Nina Sarubin1, Caroline Nothdurfter2, Cornelius Schüle3, Martin Lieb4, Manfred Uhr5, Christoph Born3, Ricarda Zimmermannc3, Markus Bühner6, Katharina Konopka4, Rainer Rupprecht2, Thomas C Baghai4. 1. Department of Psychiatry and Psychotherapy, University Regensburg, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany. Electronic address: nina.sarubin@med.uni-muenchen.de. 2. Department of Psychiatry and Psychotherapy, University Regensburg, Germany; Max-Planck-Institute of Psychiatry, Munich, Germany. 3. Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany. 4. Department of Psychiatry and Psychotherapy, University Regensburg, Germany. 5. Max-Planck-Institute of Psychiatry, Munich, Germany. 6. Department of Psychology/Statistics and Evaluation, Ludwig-Maximilian-University, Munich, Germany.
Abstract
OBJECTIVES: The impact of Hatha yoga as add-on treatment to quetiapine fumarate extended release (QXR) or escitalopram (ESC) in depressed patients on hypothalamic-pituitary-adrenal (HPA) axis activity was assessed. METHODS:60 inpatients suffering from major depressive disorder (MDD) according to DSM-IV were randomized for a 5 week treatment with Yoga or not (control group) and with either QXR (300 mg/day) or ESC (10 mg/day). Serial dexamethasone/corticotropin releasing hormone (DEX/CRH) tests were performed to assess HPA axis function. The Hamilton Depression Rating Scale (21-HAMD) was used weekly. RESULTS: A more pronounced down regulation of the HPA axis activity due to yoga could not be detected. The stepwise long term cortisol reduction was seen in both medication groups, irrespectively of yoga add-on treatment. In addition, cortisol improvers in week 1 of therapy (reduction in cortisol peak value within the DEX/CRH test) reached significant greater amelioration of depressive symptoms after 5 weeks. CONCLUSIONS: Our results suggest that antidepressant agents down regulate HPA axis function to a greater extent than additional Hatha yoga treatment. Moreover, an early reduction of HPA system hyperactivity after one week of pharmacological treatment seems to raise the possibility of a favorable treatment response.
RCT Entities:
OBJECTIVES: The impact of Hatha yoga as add-on treatment to quetiapine fumarate extended release (QXR) or escitalopram (ESC) in depressedpatients on hypothalamic-pituitary-adrenal (HPA) axis activity was assessed. METHODS: 60 inpatients suffering from major depressive disorder (MDD) according to DSM-IV were randomized for a 5 week treatment with Yoga or not (control group) and with either QXR (300 mg/day) or ESC (10 mg/day). Serial dexamethasone/corticotropin releasing hormone (DEX/CRH) tests were performed to assess HPA axis function. The Hamilton Depression Rating Scale (21-HAMD) was used weekly. RESULTS: A more pronounced down regulation of the HPA axis activity due to yoga could not be detected. The stepwise long term cortisol reduction was seen in both medication groups, irrespectively of yoga add-on treatment. In addition, cortisol improvers in week 1 of therapy (reduction in cortisol peak value within the DEX/CRH test) reached significant greater amelioration of depressive symptoms after 5 weeks. CONCLUSIONS: Our results suggest that antidepressant agents down regulate HPA axis function to a greater extent than additional Hatha yoga treatment. Moreover, an early reduction of HPA system hyperactivity after one week of pharmacological treatment seems to raise the possibility of a favorable treatment response.
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