Study: Rhodiola Rosea against Sertralin in Major Depression
Study: Rhodiola Rosea against Sertralin in Major Depression
Reference
Mao JJ, Xie Sx, Zee J, et al. Rhodiola Rosea Versus Sertraline for serious depressive disorders: a randomized placebo -controlled study. phytomedicine . 2015; 22 (3): 394-399.
Design
This study was a randomized, placebo-controlled phase 2 study.
participant
A total of 57 patients with mild to moderate major depression (MDD) were recruited for this study. The exclusions included severe severe depression, bipolar disorders, drug abuse, dependency disorders or primary anxiety. Participants were also excluded if they have already undergone antidepressants or herbal therapies or suffered from another serious illness that could affect mood or cognition.
Intervention
The participants were randomized to receive either capsules with 340 mg of a powdered extract rose root standardized on a content of 3.7 % rosavine, 50 mg sertralin-HCL (zoloft) or placebo (lactose monohydrate) for 12 weeks. Twenty patients were randomized rose root group, 19 in the Sertralin group and 18 in the placebo group.
The drug was administered in a dose escalation. A capsule was administered in the first 2 weeks. If the Hamilton Depression Rating (Ham-D) scale was reduced by less than 50 % in patients, the dosage for weeks 3 and 4 on 2 capsules was increased daily. For patients who still had less than 50 % HAM -D scale reduction, 5 and 6 on 3 capsules were increased daily in the weeks. If the reduction was still not improved to a 50%Ham-D reduction compared to the starting value after 6 weeks, the dosage for the rest of the study was increased to 4 capsules.
target parameter
The patients were assessed as a primary result assessment with the Beck Depression Inventory (BDI) and the Clinical Global Impression Change (CGI/C) scores for secondary result measurements at the beginning of the study. The patients were examined at the beginning of the course and after 2, 4, 6, 8 and 12 weeks.
important knowledge
All treatment groups showed statistically non-significant reductions in Ham-D, BDI and CGI/C reviews without significant difference between the groups. The waste of Ham-D was larger for Sertralin vs rose root (‒8,2 vs. ‒5.1) or placebo (‒4.6), whereby from Sertralin (63.2 %) more patients suffered from side effects rose root (30.0 %) or placebo (16.1 %) ( p = 0.012)). The overall effectiveness of both medication does not differ from that of the placebo.
practice implications
This study is for the first time rose root was compared in a double-blind, placebo-controlled, randomized study with a selective serotonin reuptake inhibitor such as sertraline. These results indicate that Sertralin had a slightly greater effect compared to Sertralin rose root , while botanical medicine had significantly fewer side effects. It should be noted that the advantages of neither the medication nor the herb differ greatly from placebo. Meta -analyzes have shown that medication in mild to moderate depression generally does not work better than placebo. 1 that pretends to an efficacy rate of 25 % to 30 %. This study of Lochfraß rose root against Sertraline is in line with a larger number of research results, which show minimal but measurable effects for monotherapeutic approaches in light and moderate depression.
This research underlines the need for 2 research -based modifications to treat depressive disorders more effectively in the future. A modification is that medical research focuses more on multidimensional treatment paradigms. In this special study, as in most double -blind studies, the only change in patient care was pharmaceutical or herbal intervention. It is likely that an expansion of treatment by working on the life of the patient's way of life and the simultaneous use of nutritional and psychological therapy with the intervention would lead to larger advantages. While this can confuse the exact mechanism that brings benefits, I believe that the effectiveness rates for treatment would improve significantly.
It is likely that an expansion of treatment by working on the life of the patient's way of life and the simultaneous use of nutritional and psychological therapy with intervention would lead to larger advantages.
The second necessity is to make a better understanding of patient -specificity to choose more effective therapies. For example, I often recommend rose root for patients with a long -term history of chronic stress, in which they have tested in the early morning they show high cortisol levels that increase the patient's wake -up reaction. Previous work has shown rose root to reduce the cortisol reaction to awakening stress. 2 This current study takes into account this current study, like most studies, not the individuality of each participant. For future studies, it can be advantageous to measure the cortisol level among the participants in order to find out whether Rhodiola was of particular benefit in a subgroup of people with early morning high cortisol levels.
A restriction of this study is the termination of 13 patients in week 8. Two of these patients took sertraline (which had an effect), but it dropped due to side effects, and 4 patients left treatment due to a lack of effectiveness. A second restriction was that the study started with lower doses and the dosage was increased if no effect was observed. It is possible that the beginning with the higher doses in week 1 had a greater effect that was measurable over the 12-week period. Antidepressants usually need a given dosage for a full 12 weeks before an effect can be seen. This can apply to vegetable remedies such as rose root as well.
rose root was originally observed in Russian literature as a useful plant medicine to combat physical, biological and chemical stressors. As an adaptogenic herb, Rhodiola acts as a neuroprotective, cardioprotective, anti-maturity, antidepressant, anxiolytic and nootropics (cognitively bessing) means that also has life-prolonging effects and activity to stimulate the central nervous system. My experience is that this herb, if it is used to the full extent of naturopathic treatment, can be a support to rejuvenate patients, especially those who have the feeling that they have "gone through a war".
This special study may not indicate greater effectiveness rose root over medication, but it seems to have at least the same overall effectiveness as sertraline with fewer side effects. Conventional pharmaceutical therapies can suppress depression symptoms rather than eliminate the overall risk for suicide or relapse. 4 In view of this fact and the results of this study, it is reasonable to consider rose root than with a superior risk benefit ratio. Finally, if a therapeutic intervention is desired, rose root can be a better choice for light to moderate depression towards medication.
- Fournier JC, Derubeis RJ, Hollon SD, et al. Effect of antidepressants and severity of depression: a meta -analysis at the patient level. Jama. 2010; 303 (1): 47-53.
- Olsson EM1 by Schéele B, Panossian AG. A randomized, double-blind, placebo-controlled parallel group study of the standardized extract SHR-5 from the root of Rhodiola Rosea in the treatment of subjects with stress-related fatigue. Planta med. 2009; 75 (2): 105-112.
- Panossian A, Wikman G, Sarris J. Rosenroot (Rhodiola Rosea): traditional use, chemical composition, pharmacology and clinical effectiveness. phytomedicine. 2010; 17 (7): 481-493.
- Frank E., copper DJ, Perel JM, et al. Three-year results for maintenance therapies for recurring depression. Arch gen psychiatry. 1990; 47 (12): 1093-1099.