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Objectives: Little is known about the outcome of major depressive disorder in India, especially in primary care contexts not usually associated with research. This large, prospective, naturalistic observational study examined the feasibility of studying first-episode major depressive disorder outcomes in such contexts, and examined outcomes after antidepressant drug treatment.Methods: A convenience sample of 205 psychiatrists across India each recruited five adults with first-episode major depressive disorder. No patient had clinically significant suicidal ideation, psychotic symptoms, or significant medical or psychiatric comorbidity. Patients were naturalistically treated with antidepressant medication and rated using the Montgomery-Asberg Depression Rating Scale and other instruments, including patient-reported outcome measures. Assessments were obtained at baseline and at a 6-week follow-up.Results: Of 900 patients recruited, 92 did not meet selection criteria, and there were 10 dropouts, leaving 798 evaluable patients. The most common antidepressants received were desvenlafaxine, vilazodone, and escitalopram. The primary outcome, response (50% attenuation of Montgomery-Asberg Depression Rating Scale score), was identified in 66.1% of the sample. The patient-reported outcome measures-defined response rate was 53.1%. Remission (endpoint Montgomery-Asberg Depression Rating Scale score of 10 or less) was observed in 36.7% of the sample. Response (but not remission) was very slightly but significantly better in women than in men on some but not all measures.Conclusions: It is feasible to conduct simple but meaningful observational studies in primary care contexts that are not usually associated with research. About two-thirds of real-world adults in primary care in India diagnosed with uncomplicated first-episode major depressive disorder respond to 6 weeks of antidepressant medications; about one-third of the adults remit. [ABSTRACT FROM AUTHOR]

Depression is associated with low serum Brain Derived Neurotrophic Factor (BDNF) and elevated levels of serum cortisol. Yoga practices have been associated with antidepressant effects, increase in serum BDNF, and reduction in serum cortisol. This study examined the association between serum BDNF and cortisol levels in drug-naïve patients with depression treated with antidepressants, yoga therapy, and both. Fifty-four drug-naïve consenting adult outpatients with Major Depression (32 males) received antidepressants only (n = 16), yoga therapy only (n = 19), or yoga with antidepressants (n = 19). Serum BDNF andcortisol levels were obtained before and after 3 months using a sandwich ELISA method. One-way ANOVA, Chi-square test, and Pearson’s correlation tests were used for analysis. The groups were comparable at baseline on most parameters. Significant improvement in depression scores and serum BDNF levels, and reduction in serum cortisol in the yoga groups, have been described in previous reports. A significant negative correlation was observed between change in BDNF (pre–post) and cortisol (pre–post) levels in the yoga-only group (r = −0.59,p= 0.008). In conclusion, yoga may facilitate neuroplasticity through stress reduction in depressed patients. Further studies are needed to confirm the findings and delineate the pathways for these effects. [ABSTRACT FROM PUBLISHER]

Myrica nagi Hook (syn. Myrica esculenta Buch. & Ham) (Myricaceae) is commonly known as box berry. The bark of Myrica nagi is used in the treatment of mental illness by different ethnic groups of the rural region of Orissa (India). In the present work, the anxiolytic and antidepressant effects of an ethanol extract of M. nagi were analyzed at three different dosages (100, 200, and 400 mg/kg, p.o.) by elevated plus-maze, light/dark exploration test, tail suspension test, and the forced swimming model. Oral administration of the ethanol extract (100, 200, and 400 mg/kg, p.o.) of M. nagi showed significant (p < 0.01) and dose-dependent anxiolytic activity by increasing time spent in the open arms of the elevated plus-maze and in the lit box indicating an anxiolytic effect. Nevertheless this treatment was unable to exhibit an effect identical to antidepressants in the tail suspension and forced swimming tests. Altogether, these results suggest an anxiolytic effect of the ethanol extract of M. nagi. [ABSTRACT FROM AUTHOR]