Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
Neurotox Res. 2018 Apr;33(3):621-633. doi: 10.1007/s12640-017-9860-4. Epub 2018 Jan 11.
Activation of immune-inflammatory and oxidative-nitrosative (IO&NS) stress pathways plays a role in major depression (MDD). Evidence suggests that curcumin (500-1000 mg/day), a polyphenol with strong anti-IO&NS properties, may have efficacy either as monotherapy or as an adjunctive treatment for depression. Further controlled trials with extended treatment periods (> 8 weeks) and higher curcumin doses are warranted. This 12-week study was carried out to examine the effects of adjunctive curcumin for the treatment of MDD. In this double-blind, placebo-controlled trial, 65 participants with MDD were randomized to receive either adjunctive curcumin (increasing dose from 500 to 1500 mg/day) or placebo for 12 weeks. Four weeks after the active treatment phase, a follow-up visit was conducted at week 16. Assessments of the primary, i.e., the Montgomery-Asberg Depression Rating Scale (MADRS), and secondary, i.e., the Hamilton Anxiety Rating Scale (HAM-A), outcome measures were rated at baseline and 2, 4, 8, 12, and 16 weeks later. Curcumin was more efficacious than placebo in improving MADRS scores with significant differences between curcumin and placebo emerging at weeks 12 and 16. The effects of curcumin were more pronounced in males compared to females. There were no statistically significant treatment-emerging adverse effects and no significant effects of curcumin on blood chemistry and ECG measurements. Adjunctive curcumin has significant antidepressant effects in participants with MDD as evidenced by significant benefits occurring 12 and 16 weeks after treatment initiation. Curcumin administration was safe and well-tolerated even when combined with antidepressants. Future trials should include treatment-by-sex interactions to examine putative antidepressant effects of immune-modifying compounds.
免疫炎症和氧化硝化(IO&NS)应激途径的激活在重度抑郁症(MDD)中发挥作用。有证据表明,姜黄素(每天 500-1000 毫克)作为一种具有强大抗 IO&NS 特性的多酚,无论是作为单一疗法还是作为抑郁症的辅助治疗,都可能有效。需要进行进一步的对照试验,延长治疗期(>8 周)并增加姜黄素剂量。这项为期 12 周的研究旨在检验辅助姜黄素治疗 MDD 的效果。在这项双盲、安慰剂对照试验中,65 名 MDD 患者被随机分配接受辅助姜黄素(剂量从 500 毫克增加到 1500 毫克/天)或安慰剂治疗 12 周。在积极治疗阶段结束后四周,在第 16 周进行随访。主要评估指标,即蒙哥马利-阿斯伯格抑郁评定量表(MADRS)和次要评估指标,即汉密尔顿焦虑评定量表(HAM-A),在基线和 2、4、8、12 和 16 周后进行评估。姜黄素在改善 MADRS 评分方面比安慰剂更有效,姜黄素和安慰剂之间的差异在第 12 和 16 周时显现出来。姜黄素的效果在男性中比女性更明显。没有出现统计学上显著的治疗后不良反应,也没有发现姜黄素对血液化学和心电图测量有显著影响。辅助姜黄素在 MDD 患者中具有显著的抗抑郁作用,这从治疗开始后 12 和 16 周出现的显著益处中可以得到证明。即使与抗抑郁药联合使用,姜黄素给药也是安全且耐受良好的。未来的试验应包括治疗性别交互作用,以检验免疫调节化合物的潜在抗抑郁作用。