November 22, 2016
Controlled Breathing Practices Show Promise in Patients Who Don't Fully Respond to Antidepressants
PHILADELPHIA— A breathing-based meditation practice known as Sudarshan Kriya yoga helped alleviate severe depression in people who did not fully respond to antidepressant treatments, reports a new study published today in the Journal of Clinical Psychiatry from researchers in the Perelman School of Medicine at the University of Pennsylvania. The study bolsters the science behind the use of controlled yogic breathing to help battle depression.
In a randomized, controlled pilot study, led by Anup Sharma, MD, PhD, a Neuropsychiatry research fellow in the department of Psychiatry at Penn, researchers found significant improvement in symptoms of depression and anxiety in medicated patients with major depressive disorder (MDD) who participated in the breathing technique compared to medicated patients who did not partake. After two months, the yoga group cut its mean Hamilton Depression Rating Scale (HDRS) score by several points, while the control group showed no improvements. HDRS is the most widely used clinician-administered depression assessment that scores mood, interest in activities, energy, suicidal thoughts, and feelings of guilt, among other symptoms.
More than half of the 41 million Americans who take antidepressants do not fully respond. Add-on therapies are often prescribed to enhance the effects of the drugs in these patients, but they typically offer limited additional benefits and come with side effects that can curb use, prolonging the depressive episode. What’s more, patients who don’t fully respond to antidepressants are especially at risk of relapse.
“With such a large portion of patients who do not fully respond to antidepressants, it’s important we find new avenues that work best for each person to beat their depression,” Sharma said. “Here, we have a promising, lower-cost therapy that could potentially serve as an effective, non-drug approach for patients battling this disease.”
The meditation technique, which is practiced in both a group setting and at home, includes a series of sequential, rhythm-specific breathing exercises that bring people into a deep, restful, and meditative state: slow and calm breaths alternated with fast and stimulating breaths.
“Sudarshan Kriya yoga gives people an active method to experience a deep meditative state that’s easy to learn and incorporate in diverse settings,” Sharma said.
In past studies, the practice has demonstrated a positive response in patients with milder forms of depression, depression due to alcohol dependence, and in patients with MDD; however, there are no clinical studies investigating its use for depression in an outpatient setting. Past studies suggest that yoga and other controlled breathing techniques can potentially adjust the nervous system to reduce stress hormones. Overall, the authors also note, well-designed studies that evaluate the benefits of yoga to treat depression are lacking, despite increased interest in the ancient Indian practice. Millions of Americans participate in some form of yoga every year.