A Patient with Treatment-resistant Depression Who Achieved Remission with Heated Yoga: A Case Report

Abstract

Novel interventions are needed to manage treatment-resistant depression (TRD), defined as patients who do not respond to two or more antidepressant trials of adequate dose and duration. We report on a 28-year-old female with TRD with nonresponse to several adequate trials of antidepressants who experienced full symptomatic remission after participating in the heated hatha yoga (HY) arm of a randomized controlled trial (RCT) for depression. Patients, including the one of interest, were randomized to 8 weeks of at least twice weekly HY or an 8-week waitlist followed by 8 weeks of HY. HY incorporates yoga plus heat through a series of standardized poses performed in a heated room (105°F). The 30-item Inventory of Depressive Symptoms, Clinician-Rated (IDS-C₃₀) and 28-item Hamilton Depression Rating Scale (HAM-D₂₈) were assessed at key time points throughout the study. The patient attended 16 classes over 8 weeks. Her baseline IDS-C₃₀ score of 42 decreased to 26 following 2 weeks of HY, and continued declining throughout the intervention, with a final score of 6 (remission) after 8 weeks. HAM-D₂₈ scores decreased from 26 at baseline to 4 (remission) after 8 weeks. At the 1-month follow-up, the patient's scores remained stable at 4 on IDS-C₃₀ and 7 on HAM-D₂₈, respectively. HY may serve as a potential intervention for TRD in patients who have not previously responded to conventional antidepressants. The rigorousness of the intervention must be considered regarding recommendations for use in the general population.