Investigating the effect of magnesium supplement in patients with major depressive disorder under selective serotonin reuptake inhibitor treatment

Abstract

A BSTRACT Background: Major depression disorder (MDD) is a mental disorder that affects millions of people worldwide. This disease has negative impacts on quality of life and psychological-related functions. This is a multifactorial disorder; both genetic background and environmental factors have their role. Antidepressants are prescribed as the first line of treatment for patients with depressive disorders. Selective serotonin reuptake inhibitor (SSRI) antidepressants are used to treat MDD and anxiety; however, some patients do not respond to them. Regarding that, magnesium plays a major role in mood regulation; therefore, this study aimed to investigate the role of magnesium supplement in patients with MDD and under an SSRI treatment regimen. Methods: In this randomized, double-blind controlled trial, 60 patients with major depressive disorders based on the DSM-V diagnosis referred to Golestan Hospital in Ahvaz, Iran, were included. The eligible patients were categorized randomly into two thirty-people groups receiving magnesium (intervention) and placebo (control) along with SSRI for 6 weeks. To evaluate the depression status, the Beck II test was applied. Subjects were examined before and after the intervention. Results: There was no statistically significant difference between the two groups in terms of demographic characteristics ( P > 0.05). The mean Beck scores at the beginning of the study and the second week after the intervention were not different between the two groups ( P = 0.97, P = 0.56), whereas the mean Beck scores were lower in the intervention group than in the control group in the fourth and sixth weeks after the intervention ( P = 0.02 and P = 0.001, respectively). Conclusion: Administration of Mg supplement for at least 6 weeks might improve depression symptoms. It can also be considered as a potential adjunct treatment option for MDD patients who are under SSRI treatment.

Magnesium supplementation beneficially affects depression in adults with depressive disorder: a systematic review and meta-analysis of randomized clinical trials

“…Finally, seven eligible RCTs were included in the current systematic review and meta-analysis. Depression symptoms were assessed using Beck’s Depression Inventory (BDI) ( 5 , 10 ), BDI II ( 14 , 15 ), and the Hamilton Depression Rating Scale (HAM-D) ( 11 , 16 ) among the included studies. Moreover, one study reported a mean depression symptom score ( 17 ).…”

“…The characteristics of the seven included RCTs are summarized in Table 1 . These RCTs were published between 2016 and 2022 and were from the United States ( 16 ), Poland ( 11 ), and Iran ( 5 , 10 , 14 , 15 , 17 ). Two studies were exclusively performed on female subjects ( 14 , 17 ), and the other five were performed on both genders.…”

“…Only the study at Mehdi et al ( 16 ) was a crossover trial, while all the other studies had a parallel design. With regard to the type of intervention, two studies administered magnesium sulfate ( 16 , 17 ), two studies administered magnesium oxide ( 15 , 18 ), one study administered magnesium chloride ( 10 ), one study used magnesium aspartate ( 11 ), and one study did not report the type of administered magnesium supplement ( 5 ).…”

“…In some studies, the baseline severity of depression was mild to moderate ( 10 , 14–16 ), while in three studies, participants had major depressive disorders ( 5 , 11 , 17 ). With regard to Cochrane Risk of Bias Assessment Tool results, only two studies ( 16 , 17 ) could be considered high-quality studies with a totally low risk of bias for all domains.…”

“…Magnesium acts as a co-factor in more than 350 enzymes in humans; the majority of them play a crucial role in brain function. It affects mood regulation by balancing chemical compounds in the brain ( 5 ). Magnesium increases the expression of brain-derived neurotrophic factor (BDNF), through which it may reduce the function of the N-methyl-D-aspartic acid (NMDA) ionotropic glutamate receptor.…”