Curcumin in Depression: Potential Mechanisms of Action and Current Evidence—A Narrative Review

Abstract

Major depressive disorder (MDD) is one of the most prevalent and debilitating disorders. Current available treatments are somehow limited, so alternative therapeutic approaches targeting different biological pathways are being investigated to improve treatment outcomes. Curcumin is the main active component in the spice turmeric that has been used for centuries in Ayurvedic medicine to treat a variety of conditions, including anxiety and depressive disorders. In the past decades, curcumin has drawn researchers' attention and displays a broad range of properties that seem relevant to depression pathophysiology. In this review, we break down the potential mechanisms of action of curcumin with emphasis on the diverse systems that can be disrupted in MDD. Curcumin has displayed, in a number of studies, a potency in modulating neurotransmitter concentrations, inflammatory pathways, excitotoxicity, neuroplasticity, hypothalamic–pituitary–adrenal disturbances, insulin resistance, oxidative and nitrosative stress, and endocannabinoid system, all of which can be involved in MDD pathophysiology. To date, a handful of clinical trials have been published and suggest a benefit of curcumin in MDD. With evidence that is progressively growing, curcumin appears as a promising alternative option in the management of MDD.

An Update on the Exploratory Use of Curcumin in Neuropsychiatric Disorders

“…In addition to the recognized role of curcumin as an anti-inflammatory and antioxidant agent, positive improvement of depressive deficits could be exerted through modulation of the indolamine 2,3-dioxygenase (IDO) enzyme, involved in the kynurenine pathways and, thus, in the inhibition of serotonin synthesis. Curcumin treatment was shown to be able to counteract the action of this enzyme [ 76 , 106 ]. Therefore, the overall effect of curcumin in this disorder seems to be mainly positive.…”

Anti-Inflammatory Effects of Curcumin in the Inflammatory Diseases: Status, Limitations and Countermeasures

“…109 Curcumin has shown favorable antidepressant effects in animal models of depression, but clinical trials have not yielded consistent, positive results. 101,[110][111][112][113][114] In a metaanalysis of nine clinical trials, curcumin may improve symptoms of depression and anxiety in patients with https://doi.org/10.2147/DDDT.S327378…”

The pharmacological basis of the curcumin nutraceutical uses: an update

“…Depression is a multifactorial disease that combines genetic predisposition with environmental factors, among which chronic stress plays an important role. Ramaholimihaso et al extensively reviewed the different potential mechanism of action of curcumin in major depressive disorders (215) and their major findings are reported in brief. One of the main molecular causes of the disease has C o p y r i g h t E d r a S .…”