Download In patients with depression, does curcuman

Curcumin for Patients with Depression
Appraised by: Kayla Dolyniuk SN, Alexis Hogan SN, Alexa Boyd SN, and
Kristen Greenstein SN
NDSU Nursing at Sanford Health, Bismarck, ND
Clinical Question:
Does the use of curcumin decrease depressive symptoms in patients with depression?
Articles:
Kukarni, S., Bhutani, M., & Bishnoi, M. (2008). Antidepressant activity of serotonin and
dopamine system. Psychopharmacology. 201 (3). 435-442. doi:10.10071500213-0081300-4
Lopresti, A., Maes, M., Maker, G., Hood, S., & Drummond, P. (2014). Curcumin for the
treatment of major depression: a randomized double-blind, placebo controlled study.
Journal of Affective Disorders. 167, 368-375. doi: 10.1016/j.jad.2014.06.001.
Panahi, Y., Badeli, R., Karami, G., & Sahebkar, A. (2014). Investigation of the efficacy of
adjunctive therapy with bioavailability – boosted curcuminoids in major depressive
disorder. Phytotherapy Research. doi:10.1002/ptr.5211
Sanmukhani, J., Satodio, V., Trivedi, J., Patel, T., Tiwari, D., Panchal, B., Bhanu Tripathi, C.
(2013). Efficacy and safety of curcumin in major depressive disorder: a randomized
controlled trial. Phytotherapy Research. 28(4), 579-585. doi:10.1002/ptr.5025
Synthesis of Conclusions:
Four research articles pertaining to the use of curcumin to treat symptoms of depression
were appraised. Each study appraised was rated on the strength of their evidence from Levels I to VII,
with Level I being a systematic review of random control trials and Level VII opinion of authorities. Two
of the articles were random control trials, one was an experimental design, and the other a quasiexperimental. All of the studies had limitations and the validity and reliability of the data
collection was not reported in any of the studies, however they did appropriately describe the
methods of collection and measurement tools used.
The first study by Kukarni, S., Bhutani, M., & Bishnoi, M. (2008) concluded that the use
of curcuminoids increased dopamine and serotonin levels in mice. The second study by Lopresti
et al (2014) conducted a level I randomized double-blind placebo-controlled clinical trial. This
experiment tested the antidepressant effects of curcumin in people with major depressive
disorder and concluded with partial support of curcumin due to the limitation of a small sample
size. Sanmukhani et al (2013) conducted a level I randomized controlled trial over a 6 week
period in which the efficacy and safety of curcumin was proven for patients diagnosed with
depression. Lastly, Panahi et al (2014) conducted a level III quasi-experimental study to
investigate the effect of curcumin in patients who were already receiving standard antidepressant
medication. This study showed that curcumin is effective in adjunct to standard medications for
patient with Major Depressive Disorder.
All 4 of these studies were included in this research, because they focus on the effects of
curcumin on depressive symptoms, but with a wide variety of treatment styles and study designs.
Each study showed positive evidence for the use of curcumin as a natural medication to decrease
the symptoms of depression.
Bottom Line:
Evidence based research shows that curcumin was found to be safe and effective in
treating depressive symptoms. The natural supplement was studied by comparing it to placebos
or current medications used to treat depression and/or in combination with these medications.
The evidence found in researching this topic addressed the issue of depression, the symptoms
experienced form the disorder, and the effects of multiple treatment options. With the
background knowledge that natural supplements produce few side-effects, and the research
showing that curcumin does decrease the signs and symptoms of depression and is as effective as
the current medications used, there is sufficient evidence to suggest changing the current
standards of treatment to improve clinical outcomes and patient satisfaction.
Implications for Nursing Practice:
Practice recommendations include an in-service with medical providers who work in the
psychiatric field. A staff meeting for nurses working alongside these providers would also
receive an in-service or online education about the benefits and plan for use of curcumin in
patients diagnosed with depression. With these education opportunities nurses would be able to
properly educate patients on the benefits of a holistic approach to treating depression. Ideally
medical providers would implement the recommendation of curcumin gradually in their practice,
and after one year at least 50% of patients with depression would have either curcumin
prescribed to treat their depression primarily or prescribed in conjunction with their regular
depression medication. Careful documentation would be integrated into prescribing curcumin to
further enforce the evidence of positive patient outcomes. We would like to give the patient the
option of a natural supplement to treat symptoms of depression with fewer negative side effects
than standard antidepressant medications.