Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Journal of Complementary and Integrative Medicine

Editor-in-Chief: Lui, Edmund

Ed. by Ko, Robert / Leung, Kelvin Sze-Yin / Saunders, Paul / Suntres, PH. D., Zacharias

CiteScore 2017: 1.41

SCImago Journal Rank (SJR) 2017: 0.472
Source Normalized Impact per Paper (SNIP) 2017: 0.564

See all formats and pricing
More options …

Effect of integrated yoga on anti-psychotic induced side effects and cognitive functions in patients suffering from schizophrenia

Meghnath Verma
  • School of Yoga and Life Sciences, S-VYASA Yoga University, No.19, EknathBhavan, Gavipuram circle, Kempegowda Nagar, Bangalore 560019, Karnataka, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Hemant Bhargav
  • Corresponding author
  • NIMHANS, Integrate Centre for Yoga, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hosur Road, Lakkasandra, Bengaluru 560029, India
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Shivarama Varambally
  • Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hosur Road, Lakkasandra, Bengaluru 560029, Karnataka, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Nagarathna Raghuram
  • School of Yoga and Life Sciences, S-VYASA Yoga University, No.19, EknathBhavan, Gavipuram circle, Kempegowda Nagar, Bangalore 560019, Karnataka, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Gangadhar BN
  • Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Hosur Road, Lakkasandra, Bengaluru 560029, Karnataka, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2018-06-26 | DOI: https://doi.org/10.1515/jcim-2017-0155



Twenty one (12 females) subjects, diagnosed with schizophrenia by a psychiatrist using ICD-10, in the ages 52.87 + 9.5 years and suffering since 24.0 ± 3.05 years were recruited into the study from a schizophrenia rehabilitation center in Bengaluru.


All subjects were taking anti-psychotic medications and were in stable state for more than a month. Psychiatric medications were kept constant during the study period. Assessments were done at three points of time: (1) baseline, (2) after one month of usual routine (pre) and (3) after five months of validated Integrated Yoga (IY) intervention (post). Validated 1 h Yoga module (consisting of asanas, pranayama, relaxation techniques and chantings) was practiced for 5 months, five sessions per week. Antipsychotic-induced side effects were assessed using Simpson Angus Scale (SAS) and Udvalg for Kliniske Undersogelser (UKU) side effect rating scale. Cognitive functions (using Trail making Test A and B), clinical symptoms and anthropometry were assessed as secondary variables. Comparisons between “pre” and “post” data was done using paired samples t-tests after subtracting baseline scores from them respectively.


At the end of five months, significant reduction in drug-induced Parkinsonian symptoms (SAS score; p=0.001) and 38 items of UKU scale was observed along with significant improvement in processing speed, executive functions and negative symptoms of schizophrenia patients. No side effects of Yoga were reported.


The present study provides preliminary evidence for usefulness of Integrated Yoga intervention in managing anti-psychotic-induced side effects.

Keywords: anti-psychotic medications; cognition; integrated yoga; positive and negative symptoms; schizophrenia


  • [1]

    Arana GW. Overview of side effects caused by typical anti-psychotics. J Clin Psychiatry. 2000;61:5–11.Google Scholar

  • [2]

    Fakhoury WK, Wright D, Wallace M. Prevalence and extent of distress of adverse effects of antipsychotics among callers to a United Kingdom National Mental Health Helpline. Int Clin Psychopharmacol. 2001;6:153–62.Google Scholar

  • [3]

    Usher K, Foster K, Park T. The metabolic syndrome and schizophrenia: the latest evidence and nursing guidelines for management. J Psychiatr Ment Health Nurs. 2006;13:730–4.PubMedCrossrefGoogle Scholar

  • [4]

    Sharma T. Cognitive effects of conventional and atypical antipsychotics in schizophrenia. Br J Psychiatry. 1999;174:44–51.CrossrefGoogle Scholar

  • [5]

    Gallhofer B, Bauer U, Lis S, Krieger S, Gruppe H. Cognitive dysfunction in schizophrenia: comparison of treatment with atypical antipsychotic agents and conventional neuroleptic drugs. Eur Neuropsychopharmacol. 1996;6:13–20.CrossrefGoogle Scholar

  • [6]

    Meltzer HY, McGurk SR. The effects of clozapine, risperidone, and olanzapine on cognitive function in schizophrenia. Schizophr Bull. 1999;25:233–56.PubMedCrossrefGoogle Scholar

  • [7]

    McEvoy JP, McCue M, Spring B, Mohs RC, Lavori PW, Farr RM. Effects of amantadine and trihexyphenidyl on memory in elderly normal volunteers. Am J Psychiatry. 1987;144:573–7.PubMedCrossrefGoogle Scholar

  • [8]

    Feinberg M. The problem of anticholergic adverse effect in older patients. Drug Aging. 1993;3:335–48.CrossrefGoogle Scholar

  • [9]

    Minzenberg MJ, Poole JH, Benton C, Vinogradov S. Association of anticholinergic load with impairment of complex attention and memory in schizophrenia. Am J Psychiatry. 2004;161:116–24.CrossrefPubMedGoogle Scholar

  • [10]

    Woolery A, Myers H, Sternlieb B, Zeltzer L. A yoga intervention for young adults with elevated symptoms of depression. Altern Ther Health Med. 2004;10:60–3.PubMedGoogle Scholar

  • [11]

    Vancampfort D, Vansteelandt K, Scheewe T, Probst M, Knapen J, De Herdt A, et al. Yoga in schizophrenia: a systematic review of randomised controlled trials. Acta Psychiatr Scand. 2012;126:12–20.CrossrefWeb of SciencePubMedGoogle Scholar

  • [12]

    Duraiswamy G, Thirthalli J, Nagendra HR, Gangadhar BN. Yoga therapy as an add‐on treatment in the management of patients with schizophrenia – a randomized controlled trial. Acta Psychiatr Scand. 2007;116:226–32.Web of ScienceCrossrefPubMedGoogle Scholar

  • [13]

    Varambally S, Gangadhar BN, Thirthalli J, Jagannathan A, Kumar S, Venkatasubramanian G, et al. Therapeutic efficacy of add-on yogasana intervention in stabilized outpatient schizophrenia: randomized controlled comparison with exercise and waitlist. Indian J Psychiatry. 2012;54:227.CrossrefPubMedGoogle Scholar

  • [14]

    Manjunath RB, Varambally S, Thirthalli J, Basavaraddi IV, Gangadhar BN. Efficacy of yoga as an add-on treatment for in-patients with functional psychotic disorder. Indian J Psychiatry. 2013;55:374.CrossrefWeb of ScienceGoogle Scholar

  • [15]

    Visceglia E, Lewis S. Yoga therapy as an adjunctive treatment for schizophrenia: a randomized, controlled pilot study. J Altern Complement Med. 2011;17:601–7.CrossrefWeb of SciencePubMedGoogle Scholar

  • [16]

    Thirthalli J, Duraiswamy G, Varambally S, Nagendra HR, Gangadhar BN. Yoga as an add-on treatment in the management of schizophrenia: a randomized controlled trial. Ann Gen Psychiatry. 2006;5:84.CrossrefGoogle Scholar

  • [17]

    Jayaram N, Varambally S, Behere RV, Venkatasubramanian G, Arasappa R, Christopher R, et al. Effect of yoga therapy on plasma oxytocin and facial emotion recognition deficits in patients of schizophrenia. Indian J Psychiatry. 2013 Jul;55:S409.CrossrefWeb of ScienceGoogle Scholar

  • [18]

    Hall E, Verheyden G, Ashburn A. Effect of a yoga program on an individual with Parkinson’s disease: a single-subject design. Disabil Rehabil. 2011;33:1483–9.CrossrefGoogle Scholar

  • [19]

    Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review. J Am Board Fam Pract. 2005;18:491–519.CrossrefGoogle Scholar

  • [20]

    Ikai S, Uchida H, Suzuki T, Tsunoda K, Mimura M, Fujii Y. Effects of yoga therapy on postural stability in patients with schizophrenia-spectrum disorders: a single-blind randomized controlled trial. J Psychiatr Res. 2013;47:1744–50.Web of ScienceCrossrefPubMedGoogle Scholar

  • [21]

    Janno S, Holi MM, Tuisku K, Wahlbeck K. Validity of Simpson-Angus Scale (SAS) in a naturalistic schizophrenia population. BMC Neurol. 2005 Mar 17;5:5.CrossrefGoogle Scholar

  • [22]

    Lingjaerde O, Ahlfors UG, Bech P, Dencker SJ, Elgen K. The UKU side effect rating scale: a new comprehensive rating scale for psychotropic drugs and a cross‐sectional study of side effects in neuroleptic‐treated patients. Acta Psychiatr Scand. 1987;76:1–00.CrossrefGoogle Scholar

  • [23]

    Zalonis I, Kararizou E, Triantafyllou NI, Kapaki E, Papageorgiou S, Sgouropoulos PE, et al. A normative study of the trail making test A and B in Greek adults. Clin Neuropsychol. 2008 Sep 1;22:842–50.CrossrefWeb of ScienceGoogle Scholar

  • [24]

    Norman RM, Malla AK, Cortese L, Diaz F. A study of the interrelationship between and comparative interrater reliability of the SAPS, SANS and PANSS. Schizophr Res. 1996 Mar 31;19:73–85.CrossrefPubMedGoogle Scholar

  • [25]

    Govindaraj R, Varambally S, Sharma M, Gangadhar BN. Designing and validation of a yoga-based intervention for schizophrenia. Int Rev Psychiatry. 2016;28:323–6.CrossrefWeb of SciencePubMedGoogle Scholar

  • [26]

    Bhatia T, Agarwal A, Shah G, Wood J, Richard J, Gur RE, et al. Adjunctive cognitive remediation for schizophrenia using yoga: an open, non‐randomised trial. Acta Neuropsychiatr. 2012;24:91–100.Web of ScienceCrossrefGoogle Scholar

  • [27]

    Bhargav H, Nagendra HR, Gangadhar BN, Nagarathna R. Frontal hemodynamic responses to high frequency yoga breathing in schizophrenia: a functional near-infrared spectroscopy study. Front Psychiatry. 2014;5:29PubMedWeb of ScienceGoogle Scholar

  • [28]

    Streeter CC, Gerbarg PL, Saper RB, Ciraulo DA, Brown RP. Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Med Hypotheses. 2012;78:571–9.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [29]

    Naveen GH, Thirthalli J, Rao MG, Varambally S, Christopher R, Gangadhar BN. Positive therapeutic and neurotropic effects of yoga in depression: a comparative study. Indian J Psychiatry. 2013;55:S400.Web of ScienceCrossrefGoogle Scholar

About the article

Received: 2017-11-16

Accepted: 2018-05-02

Published Online: 2018-06-26

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Journal of Complementary and Integrative Medicine, Volume 16, Issue 1, 20170155, ISSN (Online) 1553-3840, DOI: https://doi.org/10.1515/jcim-2017-0155.

Export Citation

© 2019 Walter de Gruyter GmbH, Berlin/Boston.Get Permission

Comments (0)

Please log in or register to comment.
Log in