Comparative Efficacy of Celastrus paniculatus (Willd.) and Escitalopram, Alone and in Combination, in Major Depressive Disorder: A Prospective Interventional Study

Abstract

Background- Depression is rated as third leading cause of the burden of disease worldwide according to WHO in 2008. It often goes untreated. Conventional treatment approaches include antidepressant medications like Serotonin Reuptake Inhibitors (SSRIs) and properly modulated and planned psychotherapies. A shrub belonging from Celastraceae family called Jyotishmati (Celastrus panniculatus Willd.) contains a seed oil which is tranquilizer and sedative. Current study is an attempt to find out efficacy of this ayurvedic medication in treating depression

Aims and objectives- 1. To assess antidepressant efficacy of Jyotishmati (Celastrus panniculatus Willd.) in treating Major Depressive Disorder (MDD). 2. To compare its efficacy with Escitalopram 10mg alone and its combination with escitalopram.

Methodology- This study was conducted in department of Psychiatry of Government Medical College and Rajindra Hospital, Patiala from 28-12-2020 to 31-05-2023, 182 patients suffering from Major Depressive Disorder (MDD) were included in study. They were randomly divided into 3 groups using computer generated random numbers. Sociodemographic data was collected using sociodemographic proforma. Diagnosis of MDD was confirmed using International Classification of Diseases for mental health and behavioural disorders 10^th edition (ICD-10). Hamilton Depression Rating Scale -17 was applied at baseline to know severity of depression and at 6 months of administering medications to know therapeutic response. Group A patients received 10mg of Escitalopram, Group B patients received Jyotishmati seed oil in capsule preparation and Group C subjects received both 10mg Escitalopram and Jyotishmati. Institutional Ethics committee permission was obtained before commencing the study. Written informed consent was obtained from all patients before including them into this project.

Observations-  Out of 182 patients suffering from MDD, 14 patients dropped out during the course of study. 18 were excluded because of exclusion criteria. 150 subjects (50 in each group) were finally left behind. It was observed there was statistically significant reduction of HDRS-17 scores in subjects receiving Jyotishmati (Group B) (13.2±3.92 to 11.36± 4.66 in 6 months).  This reduction was less than the group receiving escitalopram 10mg  (Group A) and group receiving both escitalopram and Jyotishmati (Group C). Maximum reduction was seen in combination treatment group (13.46±3.84 to 7.16 ± 3.48 in 6 months)

Conclusion- This gives us scope of combining ayurvedic medications like Jyotishmati with conventional antidepressant medications for better results. For that more extensive research is needed.