Evaluation of Prunus dulcis as an Adjunct in Major Depressive Disorder: A Randomised Open Label Clinical Study

Introduction: Depression is a common mental disorder affecting over 264 million people worldwide, impacting daily life and overall mental and physical well-being. Commonly used antidepressants often cause significant side effects, creating a need for safer alternatives or adjunctive treatments to existing medications. Aim: To evaluate the effect of inositol-rich Prunus dulcis as an adjunct to standard therapy in individuals diagnosed with Major Depressive Disorder (MDD). Materials and Methods: An open-label, randomised, parallelgroup controlled trial included 61 patients with MDD, divided into two groups: the control group (n=32), which received escitalopram (10-20 mg/day) for eight weeks, and the study group (n=33), which received escitalopram (10-20 mg/day) plus 6g/day of Prunus dulcis (eight almonds) for eight weeks. Primary outcomes assessed changes in Hamilton Depression Rating Scale (HDRS) and Beck Depression Inventory (BDI) scores from baseline to weeks 4, 6, 8, and 12. Secondary outcomes included clinical health improvements (weight, blood pressure) and adverse drug reactions. Intergroup comparisons used an unpaired t-test, with p<0.05 considered statistically significant. Results: Most patients were aged 41-50 years, with 59% female and 41% male participants. Mean BDI scores in mild depression patients at the 4th, 6th, 8th, and 12th weeks were 10±12, 8.8±2.1, 7.6±1.2, and 6.9±1.2 in the study group versus 9±13.89, 12.9±1.7, 10.6±1.2, and 8.9±0.9 in the control group (p<0.05). Other grades showed no significant differences. Mean HDRS scores in mild depression at the 6th week were 8.0±1.7 (study group) versus 10.3±1.1 (control group, p=0.003). HDRS scores for moderate depression at the 8th and 12th weeks also showed significant differences (p<0.05). Overall weight comparisons between groups showed significant differences (p<0.05) at each assessment point, with the study group consistently having a higher mean weight. Conclusion: Prunus dulcis (almond), when used as an add-on to standard antidepressant therapy, accelerated recovery among patients with mild depression from the 6th week onwards. Furthermore, it also contributed to significant weight gain in patients suffering from MDD.