Nutritional and herbal supplements in the treatment of obsessive compulsive disorder

Abstract

Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder that is characterised by obsessions and compulsions. The recommended treatments for OCD are cognitive– behavioural therapy using exposure and response prevention and/or pharmacotherapy. On the other hand, some nutritional and herbal supplements may be effective in the treatment of OCD. Nutritional and herbal supplements in OCD treatment will be reviewed in this paper. PubMed (Medline), Cochrane Library and Google Scholar databases were reviewed for the topic. There are some supplements that have been researched in OCD treatment studies such as vitamin D, vitamin B12, folic acid, homocysteine, trace elements, N-acetyl cysteine, glycine, myoinositol, St John’s wort, milk thistle, valerian root, curcumin and borage. The effectiveness of herbal and nutritional supplements in the treatment of OCD should be supported with more conclusive evidence.

Vitamin D supplementation improves anxiety but not depression symptoms in patients with vitamin D deficiency

“…Multiple hypotheses regarding possible pathophysiological mechanisms of these mood disorders included altered neurotransmission, chemical imbalance in the brain, inflammation, reduced neuroplasticity, chronic stress, and nutrient deficiency (Berridge, 2017; Maletic et al., 2007; Pertile, Cui, Hammond, & Eyles, 2018). Extensive research over the past decades has shown a critical role of malnutrition in depression and anxiety disorder (Kuygun Karci & Gul Celik, 2020; Milaneschi et al, 2019; Sanchez‐Villegas et al., 2009). Moreover, this body of research has supported a complex involvement of vitamin D (VD) deficiency in mood disorders (Ju, Lee, & Jeong, 2013); however, the relationship between the two was not fully elucidated.…”

Augmenting Clinical Interventions in Psychiatric Disorders: Systematic Review and Update on Nutrition

“…Several studies have corroborated the fact that deficiency of some vitamins and other essential nutrients lead to cognitive impairments ( 126 , 127 ). Vitamin D plays an important role in immunity modulation, inflammatory response, and antioxidant processes, as well as in normal brain development and functioning, neurotransmission, neuroprotection, proliferation, and differentiation ( 80 , 128 , 129 ). Vitamin D deficiency can be associated with numerous neuropsychiatric diseases, including autism, major depressive disorder, schizophrenia, and Obsessive-Compulsive Disorder (OCD) ( 130 , 131 ).…”

“…Although some studies found no evidence for the efficacy of myoinositol in OCD treatment, others have reported the effectiveness of myoinositol supplementation in the treatment of OCD ( 78 , 138 ). Available clinical evidence suggests that MI may potentially be effective as monotherapy in OCD ( 80 ). The suggested mechanisms of action involve modulation of the reuptake of serotonin and an increase in 5-HT2 receptor density ( 79 ).…”

“…The suggested mechanisms of action involve modulation of the reuptake of serotonin and an increase in 5-HT2 receptor density ( 79 ). Silymarin, a flavonoid derived from the plant Milk thistle (Silybummarianum), has been reported to have anti-inflammatory, antioxidant, immune modulator, sedative, and antidepressant effects ( 80 ). It increases serotonin in the cortex and acts as a monoamine oxidase inhibitor ( 81 ).…”

“…It contains flavonoids, and its neurobiological activity involves monoamine reuptake inhibition, neuroendocrine modulation, increased sensitization, and binding to receptors (e.g., 5-HT) ( 85 ). Although some herbal medicines may provide a synergistic effect with conventional drugs, there should be some precautions in the use of some herbal supplements and some pharmaceuticals, for example, St John's Wort with SSRIs due to potential adverse serotonin syndrome ( 80 ). Polyphenols are natural compounds present in plant-based foods.…”