Yoga for Depression

Recruiting at 1 trial location

Overseen By Sudha Prathikanti, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, San Francisco

Must not be taking: Antidepressants

Disqualifiers: Psychotherapy, Pregnancy, Medical issues, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

180 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this single-center, single-blind, randomized, controlled, parallel group, interventional trial is to evaluate antidepressant efficacy of yoga monotherapy of 12-weeks duration in 180 adults meeting diagnostic criteria for mild-to-moderate major depression at the Zuckerberg San Francisco General Hospital. Researchers will compare the yoga interventions to an education control intervention on holistic healthcare.

Will I have to stop taking my current medications?

If you are currently using antidepressant medication, you cannot participate in this trial. The trial is for those not taking antidepressants.

What data supports the effectiveness of the treatment Yoga, Mindfulness Program, Meditation Program, Yoga Therapy for depression?

Research shows that yoga, especially when combined with mindfulness or meditation, can help reduce symptoms of depression. Studies found that yoga can improve mindfulness and reduce rumination (repetitive negative thinking), which are important for managing depression. ^{1 2 3 4 5}

Is yoga generally safe for humans?

Research shows that yoga is generally safe for humans, with no significant differences in serious adverse events compared to usual care or exercise. However, there may be more nonserious adverse events compared to psychological or educational interventions. ^{6 7 8 9 10}

How is yoga different from other treatments for depression?

Yoga for depression is unique because it combines physical postures with mindfulness and meditation, focusing on calmness and being non-judgmental. Unlike medications, it is a mind-body approach that can improve both mental and physical health without the use of drugs. ^{1 4 9 10 11}

Research Team

Sudha Prathikanti, MD

Principal Investigator

University of California, San Francisco

Eligibility Criteria

Adults over 18 with mild-to-moderate major depression can join this study in San Francisco. Participants must speak English well and be able to attend all sessions. They shouldn't have severe mental illnesses besides depression, use antidepressants or psychotherapy during the trial, or have certain medical conditions like severe pulmonary disease.

Inclusion Criteria

People of all different backgrounds and ethnicities are welcome to participate.

You have been diagnosed with major depression based on a special interview with a healthcare professional.

My gender identity does not limit my participation.

Exclusion Criteria

You have been diagnosed with a drug or alcohol addiction within the past two months.

I have a severe lung condition.

I have a narrowing in my carotid artery.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants are randomized to one of three in-person group interventions: Standard yoga practice, Ayurvedic yoga practice, or educational attention-control modules for 12 weeks

12 weeks

Weekly in-person sessions

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Yoga

Trial Overview This study tests if yoga alone can help treat depression compared to an education program about holistic healthcare. It's a controlled trial where adults diagnosed with depression do yoga for 12 weeks at Zuckerberg San Francisco General Hospital.

Participant Groups

Group I: Yoga practice Experimental Treatment 1 Intervention

Yoga practice groups

Group II: Education Active Control 1 Intervention

Education module group

Who Is Running the Clinical Trial?

University of California, San Francisco

Lead Sponsor

Trials

2,636

Recruited

19,080,000+

Findings from Research

Mindfulness yoga significantly reduces depression severity in patients with major depressive disorder (MDD), with a moderate effect size based on a meta-analysis of nine randomized controlled trials involving 581 participants.

The intervention also appears to alleviate anxiety levels in MDD patients, although it did not show a significant impact on rumination immediately after the intervention, suggesting potential benefits in the longer term.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of mindfulness yoga on patients with major depressive disorder: a systematic review and meta-analysis of randomized controlled trials. Miao, C., Gao, Y., Li, X., et al.[2023]

In a study of 110 persistently depressed individuals, yoga was found to significantly increase mindfulness, particularly the 'observe' aspect, compared to a health education class over a 10-week period.

While yoga showed a positive effect on mindfulness, it did not significantly reduce rumination, indicating that while yoga may enhance awareness, it may not directly address repetitive negative thinking associated with depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Yoga v. health education for attentional processes relevant to major depressive disorder. West, JL., Tremont, G., Miller, IW., et al.[2022]

A 10-week hatha yoga program for 50 participants with moderate depression showed that a supportive and non-judgmental teaching environment, along with mindfulness and breathing exercises, can enhance the effectiveness of yoga in addressing depression.

Participants emphasized the importance of mindfulness and self-acceptance as key mechanisms through which yoga may help alleviate depressive symptoms, although some expressed concerns about the physical difficulty of the classes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perceptions of hatha yoga amongst persistently depressed individuals enrolled in a trial of yoga for depression. Uebelacker, LA., Kraines, M., Broughton, MK., et al.[2018]

A systematic review of 12 randomized controlled trials involving 619 participants found that yoga has moderate short-term effects in reducing the severity of depression compared to usual care, with a significant effect size (SMD = -0.69).

Yoga also showed limited effectiveness in reducing anxiety compared to relaxation techniques, suggesting it could be a beneficial adjunct treatment for individuals with depression, although safety data was not reported.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Yoga for depression: a systematic review and meta-analysis. Cramer, H., Lauche, R., Langhorst, J., et al.[2022]

A 9-week mindful yoga intervention (MYI) added to standard treatment did not significantly reduce depression symptoms or improve quality of life in young women with major depressive disorder (MDD) compared to standard treatment alone, based on a randomized controlled trial with 171 participants.

The study found no significant mediating effects from factors like self-criticism or mindfulness, except for self-compassion, indicating that MYI may not enhance the effectiveness of standard treatment for depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mindful yoga intervention as add-on to treatment as usual for young women with major depressive disorder: Results from a randomized controlled trial. Vollbehr, NK., Hoenders, HJR., Bartels-Velthuis, AA., et al.[2023]

Yoga has been shown to significantly improve short-term depressive symptoms, based on a systematic review of 12 randomized controlled trials involving 619 participants, although there was a high risk of bias in many studies.

The evidence for yoga's effectiveness in treating general anxiety disorder (GAD), panic disorder (PD), and posttraumatic stress disorder (PTSD) is inconclusive, with only a few small studies available and no strong conclusions drawn.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evidence Map of Yoga for Depression, Anxiety, and Posttraumatic Stress Disorder. Duan-Porter, W., Coeytaux, RR., McDuffie, JR., et al.[2022]

A systematic review of 94 randomized controlled trials involving 8,430 participants found that yoga is as safe as usual care and exercise, with no significant differences in serious adverse events or dropouts due to adverse events.

While yoga had a higher occurrence of nonserious adverse events compared to psychological or educational interventions, the overall safety profile suggests that it is a viable therapeutic option, highlighting the need for better reporting of safety data in future studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Safety of Yoga: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cramer, H., Ward, L., Saper, R., et al.[2018]

In a study of 2508 yoga class attendees, about 27.8% reported experiencing adverse events, primarily mild musculoskeletal symptoms, indicating that while yoga is generally safe, some participants may face risks, especially those with chronic conditions.

Participants with chronic diseases, poor physical condition, or those who found the class stressful had a higher likelihood of experiencing adverse events, particularly severe ones in elderly individuals and those with chronic musculoskeletal issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A large-scale survey of adverse events experienced in yoga classes. Matsushita, T., Oka, T.[2022]

Mindful yoga appears to be a safe and beneficial intervention for older adults with depression, as participants reported improvements in both mental and physical health after the program.

The study suggests that single-sex mindful yoga groups may enhance acceptability for participants, indicating a need for further research to explore the feasibility and efficacy of this approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The experience of mindful yoga for older adults with depression. Lee, KC., Tang, WK., Bressington, D.[2019]

In a study involving 137 out-patients with major depression, those who practiced yoga (either alone or alongside medication) showed significantly greater reductions in depression scores compared to those who only received medication.

No adverse events were reported in patients practicing yoga, suggesting it is a safe and effective complementary treatment for depression in non-suicidal out-patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Positive antidepressant effects of generic yoga in depressive out-patients: A comparative study. Gangadhar, BN., Naveen, GH., Rao, MG., et al.[2021]

A new yoga protocol has been developed specifically for treating mild and moderate depression, based on classical texts and expert opinions, identifying 26 practices for mild depression and 35 for moderate depression.

Expert validation showed that a significant number of these practices (13 for mild and 12 for moderate depression) were deemed essential, marking an important step towards creating a validated treatment protocol that will be tested in future randomized controlled studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and Validation of Yoga Protocol for Patients with Depression. K S, D., K, M., Silambanan, S., et al.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

The effectiveness of mindfulness yoga on patients with major depressive disorder: a systematic review and meta-analysis of randomized controlled trials. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Yoga v. health education for attentional processes relevant to major depressive disorder. [2022]

3. Scotland pubmed.ncbi.nlm.nih.gov

Perceptions of hatha yoga amongst persistently depressed individuals enrolled in a trial of yoga for depression. [2018]

4. United States pubmed.ncbi.nlm.nih.gov

Yoga for depression: a systematic review and meta-analysis. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Mindful yoga intervention as add-on to treatment as usual for young women with major depressive disorder: Results from a randomized controlled trial. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Evidence Map of Yoga for Depression, Anxiety, and Posttraumatic Stress Disorder. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

The Safety of Yoga: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. [2018]

8. England pubmed.ncbi.nlm.nih.gov

A large-scale survey of adverse events experienced in yoga classes. [2022]

9. England pubmed.ncbi.nlm.nih.gov

The experience of mindful yoga for older adults with depression. [2019]

10. India pubmed.ncbi.nlm.nih.gov

Positive antidepressant effects of generic yoga in depressive out-patients: A comparative study. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

Development and Validation of Yoga Protocol for Patients with Depression. [2023]