Effect of Hewei Anshen Decoction on depressive insomnia and brain neurotransmitter levels

Abstract Objective To evaluate the therapeutic effect of Hewei Anshen Decoction (HAD) on both depressive symptoms and sleep quality in patients with depressive insomnia, and to investigate its impact on brain neurotransmitter levels. Methods Seventy‐two patients with depressive insomnia were randomly assigned to a treatment group and a control group. The treatment group received HAD, while the control group was treated with escitalopram oxalate tablets. Pittsburgh Sleep Quality Index (PSQI) and Hamilton Depression Rating Scale (HAMD) scores were assessed before and after treatment. Changes in the brain neurotransmitters serotonin (5‐HT), dopamine (DA), and norepinephrine (NE) were measured using encephalofluctuograph technology. Results After 1 and 2 months of treatment, both groups showed significant reductions in HAMD and PSQI scores compared to baseline. The 5‐HT levels in both groups were significantly higher after treatment. In the treatment group, DA and NE levels increased significantly compared to baseline, while no significant changes in the control group. Conclusion HAD demonstrated significant improvement in sleep quality and depressive symptoms in patients with depressive insomnia in the treatment group. While HAD's clinical efficacy was comparable to escitalopram, its mechanism of action may involve a broader upregulation of 5‐HT, DA, and NE in the brain.