Comparative study of Vamana Karma and Shirovirechana Nasya followed by Shamana Snehapana and Satwavajaya Chikitsa with Yoga in managing major depressive disorder- An Open Labelled Randomised Controlled Clinical Trial.

Major depressive disorder is a common and debilitating mental illness that is characterized by a depressed mood, appetite change, sleep disturbance, mental retardation or agitation, fatigue, guilt, loss of concentration, and suicidal ideation. Its worldwide prevalence is estimated at 4.4%.In India, it is estimated that nearly one-third of patients seeking help from healthcare facilities could have symptoms related to depression, and the crude prevalence rate of mood disorder was estimated to vary from as low as 0.5 to as high as 78 per 1000 population. Therefore in this study, Vamana Karma, Shirovirechana Nasya, Shamana Snehapana and Satwavajaya Chikitsa with Yoga is selected as the line of protocol for treating major depressive disorder. Vamana Karma can be done with Dhamargava Phala Churna. Dhamargava is indicated as the best medicine for Vamana in psychiatric disorder. For Shirovirechana Nasya, Jyotishmati Taila will be used as it is indicated as Medhya and is also included in Shirovirechana Aushadhi. Kalyanaka Ghrita will also be used for Shadhananga Snehapana, Snehana Nasya and also for Shamana Snehapana. No previous study is available to evaluate the effect of the Panchakarma procedure on the neurofilament light chain. Hence this study is conducted to prepare an effective Ayurveda protocol to treat major depressive disorder and to show the effect on the neurofilament light chain.

Null Hypothesis-H****0- There is no difference between Vamana Karma and Shirovirechana Nasya followed by Shamana Snehapana and Satwavajaya Chikitsa with Yoga on hamilton depression rating scale in patients of major depressive disorder when measured with neurodegeneration biomarker neurofilament light chain.

Alternate Hypothesis-H****1 –There is a difference between Vamana Karma and Shirovirechana Nasya followed by Shamana Snehapana and Satwavajaya Chikitsa with Yoga on hamilton depression rating scale in patients of  major depressive disorder when measured with neurodegeneration biomarker neurofilament light chain.