Observational Preliminary Study on the Safety of Long-Term Consumption of Micronutrients for the Treatment of Psychiatric Symptoms
Julia J. Rucklidge, Matthew J. F. Eggleston, Breanne Ealam, Ben Beaglehole, and Roger T. Mulder
Objectives: There is an increasing body of literature documenting the efficacy of micronutrients (vitamins and minerals) interventions for the treatment of psychiatric problems in the short term; however, long-term safety is largely unexplored. The goal of this observational study was to investigate the safety of two commercially available broad-spectrum micronutrient formulas (EMPowerplus and Daily Essential Nutrients) given at doses above the Recommended Dietary Allowances for the long-term treatment of individuals with psychiatric symptoms.
Design: Participants on long-term treatment with micronutrients (medication-free) for psychiatric problems (attention-deficit hyperactivity disorder [ADHD, n = 21], anxiety/depression [n = 13]) were identified from ongoing research studies and the community through purchasing records. Seventeen children and 17 adults had blood tests to assess their full blood count, coagulation profile, liver and kidney function, fasting glucose, iron studies, key nutrients, and prolactin. Questionnaires assessed psychological/psychiatric functioning. Seventeen of the participants had completed the same measures pretreatment.
Results: The average length of consuming micronutrients was 2.66 years (standard deviation = 2.86). Excluding B12 (which was elevated for almost all participants), 94.6% of all blood test results were within the test reference ranges. One participant was diagnosed with hemochromatosis based on iron studies. No other clinically relevant adverse changes in blood results were identified pre- and post-treatment. No clinically significant adverse effects were reported. Post-treatment psychometrics identified that 85% of the participants were in nonclinical ranges for measures of ADHD, depression, anxiety, and stress.
Conclusions: We report preliminary evidence for the safety of long-term commercially available micronutrients, although questions remain. Overall, the substantial psychiatric benefits observed appear to outweigh the minimal observed risks in these participants. Screening for potential medical problems is recommended before initiating treatment. Long-term pharmacovigilance monitoring is required to ascertain any rare but significant adverse events.
Source : journal Alternative and Complementary Medicine
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Bioactivities of serotonin transporter mediate antidepressant effects of Acorus tatarinowii Schott
Feng-Hong Zhang1 Zhi-Mei Wang1, Yan-Ting Liu Ji-Sheng Huang Shuang Liang Hong-Hua Wu Yan-Tong
Acrorus tatarinowii Schott has been widely used in the treatments of neuropsychiatric and digestive disorders in clinical practices of traditional Chinese medicine for thousands of years. Both clinical and preclinical studies demonstrated antidepressant effects of A. tatarinowii. However, the possible action mechanisms of antidepressant effects of A. tatarinowii remain unraveled.
Aim of the study:
The present study aimed to investigate the roles of serotonin transporter (SERT) in antidepressant effects of A. tatarinowii.
Materials and methods
Antidepressant effects of water extract of A. tatarinowii were evaluated by forced swimming test (FST), tail suspension test (TST) and locomotor activity test. The water extract was analyzed by ultra high performance liquid chromatography (UPLC) method. Two major fractions of A. tatarinowii, petroleum ether extract and water extract after petroleum ether processed, were prepared and analyzed by UPLC method. Further, volatile oil extracted by ether extraction, solid phase micro-extraction (SPME) and hydro-distillation were compared and analyzed by gas chromatography-mass spectrometer (GC-MS) method. Finally, major constituents of water extract of A. tatarinowii were isolated by preparative high performance liquid chromatography (HPLC) and identified by extensive spectroscopic analyses. Effects of all of the above mentioned samples on SERT activity were tested by a high content assay (HCA).
Results of FST, TST and locomotor activity confirmed that water extract of A. tatarinowii significantly decreased mice immobility time but did not change mice locomotor activity. UPLC analysis results revealed that the water extract contained trace amount of β-asarone (0.0004206%) and α-asarone (0.0001918%). HCA results demonstrated that the water extract significantly enhanced SERT activity at 100 μg/mL. Further, GC-MS and UPLC analyses revealed that petroleum ether extract contained high content of β-asarone (45.63%) and α-asarone (12.50%). GC-MS analysis results demonstrated that the volatile oil extracted by ether extraction, SPME and hydro-distillation contained similar major components. HCA results verified that the petroleum ether extract significantly enhanced SERT activity at 1.56 μg/mL. Moreover, UPLC analysis of water extract after petroleum ether processed did not show any characteristic peaks. HCA results demonstrated that this extract significantly inhibited SERT activity at 50–100 μg/mL. Finally, phytochemistry investigation on the water extract of A. tatarinowii afforded seven constituents including veratric acid (9), anisic acid (7), 3,4,5-trimethoxybenzoic acid (3), trans-isoferulic acid (2), 2,4,5-trimethoxybenzoic acid (11), 4-hydroxybenzoic acid (6) and syringic acid (13). Their structures were established on the basis of nuclear magnetic resonance (NMR) and mass spectrometer (MS) data and comparative UPLC analyses. HCA results demonstrated the major components of the water extract of A. tatarinowii demonstrated SERT enhancement/inhibition activities.
This study first systematically demonstrated the roles of SERT activity in antidepressant effects of A. tatarinowii, including water extract, major fractions and main constituents. These results revealed that A. tatarinowii could regulate SERT activities in bidirectional ways.
Source : Journal of Ethnopharmacology
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An anti-inflammatory diet as a potential intervention for depressive disorders: A systematic review and meta-analysis
Katie Tolkien, Steven Bradburn* , Chris Murgatroyd
Background & aims: There is a large body of evidence which supports the role of inflammation in the pathophysiology of mental health disorders, including depression. Dietary patterns have been shown to modulate the inflammatory state, thus highlighting their potential as a therapeutic tool in disorders with an inflammatory basis. Here we conduct a systematic review and meta-analysis of current literature addressing whether there is a link between the inflammatory potential of a diet and risk of depression or depressive symptoms.
Methods: A systematic literature search was performed to identify studies that reported an association between the inflammatory potential of the diet and risk of depressive symptoms or diagnosis of depression. Random effect models were used to meta-analyse effect sizes. Quality assessment, publication bias, sensitivity and subgroup analyses were also performed.
Results: Eleven studies, with a total of 101,950 participants at baseline (age range: 16e72 years old), were eligible for review. A significant association between a pro-inflammatory diet and increased risk of depression diagnosis or symptoms was evident, relative to those on an anti-inflammatory diet (OR: 1.40, 95% confidence intervals: 1.21e1.62, P < 0.001). No publication bias was detected; however, some study heterogeneity was evident (I2 ¼ 63%, P < 0.001). Subgroup analyses suggested the main source of study heterogeneity was the study design (cross-sectional or longitudinal) and the effect measure used (odds ratio, hazard ratio or relative risk).
Conclusion: These results provide an association between pro-inflammatory diet and risk of depression. Thus, adopting an anti-inflammatory diet may be an effective intervention or preventative means of reducing depression risk and symptoms.
Source : Journal Clinical Nutrition
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Effectiveness of Aromatherapy Massage and Inhalation on Symptoms of Depression in Chinese Community-Dwelling Older Adults
Mei Xiong, MS,* Yanzhang Li, PhD,* Ping Tang, PhD, Yuping Zhang, PhD, Min Cao, MS, Junwei Ni, MS, and Mengmeng Xing, MS
Objectives: Geriatric depression is a major public health problem in China. The study compared the intervention and follow-up effects of aromatherapy massage and inhalation on symptoms of depression in community-dwelling older adults after an 8-week intervention.
Design: A prospective, randomized controlled trial was conducted on community-dwelling adults ‡60 years old, with symptoms of depression. Participants were randomly assigned, by Latin Square, to aromatherapy massage, inhalation, or control groups (each n = 20). Interventions: The aromatherapy massage group received 30 min of aromatherapy massage with 5 mL oil, twice weekly for 8 weeks. The oil contained 50 mL (one drop) of compound essential oils (lavender [Lavandula angustifolia], sweet orange [Citrus sinensis], and bergamot (Citrus bergamia in a 2:1:1 ratio)], diluted in sweet almond oil to a concentration of 1%. The aromatherapy inhalation group received 30 min of nasal inhalation of 50 mL of the compound essential oils blended in 10 mL of purified water, twice weekly for 8 weeks. The control group received no intervention.
Outcome measures: The Geriatric Depression Scale Short Form (GDS-SF) and Patient Health Questionnaire9 (PHQ-9) were used for assessment at pretest, posttest, and 6- and 10-week follow-ups in all groups. 5- Hydroxytryptamine (5-HT) concentration was assessed pretest and posttest.
Results: Postintervention, the aromatherapy massage and inhalation groups demonstrated significantly lower GDS-SF and PHQ-9 scores than control participants. Compared with the pretest, the GDS-SF and PHQ-9 scores for depressive symptoms in both experimental groups remained lower at posttest (8 weeks), 6-week (14 weeks), and 10-week (18 weeks) follow-ups. However, the GDS-SF and PHQ-9 scores did not differ among the four time points in the control group. The posttest 5-HT concentrations in the aromatherapy massage and inhalation groups were increased over pretest values.
Conclusions: Both aromatherapy massage and aromatherapy inhalation may have important implications for intervening depression in older adults.
Source : Journal of Alternative and Complementary Medicine
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Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: a meta-analysis
Simon B. Goldberg a,b,c, Raymond P. Tucker d , Preston A. Greene c , Richard J. Davidson b,e, David J. Kearney c and Tracy L. Simpson c
Mindfulness-based cognitive therapy (MBCT) appears to be a promising intervention for the prevention of relapse in major depressive disorder, but its efficacy in patients with current depressive symptoms is less clear. Randomized clinical trials of MBCT for adult patients with current depressive symptoms were included (k = 13, N = 1046). Comparison conditions were coded based on whether they were intended to be therapeutic (specific active controls) or not (non-specific controls). MBCT was superior to nonspecific controls at post-treatment (k = 10, d = 0.71, 95% confidence interval [CI] [0.47, 0.96]), although not at longest follow-up (k = 2, d = 1.47, [−0.71, 3.65], mean follow-up = 5.70 months across all studies with follow-up). MBCT did not differ from other active therapies at post-treatment (k = 6, d = 0.002, [−0.43, 0.44]) and longest follow-up (k = 4, d = 0.26, [−0.24, 0.75]). There was some evidence that studies with higher methodological quality showed smaller effects at post-treatment, but no evidence that effects varied by inclusion criterion. The impact of publication bias appeared minimal. MBCT seems to be efficacious for samples with current depressive symptoms at post-treatment, although a limited number of studies tested the long-term effects of this therapy.
Source : Journal Cognitive Behavior Therapy
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Saffron improved depression and reduced homocysteine level in patients with major depression: A Randomized, double-blind study
Gholamali Jelodar,*,1 Zahra Javid,1 Ali Sahraian,2 and Sina Jelodar
Objectives:A correlation between hyperhomocysteinemia, and depression has been reported. Saffron (Crocus sativus) is recommended for treatment of depression; hence, in this study the effect of co-administration of saffron and fluoxetine on plasma homocysteine and depression was evaluated.
Material and methods:This was a 4-week randomized and double-blind clinical trial which was conducted from March 2013 to February 2014. In this trial, 40 male and females (20-55 years old) diagnosed with severe depression were selected and following filing the Beck form, were randomly divided into two groups. Experimental group was treated with fluoxetine 20 mg/day and saffron 30 mg /day and the control group received placebo and fluoxetine 20 mg/day for four weeks. Before treatment and at the end of the study, fasting blood samples were collected. For females, blood samples were collected on the third day of their menstrual cycle.
Results:A significant reduction of homocysteine levels was observed in both sex in the experimental group compared to before treatment (p<0.04), while no such significant change was observed in the control group. A Beck questionnaire value showed lower level in both groups on the last day of treatment as compared to before treatment. There was no significant difference between the two groups in Beck value neither before nor after treatment.
Conclusion:Saffron has beneficial effects on depression and homocysteine level in patients with major depression.
Source : Avicenna J Phytomed.
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Assessment of Bidirectional Relationships Between Physical Activity and Depression Among Adults
A 2-Sample Mendelian Randomization Study
Karmel W. Choi, PhD1,2,3,4; Chia-Yen Chen, PhD3,4,5; Murray B. Stein, MD, MPH6,7; et al
Importance Increasing evidence shows that physical activity is associated with reduced risk for depression, pointing to a potential modifiable target for prevention. However, the causality and direction of this association are not clear; physical activity may protect against depression, and/or depression may result in decreased physical activity.
Objective To examine bidirectional relationships between physical activity and depression using a genetically informed method for assessing potential causal inference.
Design, Setting, and Participants This 2-sample mendelian randomization (MR) used independent top genetic variants associated with 2 physical activity phenotypes—self-reported (n = 377 234) and objective accelerometer-based (n = 91 084)—and with major depressive disorder (MDD) (n = 143 265) as genetic instruments from the largest available, nonoverlapping genome-wide association studies (GWAS). GWAS were previously conducted in diverse observational cohorts, including the UK Biobank (for physical activity) and participating studies in the Psychiatric Genomics Consortium (for MDD) among adults of European ancestry. Mendelian randomization estimates from each genetic instrument were combined using inverse variance weighted meta-analysis, with alternate methods (eg, weighted median, MR Egger, MR–Pleiotropy Residual Sum and Outlier [PRESSO]) and multiple sensitivity analyses to assess horizontal pleiotropy and remove outliers. Data were analyzed from May 10 through July 31, 2018.
Main Outcomes and Measures MDD and physical activity.
Results GWAS summary data were available for a combined sample size of 611 583 adult participants. Mendelian randomization evidence suggested a protective relationship between accelerometer-based activity and MDD (odds ratio [OR], 0.74 for MDD per 1-SD increase in mean acceleration; 95% CI, 0.59-0.92; P = .006). In contrast, there was no statistically significant relationship between MDD and accelerometer-based activity (β = −0.08 in mean acceleration per MDD vs control status; 95% CI, −0.47 to 0.32; P = .70). Furthermore, there was no significant relationship between self-reported activity and MDD (OR, 1.28 for MDD per 1-SD increase in metabolic-equivalent minutes of reported moderate-to-vigorous activity; 95% CI, 0.57-3.37; P = .48), or between MDD and self-reported activity (β = 0.02 per MDD in standardized metabolic-equivalent minutes of reported moderate-to-vigorous activity per MDD vs control status; 95% CI, −0.008 to 0.05; P = .15).
Conclusions and Relevance Using genetic instruments identified from large-scale GWAS, robust evidence supports a protective relationship between objectively assessed—but not self-reported—physical activity and the risk for MDD. Findings point to the importance of objective measurement of physical activity in epidemiologic studies of mental health and support the hypothesis that enhancing physical activity may be an effective prevention strategy for depression.
Source JAMA Psychiatry
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The Efficacy of Saffron in the Treatment of Mild to Moderate Depression: A Meta-analysis
Barbara Tóth, Péter Hegyi, Tamás Lantos, Zsolt Szakács, Beáta Kerémi, Gábor Varga, Judit Tenk, Erika Pétervári,
Márta Balaskó, Zoltán Rumbus, Zoltán Rakonczay, Emese Réka Bálint, Tivadar Kiss, Dezső Csupor
Herbal products, especially Hypericum perforatum extracts, have been widely used as first-line treatments for mild to moderate depression. Recently, several randomized, controlled clinical trials have been conducted to evaluate the efficacy of another plant, saffron (Crocus sativus), in mild to moderate depression. We have carried out a literature review of currently available published randomized, controlled clinical trials to give an up-to-date evaluation of the efficacy of saffron in mild to moderate depression, compared to placebo or routinely used antidepressants. The meta-analysis is reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines using the PICO (patients, intervention, comparison, outcome) format and was conducted using the statistical programs Comprehensive Meta-analysis and RevMan. PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science databases were searched for relevant studies. Only placebo or active controlled, randomized clinical studies involving patients suffering from mild to moderate depression and using pharmacological doses of saffron per os were included. Hedgesʼ g was used to calculate effect sizes. Risk of bias was assessed using the Cochrane Collaboration tool, and heterogeneity was tested by both performing the Cochranʼs Q test and calculating Higginsʼ I2 indicator. Eleven randomized trials were included in the qualitative analysis, and nine were pooled for statistical analysis. According to the present meta-analysis, saffron has a significant effect on the severity of depression. Available data from randomized, controlled clinical trials support that saffron is significantly more effective than placebo (g = 0.891; 95% CI: 0.369 – 1.412, p = 0.001), and non-inferior to tested antidepressant drugs (g = − 0.246; 95% CI: − 0.495 – 0.004, p = 0.053).
Source : Journal Planta Medica
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The effects of ginseng on stress-related depression, anxiety, and the hypothalamicpituitary-adrenal axis
Seungyeop Lee, Dong-Kwon Rhee
Ginseng effectively regulates the immune response and the hormonal changes due to stress, 23 thus maintaining homeostasis. In addition to suppressing the occurrence of psychological 24 diseases such as anxiety and depression, ginseng also prevents stress-associated physiological 25 diseases. Recent findings have revealed that ginseng is involved in adjusting the 26 hypothalamic-pituitary-adrenal axis and controlling hormones, thus producing beneficial 27 effects on the heart and brain, and in cases of bone diseases, as well as alleviating erectile 28 dysfunction. Recent studies have highlighted the potential use of ginseng in the prevention 29 and treatment of chronic inflammatory diseases such as diabetes, rheumatoid arthritis, and 30 allergic asthma. However, the mechanism underlying the effects of ginseng on these stress31 related diseases has not been completely established. In this review, we focus on the disease 32 pathways caused by stress in order to determine how ginseng acts to improve health. Central to our discussion is how this effective and stable therapeutic agent alleviates the anxiety and 34 depression caused by stress and ameliorates inflammatory diseases.
Source : Journal of Ginseng Research
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Curative effect of acupuncture on quality of life in patient with depression: a clinical randomized single-blind placebo-controlled study
Objective To evaluate the effect of acupuncture on the quality of life in patients with depression by clinical randomized single-blind placebo-controlled study.
Methods one hundred and sixty-three cases of depression according with the inclusion criteria were randomly divided into a group of acupuncture dredging liver and regulating flow of theosophy (group 1), a group of acupoint shallow stab (group 2) and a group of non-acupoint shallow stab (group 3) at 1:1:1 ratio, and treated with acupuncture, moxibustion, and intradermal embedding of needle, twice a week, for a total of 12 weeks. Scale of Quality of Life (SF-36) was used to measure the scores at four different time points and evaluate the effect of acupuncture on the quality of life of the patients with depression.
Results At each time point after treatment, in scores of the 8 items, physical function, physical role, bodily pain, general physical condition, energy, social function, emotional function and mental health there were statistically significant differences among the 3 groups (P < 0.0125).
Conclusion Acupuncture can effectively improve the quality of life of patients with depression
Source : Journal of Traditional Chinese Medicine
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Neural Processing of Emotional Musical and Nonmusical Stimuli in Depression
- Rebecca J. Lepping ,
- Ruth Ann Atchley,
- Evangelia Chrysikou,
- Laura E. Martin,
- Alicia A. Clair,
- Rick E. Ingram,
- W. Kyle Simmons,
- Cary R. Savage
Anterior cingulate cortex (ACC) and striatum are part of the emotional neural circuitry implicated in major depressive disorder (MDD). Music is often used for emotion regulation, and pleasurable music listening activates the dopaminergic system in the brain, including the ACC. The present study uses functional MRI (fMRI) and an emotional nonmusical and musical stimuli paradigm to examine how neural processing of emotionally provocative auditory stimuli is altered within the ACC and striatum in depression.
Nineteen MDD and 20Sou never-depressed (ND) control participants listened to standardized positive and negative emotional musical and nonmusical stimuli during fMRI scanning and gave subjective ratings of valence and arousal following scanning.
ND participants exhibited greater activation to positive versus negative stimuli in ventral ACC. When compared with ND participants, MDD participants showed a different pattern of activation in ACC. In the rostral part of the ACC, ND participants showed greater activation for positive information, while MDD participants showed greater activation to negative information. In dorsal ACC, the pattern of activation distinguished between the types of stimuli, with ND participants showing greater activation to music compared to nonmusical stimuli, while MDD participants showed greater activation to nonmusical stimuli, with the greatest response to negative nonmusical stimuli. No group differences were found in striatum.
These results suggest that people with depression may process emotional auditory stimuli differently based on both the type of stimulation and the emotional content of that stimulation. This raises the possibility that music may be useful in retraining ACC function, potentially leading to more effective and targeted treatments.
Source : PLOSOne
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Rhodiola rosea L. as a putative botanical antidepressant
Rhodiola rosea (R. rosea) is a botanical adaptogen with putative anti-stress and antidepressant properties. Evidence-based data supporting the effectiveness of R. roseafor depression in adults is limited, and therefore a comprehensive review of available animal and human studies suggesting a putative antidepressant action is warranted.
A review of the literature was undertaken to ascertain studies of possible antidepressant mechanisms of action and studies of the safety and effectiveness of R. rosea extracts in animals and adult humans.
A search of MEDLINE and the Russian state library database was conducted (up to October 2015) on R. rosea.
Mechanism of action: R. rosea extracts and its purified constituent, salidroside, has been shown to produce a variety of mediator interactions with several molecular networks of neuroendocrine-immune and neurotransmitter receptor systems likely to be involved in the pathophysiology of depression. A wide variety of preclinical in vivo and ex vivostudies with laboratory animals suggests the presence of several biochemical and pharmacological antidepressant-like actions.
Clinical assessment of R. rosea L. rhizome extracts in humans with various depressive syndromes is based upon results from two randomized, double-blind, placebo-controlled trials of 146 subjects with major depressive disorder and seven open-label studies totaling 714 individuals with stress-induced mild depression (diagnosed as asthenic syndrome or psychoneurosis). Overall, results of these studies suggests a possible antidepressant action for R. rosea extract in adult humans.
In contrast to most conventional antidepressants, R. rosea extract appears to be well-tolerated in short-term studies with a favorable safety profile.
R. rosea demonstrates multi-target effects on various levels of the regulation of cell response to stress, affecting various components of the neuroendocrine, neurotransmitter receptor and molecular networks associated with possible beneficial effects on mood.
Source : Journal Phytomedicine
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Effects of Group Drumming Interventions on Anxiety, Depression, Social Resilience and Inflammatory Immune Response among Mental Health Service Users
Growing numbers of mental health organizations are developing community music-making interventions for service users; however, to date there has been little research into their efficacy or mechanisms of effect. This study was an exploratory examination of whether 10 weeks of group drumming could improve depression, anxiety and social resilience among service users compared with a non-music control group (with participants allocated to group by geographical location.) Significant improvements were found in the drumming group but not the control group: by week 6 there were decreases in depression (-2.14 SE 0.50 CI -3.16 to -1.11) and increases in social resilience (7.69 SE 2.00 CI 3.60 to 11.78), and by week 10 these had further improved (depression: -3.41 SE 0.62 CI -4.68 to -2.15; social resilience: 10.59 SE 1.78 CI 6.94 to 14.24) alongside significant improvements in anxiety (-2.21 SE 0.50 CI -3.24 to -1.19) and mental wellbeing (6.14 SE 0.92 CI 4.25 to 8.04). All significant changes were maintained at 3 months follow-up. Furthermore, it is now recognised that many mental health conditions are characterised by underlying inflammatory immune responses. Consequently, participants in the drumming group also provided saliva samples to test for cortisol and the cytokines interleukin (IL) 4, IL6, IL17, tumour necrosis factor alpha (TNFα), and monocyte chemoattractant protein (MCP) 1. Across the 10 weeks there was a shift away from a pro-inflammatory towards an anti-inflammatory immune profile. Consequently, this study demonstrates the psychological benefits of group drumming and also suggests underlying biological effects, supporting its therapeutic potential for mental health
Source : PLOS One
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The Omega-3 Index Is Inversely Associated with Depressive Symptoms among Individuals with Elevated Oxidative Stress Biomarkers1,2,3
- Sherman J Bigornia4,*,
- William S Harris6,
- Luis M Falcón5,
- José M Ordovás7,
- Chao-Qiang Lai5, and
- Katherine L Tucker4
Background: Omega-3 (n–3) fatty acid (FA) consumption is thought to improve depressive symptoms. However, current evidence is limited, and whether this association exists among Puerto Ricans, a population burdened by depression, remains uncertain.
Objectives: We examined the association between ω-3 FA biomarkers and depressive symptoms as well as the potential influence of oxidative stress.
Methods: Baseline and longitudinal analyses were conducted in the Boston Puerto Rican Health Study (n = 787; participants aged 57 ± 0.52 y, 73% women). Urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) concentration, a measure of oxidative stress, and erythrocyte FA composition were collected at baseline. We calculated the omega-3 index as the sum of eicosapentaenoic and docosahexaenoic acids, expressed as a percentage of total FAs. Baseline and 2-y depressive symptoms were characterized by using the Center for Epidemiological Studies–Depression Scale (CES-D). Statistical analyses included linear and logistic regression.
Results: Urinary 8-OHdG concentration tended to modify the relation between the erythrocyte omega-3 index and baseline CES-D score (P-interaction = 0.10). In stratified analyses, the omega-3 index was inversely associated with CES-D score (β = −1.74, SE = 0.88; P = 0.02) among those in the top quartile of 8-OHdG concentration but not among those in the lower quartiles. The relation between the omega-3 index and CES-D at 2 y was more clearly modified by 8-OHdG concentration (P-interaction = 0.04), where the omega-3 index was inversely associated with CES-D at 2 y, adjusted for baseline (β = −1.66, SE = 0.66; P = 0.02), only among those with elevated 8-OHdG concentrations. Among individuals not taking antidepressant medications and in the top tertile of urinary 8-OHdG concentration, the omega-3 index was associated with significantly lower odds of a CES-D score ≥16 at baseline (OR: 0.72; 95% CI: 0.53, 0.96) but not at 2 y (OR: 0.83; 95% CI: 0.60, 1.15).
Conclusions: An inverse association between the omega-3 index and depressive symptoms was observed among participants with elevated oxidative stress biomarkers. These data suggest that oxidative stress status may identify those who might benefit from ω-3 FA consumption to improve depressive symptoms.
Source : The Journal of Nutrition via Sci-hub
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A double-blind, randomized and placebo-controlled trial of Saffron (Crocus sativus L.) in the treatment of anxiety and depression
Mohsen Mazidi1, 9 / Maryam Shemshian2 / Seyed Hadi Mousavi3 / Abdolreza Norouzy2 / Tayebe Kermani4 / Toktam Moghiman2 / Akram Sadeghi5 / Naghme Mokhber6 / Majid Ghayour-Mobarhan2, 7 / Gordon A. A. Ferns8
1Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing, P.R. China
2Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3Pharmacological Research Center of Medicinal Plant, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4Department of Anatomy and Cell biology, Birjand University of Medical Sciences, Birjand, Iran
5Department of Anatomy and Cellular Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
6Psychiatry and Behavioral Sciences Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
7Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
8Division of Medical Education, Brighton & Sussex Medical School, University of Brighton, Brighten, UK
9Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Science (IC-UCAS), West Beichen Road, Chaoyang, P.R. China
BACKGROUND:Depression and anxiety are prevalent serious psychiatric disorders. Several drugs are used to treat these conditions but these are often associated with serious side effects. For this reason alternative therapies, including herbal medication such as saffron, have been proposed. We aimed to assess the effects of saffron extract for the treatment of anxiety and depression using a 12-week double-blind, placebo-controlled trial design.
METHODS:Sixty adult patients with anxiety and depression were randomized to receive a 50 mg saffron capsule (Crocus sativus L. stigma) or a placebo capsule twice daily for 12 weeks. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) questionnaires were used at baseline, 6 and 12 weeks after initiating medication. 54 subjects completed the trial.
RESULTS:Saffron supplements had a significant effect on the BDI and BAI scores of subjects in comparison to placebo at the 12 week time-point (p<0.001).
CONCLUSIONS:Saffron appears to have a significant impact in the treatment of anxiety and depression disorder. Side effects were rare.
Source : Journal Complement Integr Med.
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Antidepressant effects of the water extract from Taraxacum officinale leaves and roots in mice
.Li YC1, Shen JD, Li YY, Huang Q.
CONTEXT:The leaves and roots of the Taraxacum officinale F. (Asteraceae) is widely used as traditional medicinal herb in Eastern Asian countries.
OBJECTIVE:In the present study, the antidepressant-like effects of the water extract of T. officinale (WETO) leaves and roots were investigated in mice using forced swimming test (FST), tail suspension test (TST) and open field test (OFT).
MATERIALS AND METHODS:Effects of acute (1-day) and chronic treatments (14-days) with WETO (50, 100 and 200 mg/kg) on the behavioral changes in FST, TST and OFT, and the serum corticotrophin releasing factor (CRF), adrenocorticotropic hormone (ACTH) and corticosterone concentration were assessed in mice.
RESULTS:Chronic treatment (14-days) with WETO at the doses of 50, 100 and 200 mg/kg significantly decreased the immobility time in both FST (92.6, 85.1 and 77.4 s) and TST (84.8, 72.1 and 56.9 s). Acute treatment (1-day) with WETO at a dose of 200 mg/kg also markedly decreased the immobility time in both FST (81.7 s) and TST (73.2 s). However, all treatments did not affect the locomotor activity in the OFT. Moreover, FST induced a significant increase in serum CRF (5.8 ng/ml), ACTH (104.7 pg/ml) and corticosterone levels (37.3 ng/ml). Chronic treatment (14-days) with WETO decreased the serum CRF (200 mg/kg: 3.9 ng/ml) and corticosterone (50 mg/kg: 29.9 ng/ml; 100 mg/kg: 22.5 ng/ml; 200 mg/kg: 19.8 ng/ml) levels.
DISCUSSION AND CONCLUSION:These results clearly demonstrated the antidepressant effects of WETO in animal models of behavioral despair and suggested the mechanism involved in the neuroendocrine system.
Source : Pharm Biol.
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Evaluation of a spirituality informed e-mental health tool as an intervention for major depressive disorder in adolescents and young adults – a randomized controlled pilot trial
- Badri Rickhi,
- Ania Kania-Richmond
- Sabine Moritz,
- Jordan Cohen,
- Patricia Paccagnan,
- Charlotte Dennis,
- Mingfu Liu,
- Sonya Malhotra,
- Patricia Steele and
- John Toews
Depression in adolescents and young adults is a major mental health condition that requires attention. Research suggests that approaches that include spiritual concepts and are delivered through an online platform are a potentially beneficial approach to treating/managing depression in this population. The purpose of this study was to evaluate the effectiveness of an 8-week online spirituality informed e-mental health intervention (the LEAP Project) on depression severity, and secondary outcomes of spiritual well-being and self-concept, in adolescents and young adults with major depressive disorder of mild to moderate severity.
A parallel group, randomized, waitlist controlled, assessor-blinded clinical pilot trial was conducted in Calgary, Alberta, Canada. The sample of 62 participants with major depressive disorder (DSM-IV-TR) was defined by two age subgroups: adolescents (ages 13 to 18 years; n = 31) and young adults (ages 19 to 24 years; n = 31). Participants in each age subgroup were randomized into the study arm (intervention initiated upon enrolment) or the waitlist control arm (intervention initiated after an 8-week wait period). Comparisons were made between the study and waitlist control arms at week 8 (the point where study arm had completed the intervention and the waitlist control arm had not) and within each arm at four time points over 24-week follow-up period.
At baseline, there was no statistical difference between study and waitlist participants for both age subgroups for all three outcomes of interest. After the intervention, depression severity was significantly reduced; comparison across arms at week 8 and over time within each arm and both age subgroups. Spiritual well-being changes were not significant, with the exception of an improvement over time for the younger participants in the study arm (p = 0.01 at week 16 and p = 0.0305 at week 24). Self-concept improved significantly for younger participants immediately after the intervention (p = 0.045 comparison across arms at week 8; p = 0.0175 in the waitlist control arm) and over time in the study arm (p = 0.0025 at week 16). In the older participants, change was minimal, with the exception of a significant improvement in one of six factors (vulnerability) in study arm over time (p = 0.025 at week 24).
The results of the LEAP Project pilot trial suggest that it is an effective, online intervention for youth ages 13 to 24 with mild to moderate major depressive disorder with various life situations and in a limited way on spiritual well-being and self-concept.
Source : BMC Complementary and Alternative Medicine
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St. John’s Wort: Quality Issues and Active Compounds
St. John’s wort (Hypericum perforatum L.) (SJW) contains numerous compounds with documented biological activity. Constituents that have stimulated the most interest include the naphthodianthrones, hypericin and pseudohypericin; a broad range of flavonoids, including rutin, quercetin, quercitrin, miquelianin, amentoflavone, and hyperoside; and the phloroglucinols hyperforin and adhyperforin. Although there are some contradictions, most data suggest that several groups of active compounds are responsible for the antidepressant effi cacy of the plant extract. Thus, according to the current state of scientific knowledge, the total extract has to be considered as the active substance. Data on effi cacy and quality of SJW extracts have to be taken into consideration. Owing to the fast- growing SJW market in the United States, more and more SJW products (herb and extracts) are sold at varying levels of quality. Considerable differences exist in the composition of biologically active constituents among various commercially available preparations of SJW. Furthermore, the documented characterization of SJW preparations in published randomized controlled trials has been less than adequate. Future scientifi c and clinical publications about the effi cacy of SJW would benefi t from a full pharmaceutical and phytochemical description of the extract. SJW is used for the treatment of mild to moderate depression. The antidepressant efficacy of SJW extracts has been confirmed in numerous clinical studies and was assessed in meta- analyses (1, 2). The pharmacological actions of SJW have likewise been extensively reviewed (3– 6). Reports about the mechanism of antidepressant action of SJW extracts and their constituents both in vivo and in vitro have also been published. Antidepressant activity was reported for the phloroglucinol derivative hyperforin (for a review, see ), for the naphthodianthrones hypericin and pseudohypericin (8– 10), and for several flavonoids (11– 14). The role and the mechanisms of these different compounds are still a matter of debate. However, based on recent results, it appears that the prevailing simplistic view of one plant → one active compound → one mechanism of action is incorrect. It is more likely that the multiple bioactive compounds contribute to the antidepressant activity of the crude plant extract in a complex manner. This review focuses on the present knowledge about the active constituents of SJW and their contribution to antidepressant activity.
Source : Botanical Medicine from Bench to Bedside
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Treating Depressive Symptoms in Psychosis: A Network Meta-Analysis on the Effects of Non-Verbal Therapies
The aim of this study was to examine whether non-verbal therapies are effective in treating depressive symptoms in psychotic disorders.
Material and Methods
A systematic literature search was performed in PubMed, Psychinfo, Picarta, Embase and ISI Web of Science, up to January 2015. Randomized controlled trials (RCTs) comparing a non-verbal intervention to a control condition in patients with psychotic disorders, whilst measuring depressive symptoms as a primary or secondary outcome, were included. The quality of studies was assessed using the ‘Clinical Trials Assessment Measure for psychological treatments’ (CTAM) scale. Cohen’s d was calculated as a measure of effect size. Using a Network Meta-analysis, both direct and indirect evidence was investigated.
10 RCTs were included, of which three were of high quality according to the CTAM. The direct evidence demonstrated a significant effect on the reduction in depressive symptoms relative to treatment as usual (TAU), in favor of overall non-verbal therapy (ES: -0.66, 95% C.I. = -0.88, -0.44) and music therapy (ES: -0.59, 95% C.I. = -0.85, -0.33). Combining both direct and indirect evidence, yoga therapy (ES: -0.79, 95% C.I. = -1.24, -0.35) had a significant effect on depressive symptoms, and occupational therapy (ES: 1.81, 95% C.I. = 0.81, 2.81) was less effective, relative to TAU. Exercise therapy did not show a significant effect on depressive symptoms in comparison to TAU (ES: -0.02 95% C.I. = -0.67, 0.62). Due to inconsistency of study evidence, the indirect effects should be interpreted cautiously.
Non-verbal therapies appear to be effective in reducing depressive symptomatology in psychotic disorders, in particular music therapy and yoga therapy.
Source : PLOSone
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Antidepressant-like effects of methanolic extract of Bacopa monniera in mice
Abdul Mannan1*, Ariful Basher Abir1 and Rashidur Rahman2
BackgroundBacopa monniera has been used as a cure for various ailments that include anxiety, epileptic disorders, dementia, blood purifier, cough and rheumatism, and some important local uses of the plant are in dermatitis, anemia, diabetes, promote fertility and prevent miscarriage for many years in Bangladesh. According to this background, the aim of the study was to evaluate the antidepressant-like effect of the methanolic extract of B. monniera (MEBM) in different behavioral models such as forced swimming test (FST), measurement of locomotor activity test (MLAT) and tail suspension test (TST) on mice after two weeks treatment.
MethodsMice were divided into five groups (n = 5/group): control group (deionized water), standard group where Imipramine hydrochloride (30 mg/kg) was used as standard drug and three test groups where three doses of the methanolic extract of B. monniera (MEBM) (50, 100, and 200 mg/kg) was used for two weeks treatment. All the drug and test samples were administered via gavage through oral route. To assess the antidepressant-like effect of MEBM forced swimming test (FST), tail suspension test (TST) and measurement of locomotor activity test (MLAT) have been done in mice.
ResultsThe results showed that a strong and dose-dependent antidepressant effects in different mice models. The main findings of the MEBM significantly reduced the duration of immobility times in the forced swimming test (p < 0.001). Likewise, the extract significantly decreased the immobility time in the tail suspension test (p < 0.001). Moreover, we employed an additional measurement of locomotor activity test to check the motor stimulating activity of the MEBM. The extract also significantly increased the locomotion, rearing and defecation effects in comparison to the control group (p < 0.001).
ConclusionThe present results clearly demonstrate that the methanolic extract of B. monniera possesses antidepressant-like activity in the animal behavioral models. The current study warrants further investigation into identification of the active compounds in herbal medicines, in particular extract ofB. monniera with antidepressant-like effects.
Source : BMC Complementary and Alternative Medicine
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Aqueous Extract of Saffron (Crocus sativus) Increases Brain Dopamine and Glutamate Concentrations in Rats
Hosseinali Ettehadi1, Seyedeh Nargesolsadat Mojabi2, Mina Ranjbaran2, Jamal Shams3, Hedayat Sahraei2*, Mahdi Hedayati4, Farzad Asefi5
Recent studies involving human and animal models have identified that saffron helps in the improvement of depression. Antidepressants are known to function in part by increasing brain serotonin, norepinephrine and dopamine concentrations. Therefore, to identify the cellular and molecular mechanism(s) underlying this property of saffron, we measured changes in rat brain dopamine, serotonin, norepinephrine and glutamate concentrations after administration of varying doses of an aqueous extract of saffron stigma. Male Wistar rats (250 ± 30 g) were administered a single dose of saffron extract (5, 25, 50, 100, 150, and 250 mg/kg, i.p.), fluoxetine (10 mg/kg, i.p.), and/or desipramine (50 mg/kg, i.p.) and were sacrificed 30 min later. Brains were removed, homogenized, and centrifuged at 4˚C. The supernatant was used for subsequent neurotransmitter detection by ELISA. Our results indicated that the aqueous extract of saffron (50, 100, 150 and 250 mg/kg, i.p.) increased brain dopamine concentration in a dose-dependent manner compared with saline. In addition, the brain glutamate concentration increased in response to the highest dose of the extract (250 mg/kg, i.p.). Interestingly, the extract had no effect on brain serotonin or norepinephrine concentration. Our findings show that the aqueous extract of saffron contains an active component that can trigger production of important neurotransmitters in brain, namely, dopamine and glutamate. In addition, these results provide a cellular basis for reports concerning the antidepressant properties of saffron extract in humans and animals.
Source : Journal of Behavioral and Brain Science
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Decreased Symptoms of Depression After Mindfulness-Based Stress Reduction: Potential Moderating Effects of Religiosity, Spirituality, Trait Mindfulness, Sex, and Age
Jeffrey M. Greeson, PhD,1,2,3 Moria J. Smoski, PhD,2 Edward C. Suarez, PhD,1,2 Jeffrey G. Brantley, MD,1,2Andrew G. Ekblad, PhD,4,5 Thomas R. Lynch, PhD,6 and Ruth Quillian Wolever, PhD1,2
1Duke Integrative Medicine, Duke University Medical Center, Durham, NC.
2Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC.
3Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA.
4Department of Psychiatry, McMaster University, Hamilton, Ontario, Canada.
5Broadleaf Health, Guelph, Ontario, Canada.
6School of Psychology, University of Southampton, Southampton, United Kingdom.
Objective: Mindfulness-based stress reduction (MBSR) is a secular meditation training program that reduces depressive symptoms. Little is known, however, about the degree to which a participant's spiritual and religious background, or other demographic characteristics associated with risk for depression, may affect the effectiveness of MBSR. Therefore, this study tested whether individual differences in religiosity, spirituality, motivation for spiritual growth, trait mindfulness, sex, and age affect MBSR effectiveness.
Methods: As part of an open trial, multiple regression was used to analyze variation in depressive symptom outcomes among 322 adults who enrolled in an 8-week, community-based MBSR program.
Results: As hypothesized, depressive symptom severity decreased significantly in the full study sample (d=0.57;p<0.01). After adjustment for baseline symptom severity, moderation analyses revealed no significant differences in the change in depressive symptoms following MBSR as a function of spirituality, religiosity, trait mindfulness, or demographic variables. Paired t tests found consistent, statistically significant (p<0.01) reductions in depressive symptoms across all subgroups by religious affiliation, intention for spiritual growth, sex, and baseline symptom severity. After adjustment for baseline symptom scores, age, sex, and religious affiliation, a significant proportion of variance in post-MBSR depressive symptoms was uniquely explained by changes in both spirituality (β=−0.15;p=0.006) and mindfulness (β=−0.17; p<0.001).
Conclusions: These findings suggest that MBSR, a secular meditation training program, is associated with improved depressive symptoms regardless of affiliation with a religion, sense of spirituality, trait level of mindfulness before MBSR training, sex, or age. Increases in both mindfulness and daily spiritual experiences uniquely explained improvement in depressive symptoms.
Source : The Journal of Alternative and Complementary Medicine
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Effects of Chaiyuwendan decoction on endocannabinoids levels in adipose tissue of rats with chronic stress-induced depression
Shaodong Chen, Manting Lin, Xiao Zhao, Fan Lu, Yujie Wang, Shulei Li, Bin Yan, Haihong Zhou aa Shaodong Chen, Manting Lin, Xiao Zhao, Fan Lu, Yujie Wang, Shulei Li, Bin Yan, Haihong Zhou,
Traditional Chinese Medicine Department, Medical College of Xiamen University, Xiamen 361005, China
OBJECTIVE: To investigate how Chaiyuwendan decoction (CWD) affects endocannabinoid levels in the adipose tissue of depressed rats.
METHODS: Twenty-four male Sprague-Dawley rats were randomly divided into four groups with six rats in each. One group was randomly selected as the control group. The remaining three groups were subjected to chronic stress to induce depression. Groups were randomly assigned as a model group, CWD group, and amitriptyline group. CWD was given to the CWD group once a day from the second day of modeling. The amitriptyline group was administered amitriptyline intragastrically (10 mg/kg) once a day. After treatment for 21 days, body weight and fat weight were measured and the levels of N-arachidonoylethanolamine (AEA), 2-arachidonoylglycerol (2-AG), and N-palmitoylethanolamine (PEA) in adipose tissue were determined with liquid chromatography-mass spectrometry.
RESULTS: Compared with the control group, body weight, fat weight, AEA, and PEA were significantly lower, and 2-AG was higher, in the model group (P< 0.05, P<0.01). Compared with the model group, body weight, fat weight, the AEA, and PEA levels were significantly higher, and 2-AG level was significantly lower in the CWD group (P<0.05). However, the levels did not differ significantly between the CWD group and the amitriptyline group.
CONCLUSION: CWD could regulate the levels of AEA, 2-AG, and PEA in rats with depression induced by chronic stress.
Source : Journal of Traditional Chinese Medicine
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Rapid Antidepressant Activity of Ethanol Extract of Gardenia jasminoides Ellis Is Associated with Upregulation of BDNF Expression in the Hippocampus
Hailou Zhang,1,2 Wenda Xue,1,2 Runjie Wu,1,2 Tong Gong,1,2 Weiwei Tao,1,2 Xin Zhou,1,2 Jingjing Jiang,1,2 Ying Zhang,1,2 Nan Zhang,1,2 Yi Cui,1,2 Chang Chen,3 and Gang Chen1,2
1Center for Translational Systems Biology and Neuroscience, School of Basic Biomedical Science, Nanjing University of Chinese Medicine, Nanjing 210023, China
2Laboratory of Integrative Biomedicine of Brain Diseases, School of Basic Biomedical Science, Nanjing University of Chinese Medicine, Nanjing 210023, China
3First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210023, China
Ethanol extract of Yueju pill, a Traditional Chinese Medicine herbal formula widely used to treat mood disorders, demonstrates rapid antidepressant effects similar to ketamine, likely via instant enhancement of brain-derived neurotrophic factor (BDNF) expression in the hippocampus. Here we investigated ethanol extracts of the constituent herbs of Yueju responsible for rapid antidepressant effects. Screening with tail suspension test in Kunming mice at 24 hours after a single administration of five individual constituent herbs of Yueju, we found that only Gardenia jasminoides Ellis (GJ) showed a significant effect. The antidepressant response started at 2 hours after GJ administration. Similar to Yueju and ketamine, a single administration of GJ significantly reduced the number of escape failures in the learned helplessness test. Furthermore, GJ decreased latency of food consumption in the novelty suppressed-feeding test. Additionally, starting from 2 hours and continuing for over 20 hours after GJ administration, BDNF expression in the hippocampus was upregulated, temporally linked with the antidepressant response. These findings suggest that GJ has rapid antidepressant effects, which are associated with the elevated expression of BDNF in the hippocampus. In Yueju formula, Yue represents GJ, as thus our study demonstrates the primary role of GJ in rapid antidepressant efficacy of Yueju.
Source : Evidence Based Complementary and Alternative Medicine
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Rhodiola rosea versus sertraline for major depressive disorder: A randomized placebo-controlled trial
- Jun J. Maoa, b, , ,
- Sharon X. Xieb,
- Jarcy Zeeb,
- Irene Soellera, c,
- Qing S. Lia, c,
- Kenneth Rockwelld,
- Jay D. Amsterdamc
Background: We performed a proof of concept trial to evaluate relative safety and efficacy of Rhodiola rosea (R. rosea) versus sertraline for mild to moderate major depressive disorder.
Hypothesis: We hypothesize that R. rosea would have similar therapeutic effects as sertraline but with less adverse events.
Study design: Phase II randomized placebo controlled clinical trial.
Methods: 57 subjects were randomized to 12 weeks of standardized R. rosea extract, sertraline, or placebo. Changes over time in Hamilton Depression Rating (HAM-D), Beck Depression Inventory (BDI), and Clinical Global Impression Change (CGI/C) scores among groups were examined using mixed-effects models.
Results: Modest, albeit statistically non-significant, reductions were observed for HAM-D, BDI, and CGI/C scores for all treatment conditions with no significant difference between groups (p = 0.79, p = 0.28, andp = 0.17, respectively). The decline in HAM-D scores was greater for sertraline (−8.2, 95% confidence interval [CI], −12.7 to −3.6) versus R. rosea (−5.1, 95% CI: −8.8 to −1.3) and placebo (−4.6, 95% CI: −8.6 to −0.6). While the odds of improving (versus placebo) were greater for sertraline (1.90 [0.44–8.20]; odds ratio [95% CI]) than R. rosea (1.39 [0.38–5.04]), more subjects on sertraline reported adverse events (63.2%) than R. rosea (30.0%) or placebo (16.7%) (p = 0.012).
Conclusions: Although R. rosea produced less antidepressant effect versus sertraline, it also resulted in significantly fewer adverse events and was better tolerated. These findings suggest that R. rosea, although less effective than sertraline, may possess a more favorable risk to benefit ratio for individuals with mild to moderate depression.
Source : Phytotherapy Journal
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The Effects of Tai Chi in Centrally Obese Adults with Depression Symptoms
Xin Liu,1,2,3 Luis Vitetta,1 Karam Kostner,1,4 David Crompton,1,5,6 Gail Williams,7 Wendy J. Brown,8 Alan Lopez,9 Charlie C. Xue,10 Tian P. Oei,11 Gerard Byrne,1,12 Jennifer H. Martin,1,13 and Harvey Whiteford7
This study examined the effects of Tai Chi, a low-impact mind-body movement therapy, on severity of depression, anxiety, and stress symptoms in centrally obese people with elevated depression symptoms. In total, 213 participants were randomized to a 24-week Tai Chi intervention program or a wait-list control group. Assessments were conducted at baseline and 12 and 24 weeks. Outcomes were severity of depression, anxiety, and stress symptoms, leg strength, central obesity, and other measures of metabolic symptom. There were statistically significant between-group differences in favor of the Tai Chi group in depression (mean difference = −5.6 units, P<0.001), anxiety (−2.3 units, P<0.01), and stress (−3.6 units, P<0.001) symptom scores and leg strength (1.1 units, P<0.001) at 12 weeks. These changes were further improved or maintained in the Tai Chi group relative to the control group during the second 12 weeks of follow-up. Tai Chi appears to be beneficial for reducing severity of depression, anxiety, and stress and leg strength in centrally obese people with depression symptoms. More studies with longer follow-up are needed to confirm the findings.
Source : Evidence Based Complementary and Alternative Medicine
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Effect of Ginkgo Biloba Extract on Lipopolysaccharide-induced Anhedonic Depressive-like Behavior in Male Rats
- Kuei-Ying Yeh1,*,
- Sing-Siang Shou1,
- Yi-Xuan Lin1,
- Chao-Cin Chen1,
- Chen-Yen Chiang1 and
- Chien-Yu Yeh2
The peripheral administration of lipopolysaccharide (LPS) induces depressive-like behavior. Anhedonia is a core symptom of depression, defined as a loss of the capacity to experience pleasure. The present study used the sucrose preference test to investigate the influence of Ginkgo biloba extract (EGb 761) on LPS-induced anhedonia in male rats. The animals were randomly divided into four groups: (I) vehicle + saline, (II) vehicle + LPS, (III) EGb 761 + saline, and (IV) EGb 761 + LPS. Saline or LPS (100 µg/kg) was administered intraperitoneally 2 h before the sucrose preference test. Sucrose consumption was recorded 2, 4, 6, 13, and 24 h after 100 µg/kg of LPS or saline injection in the dark phase of the light/dark cycle. Dopamine and serotonin levels in the nucleus accumbens were measured. Our results indicated that the vehicle + LPS group exhibited a significant decrease in sucrose intake compared with the vehicle + saline group. The EGb 761 + LPS group showed more sucrose and food consumption than the vehicle + LPS group. Additionally, compared with the EGb 761 + LPS group, the vehicle + LPS group had less dopamine levels in the nucleus accumbens. Treatment with EGb 761 had no effect on water intake. Our results suggest that EGb 761 may be useful for reducing anhedonic depressive-like behavior.
Source : Phytotherapy Research
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RIA neuroscience study points to possible use of medical marijuana for depression
Scientists at the University at Buffalo’s Research Institute on Addictions (RIA) are studying chronic stress and depression, with a focus on endocannabinoids, which are brain chemicals similar to substances in marijuana.
The findings raise the possibility that components of marijuana may be useful in reducing depression that results from chronic stress.
“In the animal models we studied, we saw that chronic stress reduced the production of endocannabinoids, leading to depression-like behavior,” says RIA senior research scientist Samir Haj-Dahmane, PhD.
Endocannabinoids are naturally produced chemical compounds in the brain that affect motor control, cognition, emotions and behavior. As the name suggests, they are similar to the chemicals found in marijuana (Cannabis sativa) and its active ingredient, delta-9-tetrahydrocannabinol (THC).
“Chronic stress is one of the major causes of depression,” Haj-Dahmane says. “Using compounds derived from cannabis — marijuana — to restore normal endocannabinoid function could potentially help stabilize moods and ease depression.”
He cautions this is preliminary research. “Our research thus far has used animal models; there is still a long way to go before we know whether this can be effective in humans,” he says. “However, we have seen that some people who suffer from post-traumatic stress disorder have reported relief using marijuana.”
Haj-Dahmane says the next step in the research is to see if using a marijuana extract, cannabidiol (CBD), restores normal behaviors in the animals without leading to dependence on the drug.
The study, co-authored by Roh-Yu Shen, PhD, RIA senior research scientist, was funded by a grant from the National Institute of Mental Health. It appeared in the fall issue of the Journal of Neuroscience.
Medical marijuana remains a controversial issue. Although 23 states and the District of Columbia have approved its use to provide relief for health problems such as glaucoma, nerve pain, epilepsy, multiple sclerosis and nausea from chemotherapy, some experts are concerned that medical use of marijuana may normalize attitudes about the drug and lead people — especially youth — to believe it is completely safe.
Source : University of Buffalo
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Herbal triplet in treatment of nervous agitation in children
Inga Trompetter, Bianka Krick, and Gabriele Weiss
Emotional and behavioral problems in children and adolescents are no exception. To what extent a fixed plant extract combination is able to support children suffering from nervous agitation due to agitated depression among others for approximately 2 years has been investigated in a multicenter, prospective observational study (2008) with 115 children between 6 and 12 years. Assessments of the parents showed a distinct improvement in children who had attention problems, showed social withdrawal, and/or were anxious/depressive. Based on the physicians’ assessment, 81.6–93.9 % of the affected children had no or just mild symptoms at the end of observation concerning nine of thirteen evaluated symptoms such as depression, school/examination anxieties, further anxieties, sleeping problems, and different physical problems. Therapeutic success was not influenced by additional medication or therapies. The treatment was well tolerated. The used plant extracts have been gained from St. John’s Wort herb, valerian root, and passionflower herb.
Source : Wien Med Wochenschr.
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Antidepressant- and anxiolytic-like activities of an oil extract of propolis in rats.
Purpose: Propolis biological effects are mainly attributed to its polyphenolic constituents such as flavonoids and phenolic acids that were recently described in the chemical composition of an extract of propolis obtained with edible vegetal oil (OEP) by our group. The aim of this study was to evaluate the effect of OEP on the behavior of rats.
Materials and methods: An in vivo open field (OF), elevated Plus-maze (EPM), and forced swimming (FS) tests were performed to evaluate locomotor activity, anxiolytic- and antidepressant effects of the extract. Besides, oxidative stress levels were measured in rat blood samples after the behavioral assays by evaluation of the Trolox equivalent antioxidant capacity (TEAC) and nitric oxide levels.
Results: OEP increased locomotion in the OF test (50 mg/kg) and central locomotion and open arm entries in the OF and EPM tests (10-50 mg/kg) and decreased the immobility time in the FS test (10-50 mg/kg). Moreover, OEP reduced nitric oxide levels in response to swim stress induced in rats.
Conclusion: OEP exerted stimulant, anxiolytic and antidepressant effects on the Central Nervous System and antioxidant activity in rats, highlighting propolis as a potential therapeutic compound for behavior impairment of anxiety and depression
Source : International Journal of Phytotherapy and Phytopharmacology
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Meditation programs for psychological stress and well-being: a systematic review and meta-analysis Review published: 2014.
Bibliographic details: Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R, Berger Z, Sleicher D, Maron DD, Shihab HM, Ranasinghe PD, Linn S, Saha S, Bass EB, Haythornthwaite JA.
IMPORTANCE: Many people meditate to reduce psychological stress and stress-related health problems. To counsel people appropriately, clinicians need to know what the evidence says about the health benefits of meditation.
OBJECTIVE: To determine the efficacy of meditation programs in improving stress-related outcomes (anxiety, depression, stress/distress, positive mood, mental health-related quality of life, attention, substance use, eating habits, sleep, pain, and weight) in diverse adult clinical populations.
EVIDENCE REVIEW: We identified randomized clinical trials with active controls for placebo effects through November 2012 from MEDLINE, PsycINFO, EMBASE, PsycArticles, Scopus, CINAHL, AMED, the Cochrane Library, and hand searches. Two independent reviewers screened citations and extracted data. We graded the strength of evidence using 4 domains (risk of bias, precision, directness, and consistency) and determined the magnitude and direction of effect by calculating the relative difference between groups in change from baseline. When possible, we conducted meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals.
FINDINGS: After reviewing 18 753 citations, we included 47 trials with 3515 participants. Mindfulness meditation programs had moderate evidence of improved anxiety (effect size, 0.38 [95% CI, 0.12-0.64] at 8 weeks and 0.22 [0.02-0.43] at 3-6 months), depression (0.30 [0.00-0.59] at 8 weeks and 0.23 [0.05-0.42] at 3-6 months), and pain (0.33 [0.03- 0.62]) and low evidence of improved stress/distress and mental health-related quality of life. We found low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight. We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies).
CONCLUSIONS AND RELEVANCE: Clinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. Thus, clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior.
Source : Jama Internal Medicine
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Optimal Serum Selenium Concentrations Are Associated with Lower Depressive Symptoms and Negative Mood among Young Adults1,2,3
Background: There is evidence that low, and possibly high, selenium status is associated with depressed mood. More evidence is needed to determine whether this pattern occurs in young adults with a wide range of serum concentrations of selenium.
Objective: The aim of this study was to determine if serum selenium concentration is associated with depressive symptoms and daily mood states in young adults.
Methods: A total of 978 young adults (aged 17–25 y) completed the Center for Epidemiological Studies–Depression scale and reported their negative and positive mood daily for 13 d using an Internet diary. Serum selenium concentration was determined by inductively coupled plasma mass spectrometry. ANCOVA and regression models tested the linear and curvilinear associations between decile of serum selenium concentration and mood outcomes, controlling for age, gender, ethnicity, BMI, and weekly alcohol intake. Smoking and childhood socioeconomic status were further controlled in a subset of participants.
Results: The mean ± SD serum selenium concentration was 82 ± 18 μg/L and ranged from 49 to 450 μg/L. Participants with the lowest serum selenium concentration (62 ± 4 μg/L; decile 1) and, to a lesser extent, those with the highest serum selenium concentration (110 ± 38 μg/L; decile 10) had significantly greater adjusted depressive symptoms than did participants with midrange serum selenium concentrations (82 ± 1 to 85 ± 1 μg/L; deciles 6 and 7). Depressive symptomatology was lowest at a selenium concentration of ∼85 μg/L. Patterns for negative mood were similar but more U-shaped. Positive mood showed an inverse U-shaped association with selenium, but this pattern was less consistent than depressive symptoms or negative mood.
Conclusions: In young adults, an optimal range of serum selenium between ∼82 and 85 μg/L was associated with reduced risk of depressive symptomatology. This range approximates the values at which glutathione peroxidase is maximal, suggesting that future research should investigate antioxidant pathways linking selenium to mood
Source : The Journal of Nutrition
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Vitamin D deficiency and depression in adults: systematic review and meta-analysis
Rebecca E. S. Anglin, Zainab Samaan, Stephen D. Walter and Sarah D. McDonald
There is conflicting evidence about the relationship between vitamin D deficiency and depression, and a systematic
assessment of the literature has not been available.
To determine the relationship, if any, between vitamin D deficiency and depression.
A systematic review and meta-analysis of observational studies and randomised controlled trials was conducted.
One case–control study, ten cross-sectional studies and three cohort studies with a total of 31 424 participants
were analysed. Lower vitamin D levels were found in people with depression compared with controls (SMD = 0.60,
95% CI 0.23–0.97) and there was an increased odds ratio of depression for the lowest v. highest vitamin D categories in
the cross-sectional studies (OR = 1.31, 95% CI 1.0–1.71). The cohort studies showed a significantly increased hazard ratio
of depression for the lowest v. highest vitamin D categories (HR = 2.21, 95% CI 1.40–3.49).
Our analyses are consistent with the hypothesis that low vitamin D concentration is associated with depression, and
highlight the need for randomised controlled trials of vitamin D for the prevention and treatment of depression to
determine whether this association is causal.
Source : British Journal of Psychiatry
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New study provides insight into relationship between depression and dementia
A new study by neuropsychiatric researchers at Rush University Medical Center gives insight into the relationship between depression and dementia. The study is published in the July 30, 2014, online issue of Neurology®, the medical journal of the American Academy of Neurology.
"Studies have shown that people with symptoms of depression are more likely to develop dementia, but we haven't known how the relationship works," said study author Robert S. Wilson, PhD, neuropsychiatrist at the Rush Alzheimer's Disease Center and lead study investigator. "Is the depression a consequence of the dementia? Do both problems develop from the same underlying problems in the brain? Or does the relationship of depression with dementia have nothing to do with dementia-related pathology?"
The current study indicates that the association of depression with dementia is independent of dementia-related brain changes. "These findings are exciting because they suggest depression truly is a risk factor for dementia, and if we can target and prevent or treat depression and causes of stress we may have the potential to help people maintain their thinking and memory abilities into old age," Wilson said.
The study involved 1,764 people from the Religious Orders Study and the Rush Memory and Aging Project with an average age of 77 who had no thinking or memory problems at the start of the study. Participants were screened every year for symptoms of depression, such as loneliness and lack of appetite, and took tests on their thinking and memory skills for an average of eight years. A total of 680 people died during the study, and autopsies were performed on 582 of them to look for the plaques and tangles in the brain that are the signs of dementia and other signs of damage in the brain.
During the study, 922 people, or 52 percent of the participants, developed mild cognitive impairment (MCI), or mild problems with memory and thinking abilities that is often a precursor to Alzheimer's disease. A total of 315 people, or 18 percent, developed dementia.
The researchers found no relationship between how much damage was found in the brain and the level of depression symptoms people had or in the change in depression symptoms over time.
People who developed mild cognitive impairment were more likely to have a higher level of symptoms of depression before they were diagnosed, but they were no more likely to have any change in symptoms of depression after the diagnosis than people without MCI. People with dementia were also more likely to have a higher level of depression symptoms before the dementia started, but they had a more rapid decrease in depression symptoms after dementia developed.
Having a higher level of depression symptoms was associated with more rapid decline in thinking and memory skills, accounting for 4.4 percent of the difference in decline that could not be attributed to the level of damage in the brain.
Source : News Medical
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Antidepressant-like effect of hyperoside isolated from Apocynum venetum leaves: Possible cellular mechanisms
In the present work, we studied the possible cellular mechanisms of hyperoside isolated from Apocynum venetum leaves in corticosterone-induced neurotoxicity, using PC12 cells as a suitable in vitro model of depression. Cell viability was quantitated by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. The release amount of lactic dehydrogenase (LDH) and intracellular Ca2+ concentration were measured using kit and transcript abundances of brain-derived neurotrophic factor (BDNF) and cAMP response element binding protein (CREB) were determined by real-time RT-PCR.
The results of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and lactic dehydrogenase (LDH) assays showed that 2.5, 5 and 10μg/ml hyperoside or 10μM fluoxetine (FLU) protected PC12 cells from the lesion induced by a 48h treatment with 10μM corticosterone. Fura-2/AM (acetoxymethyl ester) assays showed that 2.5, 5 and 10μg/ml hyperoside or 10μM FLU attenuated the intracellular Ca2+ overloading in PC12 cells induced by corticosterone. The transcript abundance of BDNF and CREB in PC12 cells was elevated upon hyperoside treatment. These results suggest that the possible cellular mechanisms of hyperoside antidepressant-like effect is a cytoprotective action related to elevation the expression of BDNF and CREB through the signal pathway AC–cAMP–CREB.
Source : Intl Journal of Phytotherapy and Phytopharmacology
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Antidepressant-like effect of Salvia sclarea is explained by modulation of dopamine activities in rats
.Seol GH1, Shim HS, Kim PJ, Moon HK, Lee KH, Shim I, Suh SH, Min SS.Author information
AIM OF THE STUDY: The purpose of the present study was to screen aromatic essential oils that have antidepressant effects to identify the regulatory mechanisms of selected essential oils.
MATERIALS AND METHODS: The antidepressant effects of essential oils of Anthemis nobilis (chamomile), Salvia sclarea (clary sage; clary), Rosmarinus officinalis (rosemary), and Lavandula angustifolia (lavender) were assessed using a forced swim test (FST) in rats. Rats were treated with essential oils by intraperitoneal injection or inhalation. Serum levels of corticosterone were assessed by enzyme-linked immunosorbent assay (ELISA).
RESULTS: Among the essential oils tested, 5% (v/v) clary oil had the strongest anti-stressor effect in the FST. We further investigated the mechanism of clary oil antidepression by pretreatment with agonists or antagonists to serotonin (5-HT), dopamine (DA), adrenaline, and GABA receptors. The anti-stressor effect of clary oil was significantly blocked by pretreatment with buspirone (a 5-HT(1A) agonist), SCH-23390 (a D(1) receptor antagonist) and haloperidol (a D(2), D(3), and D(4) receptor antagonist).
CONCLUSIONS: Our findings indicate that clary oil could be developed as a therapeutic agent for patients with depression and that the antidepressant-like effect of clary oil is closely associated with modulation of the DAnergic pathway.
Source : J Ethnopharmacol.
Link to Abstract
Antioxidants prevent memory deficits provoked by chronic variable stress in rats.
Tagliari B1, Scherer EB, Machado FR, Ferreira AG, Dalmaz C, Wyse AT.Author information
Learning and memory deficits occur in depression and other stress related disorders. Although the pathogenesis of cognitive impairment after stress has not been fully elucidated, factors such as oxidative stress and neurotrophins are thought to play possible roles. Here we investigated the effect of treatment with vitamin E (40 mg/kg) and vitamin C (100 mg/kg) on the effects elicited by chronic variable stress on rat performance in Morris water maze. Brain-derived neurotrophic factor (BDNF) immunocontent was also evaluated in hippocampus of rats. Sixty-day old Wistar rats were submitted to different stressors for 40 days (stressed group). Half of stressed group received administration of vitamins once a day, during the period of stress. Chronically stressed rats presented a marked decrease in reference memory in the water maze task as well as a reduced efficiency to find the platform in the working memory task. Rats treated with vitamins E and C had part of the above effects prevented, suggesting the participation of oxidative stress in such effects. The BDNF levels were not altered in hippocampus of stressed group when compared to controls. Our findings lend support to a novel therapeutic strategy, associated with these vitamins, to the cognitive dysfunction observed in depression and other stress related diseases.
Source : Neurochem Res
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Antidepressant-like effects of omega-3 fatty acids in postpartum model of depression in rats.
Arbabi L1, Baharuldin MT2, Moklas MA1, Fakurazi S1, Muhammad SI3.Author information
Postpartum depression (PPD) is a psychiatric disorder that occurs in 10-15% of childbearing women. It is hypothesized that omega-3 fatty acids, which are components of fish oil, may attenuate depression symptoms. In order to examine this hypothesis, the animal model of postpartum depression was established in the present study. Ovariectomized female rats underwent hormone-simulated pregnancy (HSP) regimen and received progesterone and estradiol benzoate or vehicle for 23 days, mimicking the actual rat's pregnancy. The days after hormone termination were considered as the postpartum period. Forced feeding of menhaden fish oil, as a source of omega-3, with three doses of 1, 3, and 9g/kg/d, fluoxetine 15mg/kg/d, and distilled water 2ml/d per rat started in five postpartum-induced and one vehicle group on postpartum day 1 and continued for 15 consecutive days. On postpartum day 15, all groups were tested in the forced swimming test (FST) and open field test (OFT), followed by a biochemical assay. Results showed that the postpartum-induced rats not treated with menhaden fish oil, exhibited an increase in immobility time seen in FST, hippocampal concentration of corticosterone and plasmatic level of corticosterone, and pro-inflammatory cytokines. These depression-related effects were attenuated by supplementation of menhaden fish oil with doses of 3 and 9g/kg. Moreover, results of rats supplemented with menhaden fish oil were comparable to rats treated with the clinically effective antidepressant, fluoxetine. Taken together, these results suggest that menhaden fish oil, rich in omega-3, exerts beneficial effect on postpartum depression and decreases the biomarkers related to depression such as corticosterone and pro-inflammatory cytokines.
Source : Behav. Brain Res
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Effects of the Kampo Formula Tokishakuyakusan on Headaches and Concomitant Depression in Middle-Aged Women
Masakazu Terauchi,1 Shiro Hiramitsu,2 Mihoko Akiyoshi, 2 Yoko Owa,2 Kiyoko Kato, 2 Satoshi Obayashi, 2
Eisuke Matsushima,and Toshiro Kubota 2
1Department of Women’s Health, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo 113-8510, Japan
2 Department of Obstetrics and Gyneco logy, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo 113-8510, Japan
3 Department of Psychosomatics, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo, Tokyo 113-8510, Japan
Objectives. To identify the correlates of headaches in middle-aged women and investigate the effects of Tokishakuyakusan (TJ-23),a formula of traditional Japanese herbal therapy Kampo, on headache and concomitant depression.
Methods. We examined cross-sectionally the baseline records of 345 women aged 40–59 years who visited our menopause clinic. Among them, 37 women with headaches were treated with either hormone therapy (HT) or TJ-23; the data of these women were retrospectively analyzed to compare the effects of the treatment.
Results. The women were classified into 4 groups on the basis of their headache frequency, andno significant intergroup differences were noted in the physical or lifestyle factors, except age. Multiple logistic regression analysis revealed that the significant contributors to the women’s headaches were their age (adjusted OR 0.92 (95% CI 0.88–0.97)) and their depressive symptoms (adjusted OR 1.73 (95% CI 1.39–2.16)). Compared to women treated with HT, women treated with TJ-23 reported relief from headaches (65% versus 29%) and concomitant depression (60% versus 24%) more frequently. Improvement in the scores of headaches and depression correlated significantly with TJ-23 treatment.
Conclusions. Headache in middle-aged women is significantly associated with depression; TJ-23 could be effective for treating both of these symptoms
Source : Evidence Based Complementary and Alternative Medicine
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Ginseng Total Saponins Reverse Corticosterone-Induced Changes in Depression-Like Behavior and Hippocampal Plasticity-Related Proteins by Interfering with GSK-3β-CREB Signaling Pathway
Lin Chen, 1 Jianguo Dai, 1 Zhongli Wang, 1 Huiyu Zhang, 1 Yufang Huang, 1 , 2 ,* and Yunan Zhao 1 , 3 ,*
This study aimed to explore the antidepressant mechanisms of ginseng total saponins (GTS) in the corticosterone-induced mouse depression model. In Experiment 1, GTS (50, 25, and 12.5mgkg−1d−1, intragastrically) were given for 3 weeks. In Experiment 2, the same doses of GTS were administrated after each corticosterone (20mgkg−1d−1, subcutaneously) injection for 22 days. In both experiments, mice underwent a forced swimming test and a tail suspension test on day 20 and day 21, respectively, and were sacrificed on day 22. Results of Experiment 1 revealed that GTS (50 and 25mgkg−1d−1) exhibited antidepressant activity and not statistically altered hippocampal protein levels of brain-derived neurotrophic factor (BDNF) and neurofilament light chain (NF-L). Results of Experiment 2 showed that GTS (50 and 25mgkg−1d−1) ameliorated depression-like behavior without normalizing hypercortisolism. The GTS treatments reversed the corticosterone-induced changes in mRNA levels of BDNF and NF-L, and protein levels of BDNF NF-L, phosphor-cAMP response element-binding protein (Ser133), and phosphor-glycogen synthase kinase-3β (Ser9) in the hippocampus. These findings imply that the effect of GTS on corticosterone-induced depression-like behavior may be mediated partly through interfering with hippocampal GSK-3β-CREB signaling pathway and reversing decrease of some plasticity-related proteins.
The structural plasticity of the adult hippocampus is critical for the action of antidepressants and the underlying pathophysiology of depression. In the corticosterone-induced mouse depression model, certain doses of GTS exhibit antidepressant-like activities by reversing the decrease of some plasticity-related proteins and activating the CREB-BDNF signaling pathway in hippocampus. The promotion of GSK-3β inhibitory phosphorylation which activates the CREB-BDNF signaling pathway may account for the antidepressant-like activity of GTS.
Source : Evidence Based Complementary and Alternative Medicine
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Effects of Buddhism Walking Meditation on Depression, Functional Fitness, and Endothelium-Dependent Vasodilation in Depressed Elderly.
Prakhinkit S1, Suppapitiporn S, Tanaka H, Suksom D.
Objectives: The objectives of this study were to determine the effects of the novel Buddhism-based walking meditation (BWM) and the traditional walking exercise (TWE) on depression, functional fitness, and vascular reactivity. Design: This was a randomized exercise intervention study. Settings/location: The study was conducted in a university hospital setting.
Subjects: Forty-five elderly participants aged 60-90 years with mild-to-moderate depressive symptoms were randomly allocated to the sedentary control, TWE, and BWM groups. Interventions: The BWM program was based on aerobic walking exercise incorporating the Buddhist meditations performed 3 times/week for 12 weeks.
Outcome measures: Depression score, functional fitness, and endothelium-dependent vasodilation as measured by the flow-mediated dilation (FMD) were the outcome measures used.
Results: Muscle strength, flexibility, agility, dynamic balance, and cardiorespiratory endurance increased in both exercise groups (p<0.05). Depression score decreased (p<0.05) only in the BWM group. FMD improved (p<0.05) in both exercise groups. Significant reduction in plasma cholesterol, triglyceride, high-density lipoprotein cholesterol, and C-reactive protein were found in both exercise groups, whereas low-density lipoprotein cholesterol, cortisol, and interleukin-6 concentrations decreased only in the BWM group.
Conclusions: Buddhist walking meditation was effective in reducing depression, improving functional fitness and vascular reactivity, and appears to confer greater overall improvements than the traditional walking program.
Source : Journal Alternative Complementary Medicine
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Mood improvement in young adult males following supplementation with gold kiwifruit, a high-vitamin C food
Anitra C. Carr*, Stephanie M. Bozonet, Juliet M. Pullar and Margreet C. M. Vissers
Centre for Free Radical Research, Department of Pathology, University of Otago, Christchurch, PO Box 4345, Christchurch 8140, New Zealand
Enhanced intakes of fruit and vegetables have been associated with improved psychological well-being. We investigated the potential mood-enhancing effects of kiwifruit, a fruit rich in vitamin C and a number of other important micronutrients. Young adult males (n35) were supplemented with either half or two kiwifruit/d for 6 weeks. Profile of Mood States questionnaires were completed at baseline and following the intervention. No effect on overall mood was observed in the half a kiwifruit/d group; however, a 35 % (P=0·06) trend towards a decrease in total mood disturbance and a 32 % (P=0·063)trend towards a decrease in depression were observed in the two kiwifruit/d group. Subgroup analysis indicated that participants with higher baseline mood disturbance exhibited a significant 38 % (P=0·029) decrease in total mood disturbance, as well as a 38 % (P=0·048) decrease in fatigue, 31 % (P=0·024)increase in vigour and a 34 % (P=0·075) trend towards a decrease in depression, following supplementation with two kiwifruit/d. There was no effect of two kiwifruit/d on the mood scores of participants with lower baseline mood disturbance. Dietary intakes and body status of specific micronutrients indicated a significant increase in the participants’ vitamin C intakes and corresponding plasma levels of the vitamin. The results indicate that enhanced intake of kiwifruit by individuals with moderate mood disturbance can improve overall mood.
Source : Journal of Nutritional Science
Link to full Article.
Moderate Exercise Not Only Treats, but Prevents Depression
Physical activity is being increasingly recognized as an effective tool to treat depression. PhD candidate George Mammen’s review published in the October issue of the American Journal of Preventive Medicine has taken the connection one step further, finding that moderate exercise can actually prevent episodes of depression in the long term.
This is the first longitudinal review to focus exclusively on the role that exercise plays in maintaining good mental health and preventing the onset of depression later in life.
Mammen—who is supervised by Professor Guy Faulkner, a co-author of the review— analyzed over 26 years’ worth of research findings to discover that even low levels of physical activity (walking and gardening for 20-30 minutes a day) can ward off depression in people of all age groups.
Mammen’s findings come at a time when mental health experts want to expand their approach beyond treating depression with costly prescription medication. “We need a prevention strategy now more than ever,” he says. “Our health system is taxed. We need to shift focus and look for ways to fend off depression from the start.”
Mammen acknowledges that other factors influence a person’s likelihood of experiencing depression, including their genetic makeup. But he says that the scope of research he assessed demonstrates that regardless of individual predispositions, there’s a clear take-away for everyone. “It’s definitely worth taking note that if you’re currently active, you should sustain it. If you’re not physically active, you should initiate the habit. This review shows promising evidence that the impact of being active goes far beyond the physical.”
Source : Newswise
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The Role of Mindfulness and Psychological Flexibility in Somatization, Depression, Anxiety, and General Psychological Distress in a Nonclinical College Sample
Akihiko Masuda, PhD1 and Erin C. Tully, PhD1
The current study investigated whether mindfulness and psychological flexibility uniquely and separately accounted for
variability in psychological distress (somatization, depression, anxiety, and general psychologicaldistress).Anethnicallydiverse,
nonclinical sample of college undergraduates (N=494, 76% female) completed a Web-based survey that included the self-
report measures of interest. Consistent with prior research, psychological flexibility and mindfulness were positively associated
with each other, and tested separately, both variables were negatively associated with somatization, depression, anxiety, and
general psychological distress. Results also revealed that psychological flexibility and mindfulness accounted for unique variance
in all 4 measures of distress. These findings suggest that mindfulness and psychological flexibility are interrelated but not redun-
dant constructs and that both constructs are important for understanding the onset and maintenance of somatization, depres-
sion,anxiety,and general distress.
Source : Journal of Evidence Based Complementary and Alternative Medicine
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Acupuncture and Counselling for Depression in Primary Care: A Randomised Controlled Trial
Hugh MacPherson, Stewart Richmond, Martin Bland,Stephen Brealey, Rhian Gabe,Ann Hopton, Ada Keding,
Harriet Lansdown, Sara Perren, Mark Sculpher, Eldon Spackman, David Torgerson, Ian Watt
Depression is a significant cause of morbidity. Many patients have communicated an interest in non-pharmacological therapies to their general practitioners. Systematic reviews of acupuncture and counselling for depression in primary care have identified limited evidence. The aim of this study was to evaluate acupuncture versus usual care and counselling versus usual care for patients who continue to experience depression in primary care.
Methods and Findings
In a randomised controlled trial, 755 patients with depression (Beck Depression Inventory BDI-II score ≥20) were recruited from 27 primary care practices in the North of England. Patients were randomised to one of three arms using a ratio of 2:2:1 to acupuncture (302), counselling (302), and usual care alone (151). The primary outcome was the difference in mean Patient Health Questionnaire (PHQ-9) scores at 3 months with secondary analyses over 12 months follow-up. Analysis was by intention-to-treat.
PHQ-9 data were available for 614 patients at 3 months and 572 patients at 12 months. Patients attended a mean of ten sessions for acupuncture and nine sessions for counselling. Compared to usual care, there was a statistically significant reduction in mean PHQ-9 depression scores at 3 months for acupuncture (−2.46, 95% CI −3.72 to −1.21) and counselling (−1.73, 95% CI −3.00 to −0.45), and over 12 months for acupuncture (−1.55, 95% CI −2.41 to −0.70) and counselling (−1.50, 95% CI −2.43 to −0.58). Differences between acupuncture and counselling were not significant. In terms of limitations, the trial was not designed to separate out specific from non-specific effects. No serious treatment-related adverse events were reported.
In this randomised controlled trial of acupuncture and counselling for patients presenting with depression, after having consulted their general practitioner in primary care, both interventions were associated with significantly reduced depression at 3 months when compared to usual care alone.
Source : PLOS Medicine
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Clinical Trial Demonstrates that a Standardized Curcumin Product Is Efficacious in Treating Major Depressive Disorder
Sanmukhani J, Satodia V, Trivedi J, et al. Efficacy and safety of curcumin in major depressive disorder: a randomized controlled trial. Phytother Res. 2013; [epub ahead of print]. doi: 10.1002/ptr.5025.
Depression affects many people throughout the world and can be the cause of disruptive health problems, and can even lead to suicide. Although standard pharmaceutical treatments exist, chronic use of them may result in adverse effects. Botanicals may provide therapeutic options for depression with greater tolerability. Curcumin, a compound found in turmeric (Curcuma longa) root, has been shown to alleviate depression previously; suggested mechanisms include impacts on neurotransmitters and the potentiation of other antidepressant pharmaceuticals. This 6-week, randomized, controlled trial investigated curcumin, the standard antidepressant fluoxetine, and a combination of both treatments in patients suffering from major depressive disorder (MDD).
Patients diagnosed with MDD were recruited at Sir Takhtasinhji General Hospital in Bhavnagar, Gujarat, India. Patients were older than 18 years of age, had access to a caregiver, and rated higher than 7 on the Hamilton Depression Rating Scale (17-item version; HAM-D17). This scale rates symptoms of depression, and total scores of 0-7 are considered normal. Those suffering from other severe mental illness, including those with suicidal tendencies, seizures, thyroid disorders, or allergies to the study treatments, were excluded. Those for whom at least 2 other antidepressants had failed to work, those who had taken antidepressants or an "investigational" drug within 30 days prior to the study, and those who were participating in therapy were excluded. Included female patients were using contraception and were not pregnant at the time of the study's beginning.
Curcumin (50-mg capsules) was procured from Arjuna Natural Extracts; Kochi, Kerala, India. Capsules were standardized to contain 88% curcuminoids and 7% volatile oils, and the daily dose of curcumin was 1000 mg. Fluoxetine (20-mg capsules of Flunil-20®) was obtained from Intas Pharmaceuticals; Ahmedabad, Gujarat, India. The fluoxetine dosage was 20 mg per day. Prior to being randomly assigned, patients were subjected to physical and psychiatric exams, laboratory parameters, and vital sign measurements. Patients were randomly assigned to groups taking either fluoxetine only, curcumin only, or both fluoxetine at 20 mg/day and curcumin at 1000 mg/day, for 6 weeks. Curcumin was administered twice daily, 12 hours apart, in 500-mg doses taken after breakfast and dinner. During the first 2 weeks of the study, paracetamol and benzodiazepines were permitted to treat headaches and insomnia, respectively. At 2, 4, and 6 weeks into the study, parameters were measured.
The primary outcome was the HAM-D17 score, followed by the mean change in the score and the remission rate. Secondary outcomes included patients' rate of response on the Clinical Global Impression-Improvement (CGI-I) assessment scale and scores on the Clinical Global Impression-Severity of Illness (CGI-S) scale. The CGI-I is a 7-point scale where 1 means "very much improved" and 7 means "very much worse"; and the CGI-S is a 7-point scale where 1 means "normal/not at all ill" and 7 means "extremely ill." Safety was assessed by treatment-emergent adverse events (TEAEs), the measurement of vital signs, and physical exams during clinical visits. Laboratory parameters were also measured at the end of the study. Those with a HAM-D17 score of ≤ 7 were considered to be in remission; a 50% decline in HAM-D17 scores as compared with baseline scores constituted a response. According to the CGI-I scale, a score of 1 or 2 indicated a response. Efficacy and tolerability were classified as "excellent, good, fair, or poor." Pill counting was done to assess compliance.
Of the patients recruited, 60 were enrolled and were randomly assigned to the 3 groups (n=20 per group). Overall, there were no "major" deviations or violations of the protocol. Because of either loss to follow-up or withdrawal due to adverse effects (fluoxetine group), 45 patients completed the study, with 16 in the fluoxetine group, 14 in the curcumin group, and 15 in the combination group for the per-protocol analysis (the intention-to-treat [ITT] population was n=17 in the fluoxetine group, n=16 in the curcumin group, and n=18 in the combination group). According to the HAM-D17, a greater response to treatment in the ITT population was observed in the combination group compared to the curcumin group and the fluoxetine group; this was not significantly different (77.8% vs. 62.5% and 64.7%, respectively; P=0.58).
At the end of the study, the mean changes in the HAM-D17 scores in the ITT population were not significantly different between the combination group (-14.8; 95% confidence interval [CI]: -17.6, -12.0) and the fluoxetine group (-14.0; 95% CI: -18.2, -9.8) or the curcumin group (-12.6; 95% CI: -15.8, -9.5; P=0.77). This was also true of the rate of remission (P=0.58), and the results were the same in the per-protocol analysis. The efficacy rating was either "excellent" or "good" for 70.5% of those in the fluoxetine group, 75% of those in the curcumin group, and 83.3% of those in the combination group; there were no significant differences between them (P=0.66).
TEAEs were observed in 2 patients in the fluoxetine group, 2 in the curcumin group, and 5 in the combination group. Adverse effects were classified as "mild" and included gastritis, giddiness, hot flashes, nausea, photosensitivity, and mouth ulcers. No significant differences were seen at the end of the study as compared to baseline in patients' laboratory or physical parameters. Although tolerability was rated as "excellent" for 82.3% of those in the fluoxetine group and 87.5% of those in the curcumin group as compared with 66.6% of those in the combination group, these differences were not significant (P=0.30).
This study showed curcumin to have similar efficacy as fluoxetine. It is suggested that curcumin's bioactivity may be due to effects on neurotransmitters such as serotonin, or the concurrent potentiation of antidepressant pharmaceuticals. This study also shows curcumin to be well tolerated, with no serious adverse effects. It is discussed that curcumin's bioavailability was improved through the addition of curcuminoids and volatile oils, although this additive process is not described in the methods. Discussed shortcomings of this trial include the intentionally small sample size and the absence of a placebo group. Also, patients were not blinded to the treatments. A future, double-blind, placebo-controlled clinical trial will likely confirm curcumin as a good candidate for the treatment of MDD, both alone and in combination with standard treatments.
--Amy C. Keller, PhD
Source : American Botanical Council
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Coenzyme Q10 Effects on Creatine Kinase Activity and Mood in Geriatric Bipolar Depression
- Brent P. Forester, MD, MSc1,2⇓
- Chun S. Zuo, PhD2,3
- Caitlin Ravichandran, PhD2,4
- David G. Harper, PhD1,2
- Fei Du, PhD2,3
- Susan Kim, BA1
- Bruce M. Cohen, MD, Ph.D2,5
- Perry F. Renshaw, MD, PhD, MBA6
- 1Geriatric Psychiatry Research Program, McLean Hospital, MA, USA
- 2Harvard Medical School, MA, USA
- 3Neuroimaging Imaging Center, McLean Hospital, MA, USA
- 4McLean Hospital Laboratory for Psychiatric Biostatistics, MA, USA
- 5Shervert Frazier Research Institute, McLean Hospital, MA, USA
- 6The Brain Institute at the University of Utah, MA, USA
Introduction: Despite the prevalence, associated comorbidities, and functional consequences of bipolar depression (BPD), underlying disease mechanisms remain unclear. Published studies of individuals with bipolar disorder implicate abnormalities in cellular energy metabolism. This study tests the hypotheses that the forward rate constant (kfor) of creatine kinase (CK) is altered in older adults with BPD and that CoEnzyme Q10 (CoQ10), known to have properties that enhance mitochondrial function, increases kfor in elderly individuals with BPD treated with CoQ10 compared with untreated age- and sex-matched controls.
Methods: Ten older adults (ages 55 and above) with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition [DSM IV]) bipolar disorder, current episode depressed and 8 older controls underwent two 4 Tesla 31Phosphorus magnetic resonance spectroscopy (31PMRS) scans 8 weeks apart using a magnetization transfer (MT) acquisition scheme to calculate kfor. The BPD group was treated with open-label CoEnzyme Q10 400 mg/d titrated up by 400 mg/d every 2 weeks to a maximum of 1200 mg/d. The Montgomery Asberg Depression Rating Scale (MADRS) was used to measure depression symptom severity. Baseline kfor and changes in kfor were compared between individuals with BPD and controls, not receiving CoQ. Clinical ratings were compared across time and associated with kfor changes using repeated measures linear regression.
Results: The kfor of CK was nonsignificantly lower for BPD than healthy controls at baseline (BPD mean (standard deviation [SD]) = 0.19 (0.02), control mean (SD) = 0.20 (0.02), Wilcoxon rank sum exact P = .40). The kfor for both CoQ10-treated BPD and controls increased after 8 weeks (mean increase (SD) = 0.03 (0.04), Wilcoxon signed rank exact P = .01), with no significant difference in 8-week changes between groups (BPD mean change (SD) = 0.03 (0.03), control mean change (SD) = 0.03 (0.05), Wilcoxon rank sum exact P = .91). In an exploratory analysis, depression severity decreased with CoQ10 treatment in the group with BPD (F 3,7 = 4.87, P = .04) with significant reductions in the MADRS at weeks 2 (t 9 = −2.40, P = .04) and 4 (t 9 = −3.80, P = .004).
Conclusions: This study employing the novel MRS technique of MT did not demonstrate significance between group differences in the kfor of CK but did observe a trend that would require confirmation in a larger study. An exploratory analysis suggested a reduction in depression symptom severity during treatment with high-dose CoEnzyme Q10 for older adults with BPD. Further studies exploring alterations of high-energy phosphate metabolites in geriatric BPD and efficacy studies of CoQ10 in a randomized controlled trial are both warranted.
Source : J Geriatr Psychiatry Neurol
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Co-occurrence of Anemia, Marginal Vitamin B6, and Folate Status and Depressive Symptoms in Older Adults
Wen-Harn Pan, PhD1,2,3,4⇓, Yi-Ping Chang, EdD5, Wen-Ting Yeh, MS2, Yu-Shu Guei, BS6, Bi-Fong Lin, PhD3, Ien-Lan Wei, PhD7, Feili Lo Yang, PhD8, Yung-Po Liaw, PhD6,9, Kuan-Ju Chen, PhD10, Wei J. Chen, MD, ScD4
- 1Nutrition Medicine Research Program, Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, Maoli, Taiwan
- 2Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- 3Institute of Microbiology and Biochemistry, National Taiwan University, Taipei, Taiwan
- 4Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
- 5Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
- 6Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan
- 7School of Nursing, National Yang-Ming University, Taipei, Taiwan
- 8Department of Nutrition and Food Sciences, Fu-Jen University, Hsin-Chung, Taipei, Taiwan
- 9Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- 10Department of Hospitality Management, Chung Hwa University of Medical Technology, Tainan County, Taiwan
- Wen-Harn Pan, Nutrition Medicine Research Program, Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County 35053, Taiwan OR Institute of Biomedical Sciences, Academia Sinica, no. 128, Section 2, Academia Road, Taipei 14529, Taiwan Email: email@example.com OR firstname.lastname@example.org
Although nutrient deficiencies are thought to play roles in the development of depression, observational studies have yielded inconsistent results. This study aimed to investigate whether multiple marginal nutrient deficiencies are associated with symptoms of depression in community-dwelling older Taiwanese. Data from 1371 elderly adults recruited from the Elderly Nutrition and Health Survey in Taiwan was used in this study. Depressive symptom scores on depressed mood and emotions affecting daily life were derived from the Medical Outcomes Study Short Form-36 (SF-36). Hemoglobin, serum ferritin, plasma vitamins B6, B12, and folate concentration, and erythrocyte transketolase and glutathione reductase activation coefficients were measured. After adjusting for age, gender, cognitive function, physical activity, disease history, and medication in the multivariate analysis, anemia, and marginal B6 deficiency were significantly associated with the presence of depression symptoms, respectively. In addition, co-occurrence of vitamin B6 with low folate level and co-occurrence of anemia either with low vitamin B6 or with folate level were all associated with the depressive mood and with depressive emotions defined by SF-36 (odds ratios [OR] in the range of 2.32−7.13, all P values ≤.05). The magnitude of the ORs is larger when the number of deficiencies increased. Elderly people with coexisting marginal deficiencies of nutrients involved in the S-adenosylmethionine and hemoglobin production were more likely to experience depressed mood and emotion that affect daily activity. Examining status of these nutrients is worthy of consideration for older adults with depressed symptoms.
Source : J Geriatr Psychiatry Neurol
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Anxiety, Depression Identify Heart Disease Patients at Increased Risk of Dying
Heart disease patients who have anxiety have twice the risk of dying from any cause compared to those without anxiety, according to new research in the Journal of the American Heart Association.
Patients with both anxiety and depression have triple the risk of dying, researchers said.
"Many studies have linked depression to an increased risk of death in heart disease patients," said Lana Watkins, Ph.D., lead author of the study and an associate professor in Psychiatry and Behavioral Sciences at Duke University Medical Center in Durham, N.C. "However, anxiety hasn't received as much attention."
Studies show that depression is about three times more common in heart attack patients. The American Heart Association recommends that heart patients be screened for depression and treated if necessary.
Depressed heart disease patients often also have anxiety, suggesting it may underlie the risk previously attributed solely to depression, Watkins said. "It's now time for anxiety to be considered as important as depression, and for it to be examined carefully."
In the study, 934 heart disease patients, average age 62, completed a questionnaire measuring their level of anxiety and depression immediately before or after a cardiac catheterization procedure at Duke University Medical Center. Patients had anxiety if they scored 8 or higher on a scale composed of seven common characteristics of anxiety, with each item rated from 0 to 3 (range of possible scores: 0-21). Depression was measured using a similar scale composed of seven symptoms of depression.
Researchers, after accounting for age, congestive heart failure, kidney disease and other factors that affect death risk, found:
- 90 of the 934 patients experienced anxiety only, 65 experienced depression only and 99 suffered anxiety and depression.
- Among 133 patients who died during three years of follow-up, 55 had anxiety, depression or both. The majority of deaths (93 of 133) were heart-related.
Anxiety and depression each influence risk of death in unique ways. Anxiety, for example, increases activity of the sympathetic (adrenaline-producing) nervous system that controls blood pressure.
"People who worry a lot are more likely to have difficulty sleeping and to develop high blood pressure," Watkins said.
The link between depression and mortality is more related to behavioral risk factors, she said. "Depression results in lack of adherence to medical advice and treatments, along with behaviors like smoking and being sedentary."
Future studies should test strategies to manage anxiety alone and with depression in heart disease patients, Watkins said.
"Anxiety reducing medications combined with stress management could improve outcome for patients with just anxiety, whereas patients with anxiety and depression may need a stronger intervention involving more frequent outpatient monitoring and incentives to improve adherence," she said.
Source : Science Daily
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Tai Chi as an Alternative or Complementary Therapy for Patients With Depression : A Systematic Review
Manoj Sharma, MBBS, MCHES, PhD, FAAHB1 and Taj Haider, MPH2
Considering depression ranks high among the contributors to worldwide disease burden and conventional treatments have
severe limitations, Tai Chi, due to its holistic approach, is being explored as an alternative therapy. A systematic review was
conducted to determine the efficacy of Tai Chi as a treatment option for depression. Inclusion criteria included the following: (a)
studies published in the English language, (b) studies published between January 2007 and July 2012, (c) studies that included Tai
Chi as a therapy in an intervention, (d) studies that used any quantitative study design, and (e) studies that measured depression as an outcome. A total of 11 studies met these criteria. The efficacy of Tai Chi as an alternative and complementary treatment for
depression is mixed. Limitations of the reviewed interventions included a mixed usage of instruments, high dropout rates, low
sample sizes, and a lack of quality assessment tools for Tai Chi.
Although 63.6% of the studies (7 of 11) reported statistically significant reduction in depression at some point during the intervention, the multitude of scales enlisted, small sample sizes, the lack of a Tai Chi quality assessment tool, and the lack
of follow-up for the majority of the studies makes it difficult to draw conclusions regarding Tai Chi as a robust treatment for
depression.....The findings of the review indicate that Tai Chi can reduce depression, but the dosage modality and quality of the training to achieve statistically significant improvements is still not known
Source : Journal of Evidence-Based Complementary & Alternative Medicine 2013 18: 43
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Treating Vitamin D Deficiency May Improve Depression
Women with moderate to severe depression had substantial improvement in their symptoms of depression after they received treatment for their vitamin D deficiency, a new study finds. The case report series will be presented Saturday at The Endocrine Society’s 94th Annual Meeting in Houston.Because the women did not change their antidepressant medications or other environmental factors that relate to depression, the authors concluded that correction of the patients’ underlying shortage of vitamin D might be responsible for the beneficial effect on depression.
“Vitamin D may have an as-yet-unproven effect on mood, and its deficiency may exacerbate depression,” said Sonal Pathak, MD, an endocrinologist at Bayhealth Medical Center in Dover, Del. “If this association is confirmed, it may improve how we treat depression.”
Pathak presented the research findings in three women, who ranged in age from 42 to 66. All had previously diagnosed major depressive disorder, also called clinical depression, and were receiving antidepressant therapy. The patients also were being treated for either Type 2 diabetes or an underactive thyroid (hypothyroidism).
Because the women had risk factors for vitamin D deficiency, such as low vitamin D intake and poor sun exposure, they each underwent a 25-hydroxyvitamin D blood test. For all three women, the test found low levels of vitamin D, ranging from 8.9 to 14.5 nanograms per milliliter (ng/mL), Pathak reported. Levels below 21 ng/mL are considered vitamin D deficiency, and normal vitamin D levels are above 30 ng/mL, according to The Endocrine Society.
Over eight to 12 weeks, oral vitamin D replacement therapy restored the women’s vitamin D status to normal. Their levels after treatment ranged from 32 to 38 ng/mL according to the study abstract.
After treatment, all three women reported significant improvement in their depression, as found using the Beck Depression Inventory. This 21-item questionnaire scores the severity of sadness and other symptoms of depression. A score of 0 to 9 indicates minimal depression; 10 to 18, mild depression; 19 to 29, moderate depression; and 30 to 63, severe depression.
One woman’s depression score improved from 32 before vitamin D therapy to 12, a change from severe to mild depression. Another woman’s score fell from 26 to 8, indicating she now had minimal symptoms of depression. The third patient’s score of 21 improved after vitamin D treatment to 16, also in the mild range.
Other studies have suggested that vitamin D has an effect on mood and depression, but there is a need for large, good-quality, randomized controlled clinical trials to prove whether there is a real causal relationship, Dr Pathak said.
“Screening at-risk depressed patients for vitamin D deficiency and treating it appropriately may be an easy and cost-effective adjunct to mainstream therapies for depression,” she said.
Source : Newswise
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Daffodils May Fix Depression
Plant compounds from a South African daffodil may be used to treat depression, according to a University of Copenhagen study, where they tested those substance in a laboratory model of the blood-brain barrier.
Substances from the South African plant species Crinum and Cyrtanthus – akin to snowdrops and daffodils, respectively – have characteristics that enable them to negotiate the defensive blood-brain barrier, a key challenge in all new drug development.
Obviously you should not run out and start eating daffodils just yet. The lab test does not show which compounds can be used in drug development.
Associate Professor Birger Brodin says, "Several of our plant compounds can probably be smuggled past the brain's effective barrier proteins. We examined various compounds for their influence on the transporter proteins in the brain. This study was made in a genetically-modified cell model of the blood-brain barrier that contains high levels of the transporter P-glycoprotein. Our results are promising, and several of the chemical compounds studied should therefore be tested further, as candidates for long-term drug development.
"The biggest challenge in medical treatment of diseases of the brain is that the drug cannot pass through the blood-brain barrier. The blood vessels of the brain are impenetrable for most compounds, one reason being the very active transporter proteins. You could say that the proteins pump the drugs out of the cells just as quickly as they are pumped in. So it is of great interest to find compounds that manage to 'trick' this line of defence."
Discovering a new cure in 'Nature's medicine chest' will also take interdisciplinary work between chemists and biologists.
Throughout evolution, plants have developed a number of substances as defenses against herbivores and disease and some of those plant compounds can also be used as medical drugs.
André Huss Eriksson, a research scientist at Bioneer:FARMA, and Associate Professor Birger Brodin contacted Associate Professor Anna Jäger of the Department of Molecular Drug Research and Associate Professor Nina Rønsted of the Natural History Museum of Denmark, who both work with medicinal plants that affect the central nervous system to collaborate on this new work.
"In my research group, we have had a long-term focus on the body’s barrier tissue – and in recent years particularly the transport of drug compounds across the blood-brain barrier. More than 90 per cent of all potential drugs fail the test by not making it through the barrier, or being pumped out as soon as they do get in. Studies of natural therapies are a valuable source of inspiration, giving us knowledge that can also be used in other contexts," said Birger Brodin.
Citation: Eriksson, A. H., Rønsted, N., Güler, S., Jäger, A. K., Sendra, J. R. and Brodin, B. (2012), 'In-vitro evaluation of the P-glycoprotein interactions of a series of potentially CNS-active Amaryllidaceae alkaloids', Journal of Pharmacy and Pharmacology. doi: 10.1111/j.2042-7158.2012.01536.x
Source : Science Codex
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Antidepressant-like effects of methanol extract of Hibiscus tiliaceus flowers in mice
Claudia Vanzella, Paula Bianchetti, Sabrina Sbaraini, Samanta I Vanzin, Maria IS Melecchi, Elina B Caramao and Ionara R Siqueira
Background Hibiscus tiliaceus L. (Malvaceae) is used in postpartum disorders. Our purpose was to examine the antidepressant, anxiolytic and sedative actions of the methanol extract of H. tiliaceus flowers using animal models.
Methods Adult male Swiss albino mice were treated with saline, standard drugs or methanol extract of H. tiliaceus and then subjected to behavioral tests. The forced swimming and tail suspension tests were used as predictive animal models of antidepressant activity, where the time of immobility was considered. The animals were submitted to the elevated plus-maze and ketamine-induced sleeping time to assess anxiolytic and sedative activities, respectively.
Results Methanol extract of H. tiliaceus significantly decreased the duration of immobility in both animal models of antidepressant activity, forced swimming and tail suspension tests. This extract did not potentiate the effect of ketamine-induced hypnosis, as determined by the time to onset and duration of sleeping time.
Conclusion Our results indicate an antidepressant-like profile of action for the extract of Hibiscus tiliaceus without sedative side effect.
Source : BMC Complementary & Alternative Medicine
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Antidepressant-like effects of two commercially available products of Hypericum perforatum in the forced swim test: A long-term study
Some herbal products of Hypericum perforatum (Hypericaceae) are recommended for the treatment of depression. Nevertheless, some of these products do not produce antidepressant-like effects when they are evaluated in experimental models of depression, whereas others remain to be evaluated. Consequently, the antidepressant-like effects of two commercially available products of H. perforatum were evaluated and compared with the clinically effective antidepressant fluoxetine. Male Wistar rats received different doses of two products of H. perforatum or fluoxetine, and their effects were evaluated at 7, 14, 21, and 28 days of treatment in the open field and forced swim tests. H. perforatum products
significantly increased the latency to first immobility and reduced total immobility time in the forced swim test, results similar to fluoxetine, without increasing general locomotor activity in the open field test. H.perforatum products required 21 days of treatment to exert their antidepressant-like effect, whereas fluoxetine required only 14 days.
In conclusion, H. perforatum products evaluated in the present study produced an antidepressant-like effect, even at lower doses than those reported previously to be effective in the forced swim test. However, H. perforatum required more days of treatment to exert its
antidepressant-like effect compared with the antidepressant fluoxetine.
Source : _Journal of Medicinal Plants
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Antidepressant-Like Activity of 10-Hydroxy-Trans-2-Decenoic Acid, a Unique Unsaturated Fatty Acid of Royal Jelly, in Stress-Inducible Depression-Like Mouse Model
Symptoms of depression and anxiety appeared in mice after they had been subjected to a combination of forced swimming for 15 min followed by being kept in cages that were sequentially subjected to leaning, drenching, and rotation within 1-2 days for a total of 3 weeks. The animals were then evaluated by the tail-suspension test, elevated plus-maze test, and open-field test at 1 day after the end of stress exposure. Using these experimental systems, we found that 10-hydroxy-trans-2-decenoic acid (HDEA), an unsaturated fatty acid unique to royal jelly (RJ), protected against the depression and anxiety when intraperitoneally administered once a day for 3 weeks simultaneously with the stress loading. Intraperitoneally administered RJ, a rich source of HDEA, was also protective against the depression, but RJ given by the oral route was less effective. Our present results demonstrate that HDEA and RJ, a natural source of it, were effective in ameliorating the stress-inducible symptoms of depression and anxiety.
Source : Evidence-Based Complementary and Alternative Medicine Volume 2012 (2012), Article ID 139140
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A Couple Cups of Java May Keep the Blues Away
Coffee appears to protect against depression in women, and the more the better, researchers found.
In a prospective cohort study, women who drank two or three cups of coffee a day were 15% less likely to develop depression than those who drank one cup or less, according to Alberto Ascherio, MD, DrPH, of Harvard School of Public Health in Boston, and colleagues.
And the effect was slightly more pronounced for women who drank four or more cups a day, Ascherio and colleagues reported in the Sept. 26 issue of Archives of Internal Medicine.
There was no association between depression and decaffeinated coffee, suggesting that it's the caffeine, and not other components of the beverage, that is involved, the researchers reported. However, they cautioned that the longitudinal study can only suggest, but not prove, that is true.
There was also an interaction that the researchers described as "marginally significant" -- at P=0.06 – between smoking and coffee drinking that appeared to increase the benefit for smokers. Caffeine is regarded as the most widely used central nervous system stimulant in the world, with about 80% of consumption in the form of coffee, the researchers noted. Many studies have looked at caffeine and other disorders, including cardiovascular disease and inflammation, but few have examined psychiatric illness.
The findings come from the Nurses Health Study, which has been following more than 120,000 women since 1976. For this analysis, the researchers studied 50,739 women who were free of depressive symptoms in 1996, when study questionnaires started to ask about use of antidepressants, and followed them through June 1, 2006.
Ascherio and colleagues measured caffeine consumption -- including caffeine from coffee -- using validated questionnaires completed from May 1, 1980, through April 1, 2004, and computed cumulative average consumption with a two-year latency period.
They defined incident clinical depression as self-reported physician-diagnosed depression and beginning antidepressant use, and found that over the study period, there were 2,607 new cases of depression.
Both caffeine intake and coffee consumption showed an inverse dose-response association with depression, Ascherio and colleagues found. Specifically:
- Compared with women drinking one cup or less of caffeinated coffee per week, the multivariate relative risk of depression was 0.85 for those drinking two or three cups per day, with a 95% confidence interval from 0.75 to 0.95.
- Similarly, the relative risk for those drinking four or more cups a day, compared with women drinking a cup or less a week, was 0.80, with a 95% confidence interval from 0.64 to 0.99.
- The trend was significant at P=0.001.
- Compared with women consuming the least caffeine (less than 100 milligrams a day), the multivariate relative risk of depression was 0.80 for those consuming the most (at least 500 milligrams a day). The 95% confidence interval ranged from 0.68 to 0.95, and the trend was significant at P=0.02.
However, the authors noted, the interaction "was unexpected and may be due to chance."
They cautioned that they can't exclude reverse causation: The possibility that mild depressive symptoms led to low caffeine consumption.
They added that some misclassification of depression is "inevitable because of a combination of errors in reporting depression and antidepressant use, low recognition of depression by physicians, under-treatment of depression, and use of antidepressant medication for indications other than depression."
Source : MedPage Today
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