Efficacy of herbal combination of sedge, saffron, and Astragalus honey on major neurocognitive disorder

Abstract

Background:Major neurocognitive disorder (MCD) is an acquired progressive decline in cognitive abilities that causes a drop in specific acquired performance compared to former performances. We tried to investigate the efficacy of herbal combination of sedge, saffron, and Astragalus honey on cognitive and depression score of patients with MCD.Materials and Methods:It was a randomized double-blind clinical trial conducted on sixty patients with MCD, who referred to the geriatric psychiatry clinic of Isfahan University of Medical Sciences in Iran. All the study participants had been using anti-MCD medications. Participants were randomized to receive a combination of sedge, saffron, and Astragalus honey in case group (n = 30) or placebo group for 8 weeks other than anti-MCD medications. Cognitive and depression scores were assessed using Addenbrook's Cognitive Scale and Geriatric Depression Scale, respectively, before intervention and at the 1st and 2nd months after intervention. The ANCOVA repeated-measure test was used to analyze the data using SPSS 20 software.Results:The Addenbrook's Cognitive Test score was 32.2 ± 26.5 in intervention and 22.1 ± 15.1 in control group before intervention (P = 0.074) and 38.8 ± 27.7 in intervention group and 22.6 ± 14.1 in control group in control group 1 month after intervention (P = 0.007). In addition, Geriatric Depression Scale score was 14.6 ± 7.9 in intervention group and 14.5 ± 6.9 in control group before intervention (P = 0.945) and 12.9 ± 6.9 in intervention and 14.3 ± 7.1 in control group 1 month after intervention (P = 0.465) and 12.2 ± 6.5 in intervention group and 14.4 ± 7.1 in control group 2 month after intervention (P = 0.224).Conclusion:Our findings suggest that adding the herbal combination of sedge, saffron, and Astragalus honey to the current protocols of treatment of MCD patients could be useful in the improvement of cognitive and depression score of these patients.

New horizons for the study of saffron (Crocus sativus L.) and its active ingredients in the management of neurological and psychiatric disorders: A systematic review of clinical evidence and mechanisms

“…A total of 7 publications with 368 patients were eligible for inclusion, and the intervention duration varied from 8 to 48 weeks (Abbaszadeh‐Mashkani et al, 2020; Akhondzadeh, Sabet, et al, 2010; Akhondzadeh, Shafiee Sabet, et al, 2010; Akouchekian et al, 2018; Farokhnia et al, 2014; Moazen‐Zadeh et al, 2018; Tsolaki et al, 2016). Six studies were conducted in Iran and one in Greece.…”

“…For placebo‐controlled studies (Abedimanesh et al, 2017; Agha‐Hosseini et al, 2008; Akhondzadeh et al, 2005; Akhondzadeh et al, 2020; Akouchekian et al, 2018; Ghaderi et al, 2019; Jalali & Hashemi, 2018; Kashani et al, 2018; Kell et al, 2017; Khalatbari‐Mohseni et al, 2019; Lopresti et al, 2018, 2020; Lopresti & Drummond, 2017; Mazidi et al, 2016; Milajerdi et al, 2018; Moazen‐Zadeh et al, 2018; Moshiri et al, 2006; Salek et al, 2021; Tabeshpour et al, 2017; Tajaddini et al, 2021; Tsolaki et al, 2016), the pooled analysis suggested that saffron showed a greater improvement in depression symptoms when compared with placebo, with an average net change in scores ranging from −8.96 to 1.13 and 12 of 22 trials reaching statistical significance (Figure 2a). After meta‐analysis, the overall effect size of saffron was −4.26 (95% CI: −5.76, −2.77), and high heterogeneity with an I 2 of 85.3% was observed.…”

“…Therefore, large‐scale trials with consistent outcome measures are needed to assess the effects of saffron on cognitive disorders. Of the seven included studies, one study evaluated the effects of saffron (60 mg) in combination with sedge and honey in patients with major neurocognitive disorders compared with routine anti‐MCD medications (Akouchekian et al, 2018), one study reported the effects of crocin in patients under methadone maintenance treatment (Abbaszadeh‐Mashkani et al, 2020), and the remaining studies examined the effects of saffron alone in patients with mild cognitive impairment or AD compared with placebo or anti‐AD medications. The possible mechanisms underlying the effects of saffron in improving cognitive disorders is related to its inhibitory action on acetylcholinesterase activity, aggregation of beta‐amyloid protein into amyloid plaques and tau protein into neurofibrillary tangles, partly through its antioxidant, anti‐inflammatory, and antiapoptotic abilities (Cerda‐Bernad et al, 2022; D'Onofrio et al, 2021; Saeedi & Rashidy‐Pour, 2021; Song et al, 2022; Sugiura et al, 2022; Wang et al, 2019).…”

“…b SSIR: fluoxetine 20 mg/day or sertraline 50 mg/day or citalopram 20 mg/day. c Herbal oil (two drops) with 0.02 mg saffron extract, is a mixture of saffron, lettuce seeds and sweet violet.T A B L E 3(Abbaszadeh-Mashkani et al, 2020; Akhondzadeh, Sabet, et al, 2010; Akhondzadeh, Shafiee Sabet, et al, 2010;Akouchekian et al, 2018;Farokhnia et al, 2014;Moazen-Zadeh et al, 2018;Tsolaki et al, 2016). Six studies were conducted in Iran and one in Greece.…”

Cyperus spp.: A Review on Phytochemical Composition, Biological Activity, and Health-Promoting Effects

“…The results indicated that the combination could be useful to improve the cognitive and depression score. However, the extract used was not characterized, and the preparation method was not indicated [ 134 ]. The traditional Iranian herbal medicine, Davaie Loban, composed of C. rotundus , Zingiber officinale , Acorus calamus , Piper nigrum , and Boswellia carterii has also been tested against AD.…”