Adjunctive Nutraceuticals for Depression: A Systematic Review and Meta-Analyses

Sarris, Jerome; Murphy, Julie; Mischoulon, David; Papakostas, George I.; Fava, Maurizio; Berk, Michael; Ng, Chee H.

doi:10.1176/appi.ajp.2016.15091228

Cited by 363 publications

(191 citation statements)

References 87 publications

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“…We introduced one at a time to the fully adjusted models of tables 2 and 3 variables representing inflammation (via log(C-reactive protein)), cardiovascular disease risk (via Framingham Global CVD Risk Score), reproductive history (via number of live births), and dietary elements associated with depression. The dietary variables consisted of folate, vitamin B12, zinc, vitamin D (Sarris et al, 2016) and selenium (Conner et al, 2015). Because 21 women who self-reported that they were 0 years postmenopause may actually have been perimenopausal by STRAW+10 criteria (Harlow et al, 2012), we conducted the analyses in Tables 2 and 3 again after excluding these women.…”

Section: Methodsmentioning

confidence: 99%

Do sex hormones or hormone therapy modify the relation of n-3 fatty acids with incident depressive symptoms in postmenopausal women? The MESA Study

Colangelo

Ouyang

Golden

et al. 2017

Psychoneuroendocrinology

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Introduction Considering that estradiol (E2) and n-3 polyunsaturated fatty acids (PUFAs) have roles in neurogenesis and in neurotransmission, we examined whether the association of PUFAs with incident depressive symptoms in postmenopausal women is modified by hormone therapy (HT) use or estrogen status. Methods Women (N=1616) free of depressive symptoms at baseline (2000-02) in the Multi-Ethnic Study of Atherosclerosis were classified by HT usage and quartiles of dietary eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and the sum EPA+DHA. Women with serum E2 ≤0.073 nmol/L (sample median), were classified low on E2. Poisson regression was used to model incident depressive symptoms at examination 3 (2004-05), defined by the Center for Epidemiological Studies Depression Scale ≥16 or taking an antidepressant, first as a function of HT use and n-3 PUFA quartiles, and second, as a function of low E2 status and n-3 PUFA quartiles. Results Among HT non-users, positive, graded relationships (p-trends≤0.003) were found between PUFAs and incident depressive symptoms. Compared to the lowest quartile, the adjusted risk ratios (RRs) for the highest were 2.10, 2.39, and 2.04 for EPA, DHA, and EPA+DHA, respectively. For HT users, no associations were seen. When analyses were run for E2 status, the RRs over quartiles of the PUFAs were positive and graded for low E2 women, but were null for High E2 women. Conclusions Higher intakes of DHA and EPA were associated with higher risk of depressive symptoms in nonusers of HT, contrary to hypothesis.

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Section: Methodsmentioning

confidence: 99%

Do sex hormones or hormone therapy modify the relation of n-3 fatty acids with incident depressive symptoms in postmenopausal women? The MESA Study

Colangelo

Ouyang

Golden

et al. 2017

Psychoneuroendocrinology

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“…Preclinical tests and models of depression showed antidepressant-like activity of zinc [9–15]. Clinical data pointed towards potential benefits of zinc administration in depressed patients [16, 17]. Zinc supplementation was shown to be effective as an adjunct therapy [6, 7, 18] or as a stand-alone intervention [19, 20] for depression.…”

Section: Zincmentioning

confidence: 99%

“…Importantly, zinc supplementation of therapy involving administration of imipramine was found to be more effective than administration of imipramine plus placebo in treatment-resistant patients [18]. Although a recent systematic review and meta-analysis of adjunctive nutraceuticals for depression found mixed results for zinc [17], zinc supplementation shows promise as a strategy for improving an inadequate response to antidepressants.…”

Section: Serotonin (5-ht)mentioning

confidence: 99%

Zinc in the Monoaminergic Theory of Depression: Its Relationship to Neural Plasticity

et al. 2017

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Preclinical and clinical studies have demonstrated that zinc possesses antidepressant properties and that it may augment the therapy with conventional, that is, monoamine-based, antidepressants. In this review we aim to discuss the role of zinc in the pathophysiology and treatment of depression with regard to the monoamine hypothesis of the disease. Particular attention will be paid to the recently described zinc-sensing GPR39 receptor as well as aspects of zinc deficiency. Furthermore, an attempt will be made to give a possible explanation of the mechanisms by which zinc interacts with the monoamine system in the context of depression and neural plasticity.

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“…The coadministration of standardized pharmaceutical-grade nutrients, referred to as nutraceuticals, may provide an effective and safe approach to enhancing AD effects, by either synergistically augmenting a particular activity of an AD or providing a range of additional biological effects. 23 All nutraceuticals are generally well tolerated, with gastrointestinal adverse events most commonly reported across all nutraceutical groups. Current evidence supports adjunctive use of S-adenosylmethionine, methylfolate, omega-3, and vitamin D with ADs to reduce depressive symptoms.…”

Section: New Augmentation Strategymentioning

confidence: 99%

“…Current evidence supports adjunctive use of S-adenosylmethionine, methylfolate, omega-3, and vitamin D with ADs to reduce depressive symptoms. 23 However, depression is not simply the result of neurotransmitter abnormalities. A large body of evidence points to a deregulated endocrine and inflammatory response system and reduced neurogenesis, in the pathogenesis of depression.…”

Section: New Augmentation Strategymentioning

confidence: 99%

Novel Treatment Options in Depression and Psychosis

Češková

2017

Clinical Therapeutics

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Abstract:In spite of tremendous development in central nervous system research, current treatment is suboptimal, especially in severe mental disorders. In medicine, there are two main methods of improving the health care provided: seeking new treatment procedures and perfecting (optimizing) the existing ones. Optimization of treatment includes not only practical tools such as therapeutic drug monitoring but also implementation of general trends in the clinical practice. New pharmacological options include new more sophisticated forms of monoaminergic drugs, old drugs rediscovered on the base of a better understanding of pathophysiology of mental illnesses, and drugs aimed at new treatment targets. In depression, treatment resistance to antidepressive pharmacotherapy represents one of the most important clinical challenges. Switching to monotherapy with new multimodal/multifunctional antidepressants and augmentation with new atypical antipsychotics (aripiprazole and brexpiprazole) may be promising options. Further, current evidence supports utility and safety of adjunctive treatment of nutraceuticals. Novel approaches being studied include ketamine and opioids. Recent advances in technology and emerging knowledge about dysfunctional brain circuits and neuroplasticity have led to the development of different new neuromodulation techniques usually used as add-on therapy. Antipsychotics are still the cornerstone of the current treatment of schizophrenia. Two new partial dopamine agonists, brexpiprazole and cariprazine, are now available in addition to aripiprazole. Although the mechanisms of action are similar, the two agents differ in terms of their pharmacodynamic profiles. Further, two new formulations of long-acting injections of second-generation antipsychotics (aripiprazole lauroxil and 3-month paliperidone palmitate) were introduced into clinical practice. New treatment options not yet available include cannabidiol, glutamate modulators, and nicotine receptors agonists.

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Adjunctive Nutraceuticals for Depression: A Systematic Review and Meta-Analyses

Abstract: Current evidence supports adjunctive use of SAMe, methylfolate, omega-3, and vitamin D with antidepressants to reduce depressive symptoms.

Cited by 363 publications

References 87 publications

Do sex hormones or hormone therapy modify the relation of n-3 fatty acids with incident depressive symptoms in postmenopausal women? The MESA Study

Do sex hormones or hormone therapy modify the relation of n-3 fatty acids with incident depressive symptoms in postmenopausal women? The MESA Study

Zinc in the Monoaminergic Theory of Depression: Its Relationship to Neural Plasticity

Novel Treatment Options in Depression and Psychosis

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