Feasibility and Tolerability of Vamana Dhauti as an Add-On Treatment in Patients with Depression: A Pilot Randomised Controlled Trial.

Background: Depression is a prevalent mental health disorder and a significant contributor to disability adjusted life years. It is also associated with increased cardiovascular risk, often not adequately addressed by current treatments, leading to significant gaps in the treatment. Yoga practices like Vamana Dhauti could be a potential adjunct therapy to standard treatments by balancing doshas and positively influencing vagal tone. Objective: This pilot randomised controlled trial aimed to assess the feasibility and tolerability of Vamana Dhauti in depression patients and its effects on Heart Rate Variability (HRV). Clinical changes were evaluated using the Hamilton Rating Scale for Depression (HAM-D). Methods: The study was conducted at the Department of Integrative Medicine, NIMHANS, Bengaluru. Patients with depression, aged 18-50 years, both genders, and no contraindications to Vamana Dhauti, were randomly assigned to Vamana Dhauti + Shavasana (n = 12) or Shavasana rest only (n = 12) groups using online software, which also included allocation concealment. Outcome measures include feasibility (acceptability, demand, practicality, adaptation, integration, perceived ease, and difficulty), tolerability (adverse events), HRV and HAM-D. Results: Vamana Dhauti was found feasible and tolerable in patients diagnosed with depression. Vamana Dhauti was well-accepted, could be completed within the given setting and time, and was found to be easy to practice by participants (VAS = 2 ± 1.65; 0 being very easy and 10 being very difficult) with few mild adverse events (n = 2/12). Notably, a significant group × time interaction was observed in HRV, low-frequency measures [F (1,22) = 8.168; p = .009)]. Both groups saw an increase in Low-frequency during the first 10 minutes of Shavasana (control > intervention), but after 20 minutes, only the intervention group returned to baseline values, showing improved resilience. Clinical outcomes measured by HAM-D showed a significant improvement in both groups. Conclusion: Vamana Dhauti is feasible and well-tolerated by patients diagnosed with depression, suggesting its potential integration into depression-focused Yoga modules.