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CTRI Number  CTRI/2025/07/090147 [Registered on: 03/07/2025] Trial Registered Prospectively
Last Modified On: 03/07/2025
Post Graduate Thesis  No 
Type of Trial  Observational 
Type of Study   Follow Up Study 
Study Design  Other 
Public Title of Study   Evaluation of Allopathic versus Ayurvedic Treatments for Major Depressive Disorder - A naturalistic study  
Scientific Title of Study   The SAFE Study: Clinical Effectiveness, Safety, and Health Evaluation of Allopathic versus Ayurvedic Treatments for Major Depressive Disorder: A Naturalistic Real-World Study  
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Prof Dr S N Gupta 
Designation  Distinguished Professor 
Affiliation  Maganbhai Adenwala Mahagujarat University 
Address  Department of Kayachikitsa J. S. Ayurved Mahavidyalaya College Road Nadiad
J. S. Ayurveda College Campus College Road Nadiad
Kheda
GUJARAT
387001
India 
Phone  9825261305  
Fax    
Email  guptayurveda@yahoo.com  
 
Details of Contact Person
Scientific Query
 
Name  Prof Dr Shivenarian Narsinghlal Gupta 
Designation  Distinguished Professor 
Affiliation  JS Ayurveda Mahavidyalaya and P D Patel Ayurveda Hospital 
Address  Room no. 101, Department Of Kayachikitsa P D Patel Ayurveda Hospital J. S. Ayurved College Campus College Road Nadiad
College Road Nadiad Gujarat
Kheda
GUJARAT
387001
India 
Phone  09825261305  
Fax  0268 252 0724  
Email  guptayurveda@yahoo.com  
 
Details of Contact Person
Public Query
 
Name  Prof Dr Manishkumar Vadilal Patel 
Designation  Professor & Head Department Of Kayachikitsa 
Affiliation  JS Ayurveda Mahavidyalaya and PD Patel Ayurveda Hospital 
Address  Room no. 102, P D Patel Ayurveda Hospital J. S. Ayurveda College Campus College Road Nadiad
College Road Nadiad Gujarat
Kheda
GUJARAT
387001
India 
Phone  09979589865  
Fax  0268 252 0724  
Email  manishayu97@yahoo.com  
 
Source of Monetary or Material Support  
P D Patel Ayurveda Hospital J S Ayurveda College Campus College Road Nadiad Dist Kheda Gujarat India Pincode 387001 
Shree krishna hospital Pramukhswami Medical College Gokalnagar Karamsad Gujarat India Pincode 388325 
 
Primary Sponsor  
Name  J S Ayurveda College 
Address  College Road Nadiad, Gujarat India Pincode - 387001 
Type of Sponsor  Private medical college 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Prof Dr Manishkumar Vadilal Patel  P D Patel Ayurveda Hospital   Room no. 102 OPD department of Kayachikitsa J S Ayurved Mahavidyalaya Campus College Road, Nadiad Kheda GUJARAT
Kheda
GUJARAT 
099795 89865

manishayu97@yahoo.com 
 
Details of Ethics Committee  
No of Ethics Committees= 2  
Name of Committee  Approval Status 
Bhaikaka University Institutional ethics committee  Approved 
Maganbhai Adenwala Mahagujarat University Institutional Ethics Committee for Human Research  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition:F331||Major depressive disorder, recurrent, moderate. Ayurveda Condition: UNMADAH,  
 
Intervention / Comparator Agent  
snoIntervention/ComparatorTypeDrug-TypeProcedure NameDetails
Intervention  Nil  Nil 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  65.00 Year(s)
Gender  Both 
Details  To be eligible for participation in this study potential participants must meet all of the following criteria
Gender and Age Participants must be adult females or males aged 18 to 65 years inclusive and be treated as in and or outpatients
Diagnosis Participants must have a primary diagnosis of Major Depressive Disorder MDD of moderate or severe severity as defined by clinician rating scales and clinical judgment according to DSM5 criteria Participants with active and current suicidality will be excluded
Prior Treatment Status Participants need to agree to start a new bout of allopathic or Ayurvedic treatment in the current episode regardless of any previous treatments received during the current episode
Informed Consent Participants must have the capacity to understand the study procedures and provide informed consent to participate They must also be willing to fully participate and adhere to the study protocol
These criteria aim to ensure a homogenous study sample to enhance the reliability and generalizability of study findings Any deviation from these criteria will be carefully documented and justified
 
 
ExclusionCriteria 
Details  Individuals will be excluded from participation in this study if they meet any of the following criteria
Severe Psychiatric Comorbidity
Active Suicidality
Substance Use Disorder
Pregnancy or Breastfeeding
Significant Medical or Neurological Conditions
Communication Barriers
These exclusion criteria are designed to minimize confounding variables and ensure that the study results are interpretable and generalizable to a population of individuals with MDD who are otherwise relatively healthy Any deviations from these criteria will be carefully documented and justified
 
 
Method of Generating Random Sequence   Not Applicable 
Method of Concealment   Not Applicable 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
The primary endpoint will focus on changes in depressive symptom severity, measured using three validated rating scales: the Hamilton Depression Rating Scale (HAM-D), the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Patient Health Questionnaire-9 (PHQ-9).The use of multiple scales enhances the reliability and validity of the assessment, providing a more comprehensive picture of symptom change. Statistical analyses comparing changes in scores across treatment groups will be conducted to determine the relative efficacy of each intervention.  Assessments will be conducted at baseline, bi-weekly for the first eight weeks, and then monthly until the six-month follow-up  
 
Secondary Outcome  
Outcome  TimePoints 
functional assessment and quality of life the fast clinical global impression cgi general assessment of functioning gaf and quality of life whoqolbref qlesqsf will be used to provide a detailed profile of functional status and disability this provides a patient centred perspective on treatment effectiveness complementing the clinician rated symptom severity measures  Assessments will be conducted at baseline bi-weekly for the first eight weeks and then monthly until the six month follow up 
adverse events the incidence and severity of adverse events will be meticulously recorded throughout the study period using a standardized adverse event reporting system uku gase this will allow for a direct comparison of the safety profiles of allopathic and ayurvedic treatments  Assessments will be conducted at baseline bi-weekly for the first eight weeks and then monthly until the six month follow up 
treatment adherence treatment adherence will be assessed using the medication adherence report scale mars5 supplemented by clinical judgment  Assessments will be conducted at baseline bi-weekly for the first eight weeks and then monthly until the six month follow up 
patient satisfaction patient satisfaction with treatment will be evaluated using a validated patient satisfaction questionnaire these measures will assess the acceptability and feasibility of each treatment approach  Assessments will be conducted at baseline bi-weekly for the first eight weeks and then monthly until the six month follow up 
daily functioning changes in daily functioning will be assessed using the global assessment of functioning gaf scale and the functional assessment short test fast it provides a quantitative measure of functional capacity in various domains eg social occupational and selfcare reflecting the impact of depression on daily life and the extent of functional recovery  Assessments will be conducted at baseline bi-weekly for the first eight weeks and then monthly until the six month follow up 
general health general health status will be assessed using measures such as body mass index bmi respiratory rate rr pulse ecg and comprehensive blood work such as liver function tests kidney function tests inflammatory markers such as crp leukocytes electrolytes blood tests and ecg will be taken at baseline and week 8 medical comorbidities will also be recorded allowing for adjustment in statistical analyses as needed  Assessments will be conducted at baseline bi-weekly for the first eight weeks and then monthly until the six month follow up 
 
Target Sample Size   Total Sample Size="105"
Sample Size from India="105" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   01/08/2025 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="2"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Open to Recruitment 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - YES
  1. What data in particular will be shared?
    Response - Individual participant data that underlie the results reported in this article, after de-identification (text, tables, figures, and appendices).

  2. What additional supporting information will be shared?
    Response -  Study Protocol
    Response -  Statistical Analysis Plan
    Response - Clinical Study Report

  3. Who will be able to view these files?
    Response - Researchers whose proposed use of the data has been approved by an independent review committee identified for this purpose.

  4. For what types of analyses will this data be available?
    Response - To achieve aims in the approved proposal.

  5. By what mechanism will data be made available?
    Response - Proposals should be directed to [drmanishvpatel@mamuni.edu.in].

  6. For how long will this data be available start date provided 10-06-2025 and end date provided 31-12-2030?
    Response - Beginning 3 months and ending 5 years following article publication.

  7. Any URL or additional information regarding plan/policy for sharing IPD? 
    Additional Information - Nil
Brief Summary  
Major Depressive Disorder MDD a debilitating mood disorder characterized by persistent sadness anhedonia and impaired functioning poses a significant global health challenge  While the precise etiology remains complex and multifaceted converging evidence points to a dysregulation of neurobiological systems interacting with environmental and psychosocial factors  This interplay underscores the need for comprehensive treatment approaches that address both the biological and psychological dimensions of the disorder  Current treatment strategies primarily utilize allopathic and increasingly complementary and alternative medicine CAM approaches such as Ayurvedic medicine 
Allopathic treatments for MDD predominantly focus on pharmacological interventions and various forms of psychotherapy  Pharmacological treatments primarily involve antidepressants targeting neurotransmitter systems to alleviate depressive symptoms  Selective serotonin reuptake inhibitors SSRIs serotonin norepinephrine reuptake inhibitors SNRIs tricyclic antidepressants TCAs and monoamine oxidase inhibitors MAOIs represent the main classes of antidepressants although their efficacy varies considerably between individuals Side effects including sexual dysfunction weight gain and sedation can limit treatment adherence and overall effectiveness  Furthermore a substantial proportion of individuals exhibit treatment resistance necessitating alternative or augmentation strategies  Psychotherapeutic interventions particularly cognitive behavioral therapy CBT and interpersonal psychotherapy IPT play a crucial role in modifying maladaptive thought patterns improving coping skills and enhancing interpersonal relationships  These therapies often demonstrate comparable efficacy to antidepressants particularly in preventing relapse
Ayurvedic medicine an ancient holistic system originating from India offers a complementary approach to MDD  This system emphasizes the interconnectedness of mind body and spirit aiming to restore balance through various interventions These include herbal remedies eg Ashwagandha Brahmi dietary modifications tailored to individual constitution Prakriti lifestyle adjustments promoting holistic wellbeing and mind body techniques such as yoga and meditation  While evidence level A and level B evidence studies and some smaller studies suggest the potential efficacy of Ayurvedic treatments in alleviating depressive symptoms    robust largescale randomized controlled trials comparing Ayurvedic interventions to allopathic treatments are relatively scarce  Understanding the mechanisms through which Ayurvedic interventions exert their effects on mood and related symptoms remains an area of active research
This necessitates a more comprehensive understanding of the relative efficacy safety and potential synergistic effects of integrating allopathic and Ayurvedic treatments for MDD A comparative evaluation of these approaches is crucial for informing evidence based clinical practice and optimizing therapeutic strategies for individuals experiencing this pervasive and debilitating disorder This study aims to address this critical gap in the literature through observation and analysis of real world outcomes of Allopathic and Ayurvedic treatment modalities for MDD
 Review of literature
Previous studies have shown that allopathic psychiatric medication can be combined safely with Ayurvedic treatments such as herbs    
Objectives of the present study
Hypothesis and Objectives
Based on the published literature we assume that both Allopathic and Ayurvedic treatments are efficacious Hence we do expect any statistically significant difference between the treatment groups in improving symptoms of depression over  weeks However we hypothesise that all treatment groups lead to a statistically significant reduction in symptoms between baseline and week  

This study will pursue the following scientific objectives
  Comparative Efficacy To quantitatively compare the efficacy of Allopathic and Ayurvedic treatments and their combination in reducing the severity of depressive symptoms in adults diagnosed with Major Depressive Disorder MDD as measured by validated rating scales eg Hamilton Depression Rating Scale HAMD Montgomery Åsberg Depression Rating Scale MADRS Patient Health Questionnaire PHQ at specified time points eg baseline  weeks  months  months  Statistical analyses eg ANOVA t tests will determine the significance of any differences in symptom reduction between treatment groups

  Safety adverse Effects and Quality of Life To compare the incidence type and severity of adverse events associated with Allopathic and Ayurvedic treatments using standardized adverse event reporting Furthermore to assess differences in quality of life QoL and daily functioning between treatment groups using validated QoL instruments eg WHOQOLBREF and functional assessment scales eg Global Assessment of Functioning GAF Functional Assessment Short Test FAST  Statistical analyses will determine the significance of any differences in adverse events and QoL outcomes between treatment groups

  General Health Evaluation To evaluate and compare changes in general health parameters eg Body Mass Index BMI vital signs relevant blood work indicators such as liver and kidney function electrolytes CRP leukocytes histogram and TSH across treatment groups over the study duration   Statistical analyses will assess for significant differences in general health outcomes between treatment groups

These objectives will be achieved through rigorous data collection methods and appropriate statistical analysis employing intention to treat principles to maximize the inclusion of collected data and enhance the generalizability of results The study will adhere to relevant ethical guidelines for the conduct of human subject research

 
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