Lavender and dodder combined herbal syrup versus citalopram in major depressive disorder with anxious distress: A double-blind randomized trial / 中西医结合学报

BACKGROUND@#Major depressive disorder (MDD) accompanied by anxious distress is a chronic and disabling disorder. Its conventional drug therapies often have low patient compliance due to drug-related side effects. In Persian medicine, lavender-dodder syrup is one formula often recommended for such disorders.@*OBJECTIVE@#This study compares the effects of lavender-dodder syrup to the standard drug, citalopram, for treating MDD with anxious distress.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This six-week, double-blind, randomized, clinical trial was carried out in a psychiatric outpatient clinic. During the six-week intervention period, patients in citalopram group received citalopram tablets 20 mg/d plus 5 mL placebo syrup every 12 h; patients in group B received placebo tablets once daily plus 5 mL of lavender-dodder herbal syrup every 12 h.@*MAIN OUTCOME MEASURES@#Primary outcome measures, depression and anxiety, were evaluated using the Hamilton Depression/Anxiety Rating Scales, and were scored at the beginning of the study and at weeks three and six. Secondary outcome measures including response to treatment and remission rates were also compared between the two groups.@*RESULTS@#Fifty-six participants with MDD and anxious distress were randomly assigned to two groups. Mean depression scores significantly decreased in citalopram and herbal groups at weeks three and six (time effect: P < 0.001), although the observed changes were not significantly different between the groups (intervention effect: P = 0.61). Mean anxiety scores were not significantly different between the two groups at week three (P = 0.75). However, at the end of week six, the observed decrease was significantly higher in the herbal syrup group than the citalopram group (intervention effect: P = 0.007).@*CONCLUSION@#The herbal syrup is an effective and tolerable supplement for treating MDD with anxious distress.@*TRIAL REGISTRATION NUMBER@#IRCT2016102430459N1 on Iranian Registry of Clinical Trials.

Lavender and dodder combined herbal syrup versus citalopram in major depressive disorder with anxious distress: A double-blind randomized trial / 中西医结合学报

BACKGROUND@#Major depressive disorder (MDD) accompanied by anxious distress is a chronic and disabling disorder. Its conventional drug therapies often have low patient compliance due to drug-related side effects. In Persian medicine, lavender-dodder syrup is one formula often recommended for such disorders.@*OBJECTIVE@#This study compares the effects of lavender-dodder syrup to the standard drug, citalopram, for treating MDD with anxious distress.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This six-week, double-blind, randomized, clinical trial was carried out in a psychiatric outpatient clinic. During the six-week intervention period, patients in citalopram group received citalopram tablets 20 mg/d plus 5 mL placebo syrup every 12 h; patients in group B received placebo tablets once daily plus 5 mL of lavender-dodder herbal syrup every 12 h.@*MAIN OUTCOME MEASURES@#Primary outcome measures, depression and anxiety, were evaluated using the Hamilton Depression/Anxiety Rating Scales, and were scored at the beginning of the study and at weeks three and six. Secondary outcome measures including response to treatment and remission rates were also compared between the two groups.@*RESULTS@#Fifty-six participants with MDD and anxious distress were randomly assigned to two groups. Mean depression scores significantly decreased in citalopram and herbal groups at weeks three and six (time effect: P < 0.001), although the observed changes were not significantly different between the groups (intervention effect: P = 0.61). Mean anxiety scores were not significantly different between the two groups at week three (P = 0.75). However, at the end of week six, the observed decrease was significantly higher in the herbal syrup group than the citalopram group (intervention effect: P = 0.007).@*CONCLUSION@#The herbal syrup is an effective and tolerable supplement for treating MDD with anxious distress.@*TRIAL REGISTRATION NUMBER@#IRCT2016102430459N1 on Iranian Registry of Clinical Trials.

Cardiovascular considerations in antidepressant therapy: an evidence-based review

There is a definite correlation between cardiovascular diseases and depressive disorders. Nevertheless, many aspects of this association have yet to be fully elucidated. Up to half of coronary artery disease patients are liable to suffer from some depressive symptoms, with approximately 20% receiving a diagnosis of major depressive disorders. Pharmacotherapy is a key factor in the management of major depression, not least in patients with chronic diseases who are likely to fail to show proper compliance and response to non-pharmacological interventions. Antidepressants are not deemed completely safe. Indeed, numerous side effects have been reported with the administration of antidepressants, among which cardiovascular adverse events are of paramount importance owing to their disabling and life-threatening nature. We aimed to re-examine some of the salient issues in antidepressant therapy vis-a-vis cardiovascular considerations, which should be taken into account when prescribing such medications

Knowledge, attitude and practice of herbal remedies in a group of infertile couples

The aim of this study was to evaluate knowledge, attitude and practice of herbal remedies [HRs] in infertile patients. This was a cross sectional study in a referral infertility care center. Three hundred and six outpatients, both women and men, presenting for the first time with complaint of infertility at Arash hospital, were recruited. Verbal consent for participation was received. A self administered questionnaire was used. Main outcome measure was knowledge, attitude and practice of patients toward herbal medications. 47.3% of participants were knowledgeable of HRs with female gender and lower educational background being the associated factors in knowledge. 43.4% of patients with significant female dominancy had positive attitude toward HRs. 31% of participants were using HRs. Only 3.2% of those using HRs informed their physician. The most common health condition promoting herbal use was psychological [33.3%] and gastrointestinal [30.8%] disorders. 3.5% of participants used HRs as fertility treatment which was significantly observed in women and those with lower levels of formal education. A considerable proportion of our population had used HRs without sufficient knowledge and had positive attitude toward HRs. More importantly, patients did not disclose their use of HRs to physicians. Therefore, physicians should inquire about the use of alternative remedies and provide patients with appropriate information

Buspirone versus methylphenidate in the treatment of children with attention- deficit/ hyperactivity disorder: randomized double-blind study

A recent randomized clinical trial showed buspirone efficacy in the treatment of attentiondeficit/ hyperactivity disorder [ADHD] in children. However, results from a recent multi-site controlled clinical trial of transdermal buspirone failed to separate it from placebo in a large sample of children with ADHD. Therefore, due to these inconsistent findings, this study was designed to assess the efficacy of buspirone in the treatment of children with ADHD compared to methylphenidate in a double blind randomized clinical trial. Forty outpatients with a DSM-IV-TR diagnosis of ADHD were study population of this trial. Subjects were recruited from an outpatient child and adolescent clinic for a 6 week double blind, randomized clinical trial. All study subjects were randomly assigned to receive treatment using tablet of buspirone at a dose of 20-30 mg/day depending on weight [20 mg/day for < 30kg and 30 mg/day for > 30kg] [group 1] or methylphenidate at a dose of 20-30 mg/day depending on weight [20 mg/day for < 30kg and 30 mg/day for > 30kg [group 2] for a 6 week double blind, randomized clinical trial. The principal measure of outcome was the Teacher and Parent ADHD Rating Scale IV. Patients were assessed at baseline and at 21 and 42 days after the medication started. Significant differences were observed between the two groups on the Parent and Teacher Rating Scale scores. The changes at the endpoint compared to baseline were: -8.95 +/- 8.73 [mean +/- SD] and -15.60 +/- 7.81 [mean +/- SD] for buspirone and methyphenidate, for Parent ADHD Rating Scale. The changes at the endpoint compared to baseline were: -9.80 +/- 7.06 [mean +/- SD] and -22.40 +/- 9.90 [mean +/- SD] for buspirone and methyphenidate, respectively for Teacher ADHD Rating Scale. The difference between the buspirone and methylphenidate groups in the frequency of side effects was not significant except for decreased appetite, headache and insomnia that were observed more frequently in the methylphenidate group. The results of this study suggest that administration of buspirone was less effective than methylphenidate in the treatment of ADHD

Cardiovascular effects of saffron: an evidence-based review

Herbal medicine can be a valuable source of assistance for traditional medicine. There are a number of herbs that can be used in conjunction with modern medicine. Herbs can also be taken to aid recovery from serious diseases. Although one should never aim to treat diseases such as cardiovascular disease solely with herbal medicine, the value of herbs used in tandem with modern medicine cannot be ignored. Saffron has been reported to help lower cholesterol and keep cholesterol levels healthy. Animal studies have shown saffron to lower cholesterol by as much as 50%. Saffron has antioxidant properties; it is, therefore, helpful in maintaining healthy arteries and blood vessels. Saffron is also known to have anti-inflammatory properties, which are beneficial to cardiovascular health. The people of Mediterranean countries, where saffron use is common, have lower than normal incidence of heart diseases. From saffron's cholesterol lowering benefits to its anti inflammatory properties, saffron may be one of the best supplements for cardiac health. This paper reviews the studies regarding the beneficial effects of saffron in cardiovascular health

Advances and considerations in attention-deficit/hyperactivity disorder pharmacotherapy

Attention-deficit/hyperactivity disorder [ADHD] is a highly heritable neuropsychiatric disorder associated with significant impairments in occupational, academic, neuropsychological, and social functioning. Central nervous system [CNS] stimulants are recommended as first-line medication therapy for children. CNS stimulants include formulations of methylphenidate and amphetamine derivatives and are available in a large variety of immediate-and extended-release preparations. Extended-release preparations are often preferred to limit drug administration during school or work and may help to limit side effects associated with rapid fluctuations in serum concentration. Stimulant medication is by far the most commonly used treatment in managing children with ADHD, 10-20% of those who take such medication do now show clinically significant improvements in their primary ADHD symptom. Even when a favorable response is obtained, some children experience side effects that are of sufficient occurrence and severity to prevent continued use of stimulant medication. In such instances or when families are unwilling to consider a stimulant, non-stimulant medications may be appealing. This review focuses on etiology, assessment and treatment of ADHD with various stimulant and non-stimulant agents

Association between physical activity and mental health among high-school adolescents in Boushehr province: a population based study

Mental health is one of the evaluating factors of community indicators, and physical activity is considered an important tool for the importance of public health. Previous studies have demonstrated associations between physical activity and mental health, but these studies did not include those populations in which training children have some traditional and religious aspects. Multiple logistic regression analyses were used to compare the prevalence of mental health among those who had inactive, minimally and HEPA activity in a representative sample of adolescents aged 15-19 in South of Iran using data from the Mental Health Survey [n = 2584]. The GHQ-28 and IPAQ-short forms were used to evaluate the mental health and physical activity, respectively. A total of 2584 adolescents [1401 male and 1178 female] participated in the study. The observed odds of psychological symptoms in boys compared to girls is 1.2 times [p=0.018]. We observed that HEPA-activity decreases odds of somatic distress and social dysfunction compared with inactivity [p=0.031 and 0.001, respectively]; minimally activity decreases odds of anxiety compared with inactivity [p=0.038]; but physical activity rate was not affected on odds of adolescents' depression [p>0.05]. Physical activity decreases mental health subscales except for depression among adolescents in Boushehr, southern city of Iran