Research Progress on Common Neurological Diseases Accompanied by Depression in Both Chinese and Western Medicine

Abstract

Depression is one of the most common comorbid conditions associated with various prevalent neurological disorders, including stroke, Parkinson’s disease, epilepsy, Alzheimer’s disease, and insomnia. It significantly impairs prognosis, functional recovery, and quality of life of the primary diseases, and markedly increases suicide risk and caregiver burden. Its pathogenesis involves shared mechanisms such as disruption of monoamine neurotransmitter pathways, hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis, neuroinflammation, and disconnection of neural circuits. Conventional Western medicine primarily relies on antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and psychological therapies; however, these approaches are limited by delayed onset of action, suboptimal response in some patients, and potential drug interactions. In Traditional Chinese Medicine (TCM), based on the holistic concept of “unity of body and mind,” such comorbid depression is categorized under “depression due to underlying illness.” The core pathological mechanisms involve liver qi stagnation, phlegm-blood stasis obstructing orifices, deficiency of heart and spleen, yin deficiency with fire exuberance, and kidney deficiency leading to marrow depletion. Each syndrome pattern has corresponding representative herbal formulas. Classical TCM formulas such as Chaihu Jia Longgu Muli Tang, Suanzaoren Tang,have accumulated substantial clinical evidence in alleviating depression through individualized treatment based on pattern differentiation. Their multi-target effects include modulation of monoamine neurotransmitters and neurotrophic factors, suppression of neuroinflammation, restoration of HPA axis negative feedback regulation, and modulation of the gut-brain axis. The integrated strategy of traditional Chinese and Western medicine can achieve enhanced efficacy with reduced toxicity. This article provides a systematic review of recent research progress on depression associated with common neurological disorders from both traditional Chinese and Western medical perspectives, aiming to offer reference for optimizing clinical decision-making.