Depression with Comorbid Diabetes: What Evidence Exists for Treatments Using Traditional Chinese Medicine and Natural Products?

Abstract

Comorbidity between diabetes mellitus (DM) and depression, two chronic and devastating diseases spreading worldwide, has been confirmed by a large body of epidemiological and clinical studies. Due to the bidirectional relationship between DM and depression, this comorbidity leads to poorer outcomes in both conditions. Given the adverse effects and limited effectiveness of the existing therapies for depression associated with diabetes, the development of novel therapeutic drugs with more potency and fewer side effects is still the most important goal. Hence, many researchers have made great efforts to investigate the potential usefulness of traditional Chinese medicine (TCM) and natural products, including natural extracts and purified compounds, in the treatment of comorbid depression in diabetes. Here, we reviewed the related literature on TCM and natural products that can remedy the comorbidity of diabetes and depression and presented them on the basis of their mechanism of action, focusing on shared risk factors, including insulin resistance, oxidative stress and inflammation, and nervous disturbances. In short, this review suggests that TCM and natural products could expand the therapeutic alternatives to ameliorate the association between DM and depressive disorders.

Oral herbal medicine for treatment of postherpetic neuralgia: A protocol for systematic review and meta-analysis

“…[ 25 ] Herbal medicine, in particular, is a complex ingredient that acts through various mechanisms and has therapeutic effects on CCD, in which various symptoms are complicatedly intertwined. [ 26 – 28 ]…”

“…[25] Herbal medicine, in particular, is a complex ingredient that acts through various mechanisms and has therapeutic effects on CCD, in which various symptoms are complicatedly intertwined. [26][27][28] A previous systematic review [17] suggested that oral herbal medicines for PHN may be effective and safe for pain relief. However, these results should be interpreted with caution owing to methodological issues, the low quality of the included RCTs, or problems with the selection criteria used.…”

Integrated analysis of the chemical-material basis and molecular mechanisms for the classic herbal formula of Lily Bulb and Rehmannia Decoction in alleviating depression

“…These altered miRNAs (rno-miR-879-5p, rno-miR-7a-5p, rno-miR-499-5p, rno-miR-495, rno-miR-204-5p, rno-miR-199a-3p, rno-miR-151-3p, rno-miR-144-3p, rno-miR-24-3p, rno-miR-25-3p, and rno-miR-21-5p) targeting differentially expressed mRNAs ( Btg2 , Slc39a12 , Calml4 , Foxs1 , Nr1d1 , Ntrk2 , Tnfaip6 , Arc , Ntf3 , GAT-3 , VGAT , Gad1 , and Bdnf ) were attributed to the neurotrophic, MAPK, PI3K-Akt, and cAMP signaling pathways, alanine, aspartate and glutamate metabolism, GABAergic synapse, and circadian rhythm. These signaling pathways were also involved in the anti-depression and anti-anxiety efficacy of current alternative therapy including TCM formula, Chinese herbs, extract, acupuncture, massage, exercise, and in experimental manipulations with fast-acting antidepressant-like (ketamine) activity [ 6 , 71 – 76 ].…”

“…This persistent incapacity for treating depression efficiently results in part from the heterogeneity of the disorder and the insufficient understanding of the functional and molecular mechanisms underlying its onset [ 4 ]. Hence, this is urgent need for immediate and effective treatments for depression with fewer adverse events, and complementary and alternative medicinal therapies, particularly traditional Chinese medicine (TCM), are widely tested for this purpose [ 5 , 6 ]. TCM is a holistic treatment which emphasizes the integration of a variety of biological systems in the human body and the plants represent important raw materials for new compounds that warrant further investigation.…”

Attenuated brain derived neurotrophic factor and depression in type 2 diabetes mellitus patients: A case-control study

“…28 In patients with DM and depressive disorders, a wide variety of disturbances may affect the central nervous systems, including the overactivation of the HPA axis, decreased monoamine neurotransmitters, and dysfunctional brain-derived neurotrophic factor. 29 Several mechanisms have been suggested by which BDNF influences depression in T2DM. Since BDNF forms have opposing effects on cell survival, 'yin and yang' model of neurotrophin action has been suggested.…”