Preliminary communicationAntidepressant efficacy of Sudarshan Kriya Yoga (SKY) in melancholia: a randomized comparison with electroconvulsive therapy (ECT) and imipramine
Introduction
Sudarshan Kriya (Su=right, Darshan=vision, Kriya=procedure) was devised by a spiritual guru, Pundit Ravi Shankar of the Art of Living Foundation, Bangalore, India. It has been practiced as a brief and practical self-help stress-management strategy. Impressionistic reports of the participants indicate that it reduces anxiety and depression. From the biomedical point of view, it is essentially hyperventilation with demonstrable effects on brain function (Meti and Desiraju, 1984; Meti and Raju, 1993). These observations suggest that this procedure may have antidepressant potential. However, to make it widely acceptable to patients and the medical profession, some of the adventitious components (e.g., briefing about positive attitudes to life, ‘living in the present’, etc.) were dropped as were the meditative aspects. The procedure is devised as a physiological technique consisting of only specified rhythms of breathing. This adaptation for clinical purposes was designated Sudarshan Kriya Yoga (SKY; Yoga Research Group, 1995).
In an open, three-month clinical trial, SKY, as the sole treatment in dysthymic patients (n=46), produced significant antidepressant effects, with 25 (68%) of the 37 patients who completed the treatment in remission (Janakiramaiah et al., 1998). Small but significant elevations of serum prolactin (but not of cortisol) occurred following a session of SKY (Janakiramaiah et al., 1998). Following improvement with SKY therapy, significant increments in P300 (ERP) amplitude (‘normalization’) occurred (Naga Venkatesha Murthy et al., 1997). In an independent sample of major depressive disorder patients, SKY lengthened REM sleep latency and slow wave sleep (Harish, 1997). These objective changes, associated with therapeutic effects and a response rate of 68%, further suggest that SKY produces more than a placebo antidepressant effect. In this study, we compared the therapeutic efficacy of SKY with two standard antidepressant treatments, electroconvulsive therapy (ECT) and imipramine, in melancholia.
Section snippets
Patients
Consenting inpatients (n=45) of DSM-IV melancholic depression (American Psychiatric Association, 1994) who were never treated for the current episode were recruited consecutively. All were medically fit and scored 17 or more on the total 17-item Hamilton depression rating scale (HRSD; Hamilton, 1960). They were randomized into three equal groups (Table 1) to receive SKY, ECT or imipramine (IMN) treatment for four weeks.
SKY
The procedure was documented previously (Yoga Research Group, 1995;
Results
Significant reductions in total BDI scores occurred in all three groups but there were no differences between them. There was, however, a significant group×occasion interaction. Although there were no overall differences between the groups, the ECT group had the lowest mean scores at weeks three and four, whereas the SKY and IMN groups appeared to be similar (Fig. 1). The results were similar to those obtained using the total 17-item HRSD as well as its six-item subscale (Table 2). In view of
Discussion
In this prospective randomized controlled trial, SKY produced a 67% remission rate at four weeks (Table 3). This compares with the response rate in dysthymia observed earlier (Janakiramaiah et al., 1998). As the present response rate was obtained in severe, hospitalized, melancholic depressives, the placebo response explanation is inadequate (Nelson et al., 1990; Peselow et al., 1992). Those who remitted at different points maintained their status until the end of the study, suggesting
References (13)
- et al.
Normalization of P300 amplitude following treatment in dysthymia
Biol. Psychiatry
(1997) Diagnostic and Statistical Manual of Mental Disorders (DSM IV), 4th ed.
(1994)- et al.
An inventory for measuring depression
Arch. Gen. Psychiatry
(1961) - et al.
The Hamilton depression scale: Evaluation of objectivity using logistic models
Acta. Psychiatr. Scand.
(1981) - et al.
Effect of ECT in endogenous depression: A double blind comparison with imipramine
NIMHANS. J
(1985) A rating scale for depression
J. Neurol. Neurosurg. Psychiatry
(1960)
Cited by (225)
High ventilation breathwork practices: An overview of their effects, mechanisms, and considerations for clinical applications
2023, Neuroscience and Biobehavioral ReviewsEffects of yoga in inflammatory bowel diseases and on frequent IBD-associated extraintestinal symptoms like fatigue and depression
2021, Complementary Therapies in Clinical Practice