Some Adjunctive Nutraceuticals Found to Affect Depressive Symptoms
Supplementing antidepressants with certain pharmaceutical-grade nutrients can reduce symptoms of depression, a review of clinical trials published by The American Journal of Psychiatry has found.
“There is burgeoning interest in augmentation strategies for improving inadequate response to antidepressants,” the team of seven researchers wrote. “The adjunctive use of standardized pharmaceutical-grade nutrients, known as nutraceuticals, has the potential to modulate several neurochemical pathways implicated in depression.”
Researchers conducted a meta-analysis of clinical trials performed through December 2015 on using adjunctive nutrients, known as nutraceuticals, to help treat depression.
They found “primarily positive results” from augmenting antidepressants with S-adenosylmethionine (SAMe), methylfolate, omega-3 (primarily EPA or ethyl-EPA), and vitamin D.
“Current evidence supports adjunctive use of SAMe, methylfolate, omega-3, and vitamin D with antidepressants to reduce depressive symptoms,” Jerome Sarris, PhD, MHsC, and colleagues wrote.
Zinc, folic acid, vitamin C, and tryptophan produced mixed results, and there were nonsignificant results for inositol.
Participants reported some minor digestive disturbance, but no major adverse side effects from the nutraceuticals used in the study.
The researchers searched PubMed, CINAHL, Cochrane Library, and Web of Science for the trials. When sufficient data were available, they used a random-effects model to measure the standard mean difference between treatment and placebo groups, from baseline through the endpoint, and combined the effect size data. They also performed funnel plot and heterogeneity analyses.
A meta-analysis of adjunctive omega-3 only “revealed a significant and moderate to strong effect in favor of omega-3,” and a meta-analysis on adjunctive folic acid found a nonsignificant difference from the placebo. Heterogeneity was found for both the omega-3 and folic acid studies and funnel plots revealed asymmetry, reflecting potential study bias.
—Terri Airov
Reference
Sarris J, Murphy J, Mischoulon D, et al. Adjunctive Nutraceuticals for Depression: A Systematic Review and Meta-Analyses. American Journal of Psychiatry. 2016 April 26;[Epub ahead of print].
