Antidepressant Effect of Asperugo procumbens L. in Comparison with Fluoxetine: a Randomized Double Blind Clinical Trial

Document Type: Original paper


1 Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.

2 Department of Pharmacognosy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran. Student Research Committee, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.

3 Department of Pharmacognosy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.

4 Department of Biostatistics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

5 Department of Psychiatry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.


Background and objectives: Aseprugo procumbens is used as antianxety and depression in Iranian traditional medicine; however no clinical trial has been performed about these properties. The aim of this study was to evaluate the antidepressant efficacy and safety of hydroalcoholic extract of A. procumbens. Methods: In this double blind study, 30 outpatients with mild to moderate depressive disorder (according to DMS-IV-TR criteria who had a score of 18-25 on the Hamilton Depression Rating Scale (HDRS) were randomly divided in two group, 1) received 10 mg fluoxetine capsule, 2) received 1.2 g dried extract of A. procumbens capsule (6 mg flavonoid,) orally per day. Patients were followed up for 6 weeks; the recovery process was assessed by the HDRS in weeks 0, 2, 4 and 6. Results: A significant decrease in HDRS was observed in both groups after the fourth week. After the sixth week, fluoxetine had a greater anti-depressant activity than A. procumbens (p value =0.03). There were no significant differences in terms of adverse effects in both groups. Conclusions: The hydroalcoholic extract of A. procumbens can be considered as an effective and safe remedy for mild to moderate depressive disorder.


[1] Sadock B, Sadock V, Ruiz P. Kaplan and Shaddock’s synopsis of psychiatry. Philadelphia: Wolter Kluwer, 2015.

[2] Whooley MA, Simon GE. Managing depression in medical outpatients. N Engl J Med. 2000; 343(26): 1942-1950.

[3] Moallem S, Hosseinzadeh H, Ghoncheh H. Evaluation of antidepressant effects of aerial parts of Echium vulgare on mice.  Iran J Basic Med Sci. 2007; 10(3): 189-196.

[4] Mirshafa SA, Azadbakht M, Ahangar N. Study of antidepressant and sedative-hypnotic activity of hydroalcoholic extract of Asperugo procumbens L. aerial parts in mice.  Iran J Pharm Res. 2013; 12(3): 529-535.

[5] Sravani K, Sivrama Krishna K. Anti-depressant and antioxidant activity of methanolic extract of Asparagus racemosus seeds. Asian J Pharm Clin Res. 2013; 16(1): 102-107.

[6] Freitas AE, Budni J, Lobato KR, Binfare RW, Machado DG, Jacinto J, Veronezi PO, Pizzolatti MG, Rodrigues AL. Antidepressant-like action of the ethanolic extract from Tabebuia avellanedae in mice: evidence for the involvement of the monoaminergic system. Prog Neuropsychopharmacol Biol Psychiat. 2010; 34(2): 335-343.

[7] Zhang ZJ. Therapeutic effects of herbal extracts and constituents in animal models of psychiatric disorders. Life Sci. 2004; 75(14): 1659-1699.

[8] Ghareman A. Flora of Iran. Tehran: Institute of Forests and Rangeland, 1994.

[9] Fahimi S, Naseri M. Anti-halitosis plants in Iranian traditional medicine. Res J Pharmacogn. 2015; 2(2): 61-66.

[10] Ahanjan M, Mohana D, Raveesha K. Antibacterial activity of Asperugo procumbens L. against some human pathogenic bacteria. Afr J Microbiol Res. 2008; 2(6): 138-140.

[11] Dhima K, Vasilakoglou L, Gatsis T, Eleftherohorinos L. Competitive interactions of fifty barley cultivars with Avena sterilis and Asperugo procumbens. Field Crops Res. 2010; 117(1): 90-100.

[12] Jorjani SE. Zakhireh khwarazmshahi. Tehran: Publications of Iranian Academy of Medical Sciences; 2001.

[13] Ibn Sina (Avicenna) H. Al-qanun fi al-tibb [Canon of medicine]. New Dehli: Jamia Hamdard, 1998.

[14] Bironi A. Al-Seidaneh fi'l-tibb. 3rd ed. Tehran: Tehran University Publication, 1991.

[15] Aghilli Khorasani M. Makhzan al advieh. Tehran: Sabzarang, 2008.

[16] Azadbakht M, Bahaeddini A, Shorideh S. The effect of “Vitex agnus-castus” leaf and fruit flavonoidal extracts on serum prolactin concentration. J Med Plants. 2005; 4(16): 56-61.

[17] Jia Z, Tang M, Wu J. The determination of flavonoid contents in mulberry and their scavenging effects on superoxide radicals.  Food Chem. 1999; 64(4): 555-559.

[18] Shams Ardekani M, Hajimahmoodi M, Oveisi M, Sadeghi N, Jannat B, Ranjbar A, Gholam N, Moridi T. Comparative antioxidant activity and total flavonoid content of Persian pomegranate (Punica granatum L.). Iran J Pharm Res. 2011; 10(3): 519-524.

[19] Bebbington P. The origins of sex differences in depressive disorder: bridging the gap. Int Rev Psychiatry. 1996; 18(4): 295-332.

[20] Nolen-Hoeksema S. Sex differences in unipolar depression: evidence and theory. Psychol Bull. 1987; 101(2): 259-282.

[21] Nair MK, Paul MK, John R. Prevalence of depression among adolescents. Indian J Pediatr. 2004; 71(6): 523-524.

[22] Piccinelli M, Wilkinson G. Gender differences in depression. Critical review. Br J Psychiat. 2000; 177(6): 486-492.

[23] Nikfarjam M, Parvin N, Assarzadegan N, Asghari S. The effects of Lavandula angustifolia Mill. infusion on depression in patients using citalopram: a comparison study. Iran Red Crescent Med J. 2013; 15(8): 734-739.

[24] Edzard E. Herbal remedies for depression and anxiety. Adv Psychiatr Treat. 2007; 13(4): 312-316.

[25] Wurglics M, Schubert-Zsilavecz M. Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients. Clin Pharmacokinet. 2006; 45(5): 449-468.

[26] Rakhshandah H, Hosseini M, Dolati K. Hypnotic effect of Rosa damascena in mice. Iran J Pharm Res. 2004; 3(3): 181-185.

[27] Salah SM, Jager AK. Two flavonoids from Artemisia herba-alba Asso with in vitro GABA A-benzodiazepine receptor activity. J Ethnopharmacol. 2005; 99(1): 145-146.

[28] Sadock BJ,‎ Sadock VA. Kaplan and Sadock's synopsis of psychiatry: behavioral sciences/clinical psychiatry. 10th ed. Amsterdam: Wolters Klawer, 2014.    

[29] Ni YG, Miledi R. Blockage of 5HT2C serotonin receptors by fluoxetine (Prozac). Proc Natl Acad Sci USA. 1997; 94(5): 2036-2040.

[30] Sairam K, Dorababu M, Goel RK, Bhattacharya SK. Antidepressant activity of standardized extract of Bacopa monniera in experimental models of depression in rats. Phytomed. 2002; 9(3): 207-211.