A Pilot study examining the Neurobiological correlates of Virechanakarma in Patients with Major Depressive Disorder

Depression is the most common psychiatric disorder in the world population and the most

frequent mental disorder in a primary health care. Depressive disorders are characterized by

sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or

appetite, feelings of tiredness, and poor concentration. Major depressive disorder (MDD) is

analogous to a disease condition described in Ayurveda as Vishada. Vishada is a condition

characterized by global reduction in activities of mind, sensory faculties and body arising out of

disequilibria in doshas. Vishada has been mentioned as an extraordinary disease of the vata.

Ayurveda literature has dealt with the disease and its management comprehensively. Clinically

apart from vata dosa , involvement of kapha & pitha are also seen in patients of Major depressive

disorders like reduced energy levels , increased fatiguability , loss of appetite , diurnal variation

of worsening in morning hours ,dullness , withdrawal , disgust , anxiety etc,. In the combination

of tridosa, kapha need to be addressed first, then pitha and then vata. For kaphapitha hara

virechana is the best sodhana therapy advised as per Ayurveda literature. Recent study

demonstrates a positive influence of ayurvedic therapy on psychopathology, cardiac autonomic

function and endocrinal parameters in patients with depression. Clinically, we have found

considerable improvement in mood symptoms after a course of sodhana therapy. Sodhana can be

an adjunct in treating mood disorders. No published literature on efficacy of virechana in Mood

disorders are there, despite being classically recommended in texts. Neurobiological correlates of

virechanakarma in neuropsychiatric disorders is not studied making it a novel effort. Hence, this

study aims to understand the neurobiological correlates of virechanakarma in patients with

MDD.

It is a randomised control trial study which will assess changes in clinical parameters, cardiac

autonomic function(HRV), neurohemodynamic parameters(fNIRS), physiological

parameters(CRP , S.Cortisol) and metabolic parameters(FBS & Lipid profile) after the

intervention.