Andemac Tablet

1. Psychotic depression, which occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations).
2. Postpartum depression, which many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming.
3. Seasonal affective disorder (SAD), which is characterized by the onset of depression during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer.
4. Bipolar disorder, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changes—from extreme highs (e.g., mania) to extreme lows (e.g., depression).

ANXIETY

Anxiety is an unpleasant state of inner turmoil, often accompanied by nervous behavior, such as pacing back and forth, and somatic complaints.

It is often accompanied by restlessness, fatigue, problems in concentration, and muscular tension.

Most common anxiety disorders:

1. Generalized anxiety disorder (GAD) is an anxiety disorder that is characterized by excessive, uncontrollable and often irrational worry about everyday things that is disproportionate to the actual source of worry.

Symptoms must last at least six months. Symptoms including fatigue, fidgeting,  headaches, nausea, numbness in hands and feet, muscle tension, muscle aches, difficulty swallowing, bouts of difficulty breathing, difficulty concentrating, trembling, twitching,  irritability,  agitation sweating, restlessness, insomnia, hot flashes, and rashes and inability to fully control the anxiety.

2. Obsessive-compulsive disorder (OCD) recurring irrational thoughts that lead you to perform specific, repeated behaviors.

Symptoms of the disorder include excessive washing or cleaning; repeated checking. However, OCD sufferers generally recognize their obsessions and compulsions as irrational and may become further distressed by this realization.

3. Panic disorder is an anxiety disorder characterized by recurring severe panic attacks. A person with panic disorder may live in fear of the next panic attack. Panic disorder is not the same as agoraphobia (fear of public places). Although many afflicted with panic disorder also suffer from agoraphobia. Panic disorder may be differentiated as a medical condition, or chemical imbalance.

4. Post-traumatic stress disorder (PTSD) may develop after a person is exposed to one or more traumatic events, such as sexual assault, serious injury or the threat of death.

Symptoms such as disturbing recurring flashbacks, avoidance or numbing of memories of the event, and hyper arousal (high levels of anxiety) continue for more than a month after the traumatic event. Women are more likely to develop PTSD than men.

5. Social anxiety disorder (SAD)or (social phobia) is the most common anxiety disorder. It is characterized by intense fear in social situations, causing considerable distress and impaired ability to function in at least some parts of daily life. These fears can be triggered by perceived or actual scrutiny from others.

Symptoms include excessive blushing, sweating (hyperhidrosis), trembling, palpitations and nausea. Stammering may be present, along with rapid speech. Panic attacks can also occur under intense fear and discomfort.

SAD is sometimes referred to as an ‘illness of lost opportunities’. Symptoms of anxiety can range in number, intensity, and frequency, depending on the person.

6. Separation anxiety disorder is fear of being away from home or loved ones.

General symptoms of anxiety and depression

• Restlessness
• Irritability
• Fast heartbeat
• Excessive worry
• Feeling nervous or tense

 

Anxiety and Depression according to Ayurveda

Anxiety and depression are the mental disorders known as Manasvikar or Manasroga in Ayurveda.

According to Ayurveda, person is said to behealthy when they enjoy balance between sharirika and manasikadosha, of energies produced in the body (samaganischa), tissues in the organs (samadhatu) combined with proper elimination of mala from our body (malakriya), a happy atma (prasannatma), happy of functioning mind (prasannamanaha) and proper functioning of five senses (samaindriyas).

Ayurveda described three Manasgunas, i.e. Satwa, Rajas, Tama. If there is imbalance between the Satva, Rajas and Tamas then it can lead to disease by vitiation of Manas Guna’s and becomes manas Dosha except the Satva guna. AcharayaCharak has mentioned that vitiated vata, pitta and kapha (dosha of sharira) circulate in entire body through the shrotas(circulatory channels of the body) along with manasika doshas, causes mental illness.

Some Manshika Vikaras describes in Ayurveda:

• Unmada (Psychosis)
• Apasmara (Epilepsy)
• Bhrama (illusion)
• Avasada (Depression)
• CittoUdvega (Anxiety disorder)
• Vibhrama(Delusion)

Ayurveda is believed to cure human diseases through establishment of equilibrium in the different elements of human life, the body, the mind, the intellect and the soul. Use of Medhya Rasayana drugs is a unique method of treatment described in Ayurveda for mental illness. Those specific to brain tissues called Medhya Rasayana. They are claimed to promote cognitive functions of the brain and helps in regeneration of neural tissues besides producing anti-stress and memory enhancing effect and retards brain aging. The mode of Medhyarasayana therapy involves the individual to attain sedation, calmness, tranquility or a stimulation of activities of brain. Medhyarasayana drugs are used for prevention and treatment of mental disorder of all age groups.

Medhyarasayan drugs promote “Biddhi” and “Manas” by correcting the disturbances of “Rajas” and “Tamas”. This helps the mentally disturbed patients to get relieve from stress, anxiety and depression.

Composition

Each tablet contains

Mass extract derived from: Mandukparni 300mg, Yashtimadhu 300mg, Ashwagandha  300mg, Vacha 300mg, Sugandhbala 250mg, Amla 100mg

Powders of: Jatamamsi 50mg, Ashwagandha 200mg

Bhavana: Brahmi (qs)

Features of Herbs

Mandukparni(Centellaasiatica)

In ayurveda it is described under the Medhyarasayana drugs with pitta kaphashamak properties. It is a neuroprotective agent used traditionally since decades in ayurvedic medicine.

In a clinical study, the extract of Centellaasiatica (CA) on generalized anxiety disorder (GAD) in mean was evaluated. Thirty-three participants (18 male and 15 female; average age 33 yrs) were medicated with the CA in a fixed dose regime (500 mg/capsule, twice daily, after meal). The observations revealed that, CA not only significantly attenuated anxiety related disorders but it also significantly reduced stress phenomenon and its correlated depression. CA further significantly improved the willingness for adjustment and cognition. ^{Nepal Med Coll J. 2010 Mar;12(1):8-11.}

 Ashwagandha(Withaniasomnifera)

Research conducted at the Department of Pharmacology; University of Texas Health Science Center indicated that extracts of Ashwagandha produce GABA-like activity, owing to its anxiolytic effect. Studies conducted on rats’ brains showed that Ashwagandha produced an increase in the levels of three natural anti-oxidants (superoxide dismutase, catalase and glutathione peroxidase).

In another study, the anti-stress activity of W. somnifera on cold swimming stress was evaluated and the results indicate a significant increase in the plasma corticosterone level, phagocytic index and avidity index in rats subjected to cold swimming stress. In the rats pretreated with the drug, these parameters were near control values and an increase in the total swimming time was observed W. somnifera is a potent antistressor agent in the crude form. ^{R. Archana, A. Namasi6ayam / Journal of Ethnopharmacology 64 (1999) 91–93}

 Amla(Emblicaofficinalis)

Amlahastridoshar properties. In Ayurveda, amla is a well-known rasayana drug. In a study, the antidepressant activity of E.officinalis(EO) in TST and FST was evaluated. In this study, the antidepressant efficacy of EO was found to be superior to that of the standard drug imipramine. Therefore, EO has the potential to be used as an adjuvant in the treatment of depression and other mood disorders. ^{International Journal of Applied Biology and Pharmaceutical Technology. Volume: I: Issue-2: Aug-Oct -2010}

 Jatamansi(Nardostachysjatamansi)

Jatamansi has tridosha balancing properties and exerts calming effect on mind, improves quality of sleep and reduces restlessness. Studies suggest that this herb also acts as a powerful antidote for sleeplessness and helps enhance the quality of sleep. A study was undertaken to evaluate the antidepressant activity of methanolic extract of N. jatamansi. The finding suggests that N. jatamansi extract has dose dependent antidepressant activity and can also be used in patients suffering from depression due to sleep disturbances. ^{Der Pharmacia Lettre, 2010, 2(5): 441-449}

Jatamansi(Nardostachysjatamansi)and Sugandhbala(Valerianawallichii)

A clinical study was conducted to evaluate the effect of Tagara/Sugandhbala (Valerianawallichii DC.) and Jatamansi (Nardostachysjatamansi DC.) in the management of Anidra (Insomnia). The patients were selected fulfilling the criteria for inclusions for primary insomnia were randomly selected from Out Patient Department and In Patient Department of Manasa Roga. Tagara Churna (powder of V. wallichii) and Jatamansi Churna(powder of N. jatamansi) was administered for a period of 1 month. Both the groups showed good results, but Tagara group showed better results in comparison to Jatamansi group. ^{Ayu. 2015 Jan-Mar; 36(1): 46–49.}

 Yastimadhu(Glycyrrhizaglabra)

Yastimadhu is an efficient brain tonic. It increases the circulation in the CNS system. In a study, mice received varying doses of G. glabra extract and anxiolytic activity was assessed using different paradigms. Diazepam orondansetron served as standard anxiolytic agents. In results, the extract of roots and rhizomes of Glycyrrhizaglabra possesses anxiolytic activity. ^{Journal of Natural Remedies, Vol. 1/2 (2001) 130 – 134}

 Vacha(Acoruscalamus)

The experimental study on animal models was evaluated to check the antidepressant action of plant drug Vacha. The behavioral study was conducted experimental study was done in rats to evaluate their Open Field Behavior (OFB) and High Plus Maze (HPM) before and after feeding Vacha. In results, Vacha has shown antidepressant effects in animal model of depression. ^{Ayu. 2010 Apr-Jun; 31(2): 153–158.}

Bhrami(Bacopamonnieri)

Bhramiis a commonly used Ayurvedic drug for mental disorders. The standardized extract was reported earlier to have significant anti-oxidant effect, Anxiolytic activity and improve memory retention in Alzheimer’s disease. Presently, the Bacopamonniera was investigated for potential antidepressant activity in rodent models of depression. The extract was found to have significant antidepressant activity in forced swim and learned helplessness models of depression and was comparable to that of imipramine.

Justification and Rationale of the Combination

Anxiety and depression are two of the most common mental health problems. These psychological problems can last longer for six months and more and can affect normal activities, job performance and relationships. According to Ayurveda, the imbalance of Manas guna and tridoshas are the causative factors of various psychological problems such as anxiety and depression.

Andemac tablet is the herbal formulation which is helpful in treating various types of psychological disorders. Andemac is formulated by the combination of Ayurvedicrasayan (Rejuvenator) drugs which provides strength to the mind.

• Medhyarasayan drugs such as Mandukparni, Yashtimadhu and Brahmi promotes “Biddhi” and “Manas” by correcting the disturbances of “Rajas” and “Tamas”. They also have adaptogenic and anxiolytic effects.
• Other class of Rasayana herbs like Ashwagandha, Vacha, Sugandhbala and Amla has Antistressor, anti-depressant and mild tranquilizer action therefore, effective in cases of mixed anxiety depression and associated symptoms.
• The Brain rejuvenator and tonic property of Andemac provides strength to brain and helps to treat anxiety and depression by eliminating its root cause.