Nutraceuticals as adjuvant depression treatments
Using two or more antidepressants may improve results by targeting different neurochemical pathways
For many people suffering from depression, conventional antidepressants are ineffective, or their effects are not long-lasting.
This leads a number of patients and their healthcare providers to use augmentation or combination approaches. Using two or more antidepressants may improve results by targeting different neurochemical pathways. Augmentation approaches employ agents that work synergistically with the antidepressant to provide better results. Newer augmentation approaches often provide complementary actions such as reducing inflammation.
Certain nutraceuticals have been used to maximise the effectiveness of depression treatment. A great deal of research has been done on the potential of several supplements to modulate the neurochemical pathways involved in depression, but results have been at times conflicting and confusing.
A paper published in 2016 in the American Journal of Psychiatry sought to clarify which nutraceuticals were effective in combination with antidepressants. The researchers systematically reviewed the clinical trials that used adjunctive nutrients for depression and found that evidence is strong for some nutrients but not for others. The findings are outlined below.
Primarily positive results: Research on the following nutrients were primarily positive: S-adenosylmethionine (SAMe), methylfolate, omega-3 (primarily EPA or ethyl-EPA) and vitamin D.
Isolated positive results: Isolated studies showed positive results with the following nutrients: creatine, folinic acid and an amino acid combination.
Mixed or insignificant results: Studies on the following nutrients had mixed or insignificant results: zinc, folic acid, vitamin C, tryptophan and inositol.
Other than minor digestive disturbance, no major adverse effects were noted. The authors concluded that the evidence supports using SAMe, methylfolate, omega-3 and vitamin D in combination with antidepressants as a safe and effective way to reduce symptoms of depression.
