Vitamin D3 as adjunctive therapy in the treatment of depression in tuberculosis patients: a short-term pilot randomized double-blind controlled study

Abstract

ObjectiveWe aimed to evaluate whether high-dose cholecalciferol has beneficial effects on depression in pulmonary tuberculosis (PTB) patients.MethodsThis pilot, randomized, and double-blind trial enrolled 123 recurrent PTB patients (aged ≥18 years) meeting Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria of major depressive disorder from four hospitals in Southeast China. Patients were randomly assigned to 8-week oral treatment with 100,000 IU/week cholecalciferol (Vit D group) or a matching placebo (control group). The primary outcome was treatment response, defined as a 50% reduction in symptoms and change in scores of the Chinese version of Beck Depression Inventory (BDI) from baseline to 8 weeks. Relative risks of depression were estimated using multivariable logistic regression.ResultsFinally, 120 patients were enrolled, including 56 test patients and 64 controls. After 8 weeks, the treatment response or BDI scores did not differ significantly between groups. Multivariate logistic regression showed that BDI scores were not significantly improved in the Vit D group after adjustment for age, time to first negative smear, or 25-hydroxyvitamin D level.ConclusionThe use of high-dose Vit D3 supplementation may not be warranted for reducing depressive symptoms in the PTB population. Nevertheless, this finding should be validated by further large-scale studies according to different kinds of depression or Vit D receptor polymorphism genotype.

Supplementation of Vitamin D and Mental Health in Adults with Respiratory System Diseases: A Systematic Review of Randomized Controlled Trials

“…The general descriptions of the studies included in the systematic review [ 28 , 29 , 30 , 31 , 32 ] are presented in Table 2 . The studies focused on the assessment of patients with chronic obstructive pulmonary disease (COPD) [ 28 , 31 ], but also increased susceptibility to respiratory tract infections [ 29 ], pulmonary tuberculosis [ 30 ], and bronchial asthma [ 32 ]. The majority of studies were conducted in European countries: Belgium [ 28 ], Sweden [ 29 ], and Spain [ 32 ], but also in China [ 30 ] and Iran [ 31 ].…”

Effect of vitamin D supplementation on the incidence and prognosis of depression: An updated meta-analysis based on randomized controlled trials

“…Furthermore, two studies were excluded because of non-RCT, four articles were excluded because they failed to report relevant outcomes, and two articles containing medications or nutritional supplements were also excluded. Ultimately, in accordance with inclusion and exclusion criteria, 29 eligible studies ( 7 , 18 – 45 ) were included ( Figure 1 ), 18 studies ( 18 – 35 ) for the correlation between vitamin D and the incidence of depression, and 11 studies ( 7 , 36 – 45 ) for the correlation between vitamin D and the development of depression.…”

Pharmacological or non-pharmacological interventions for treatment of common mental disorders associated with Tuberculosis: A systematic review

“…In a pilot RCT, Zhang et al 31 used vitamin D in 120 patients (56 in vitamin D group versus 64 control) presenting with pulmonary TB and meeting the DSM-IV criteria for depression. Change in scores of depressive symptoms was measured with the Chinese version of the Beck Depression Inventory (BDI).…”

“…The quality assessment of remaining five studies is provided in Figure 2. Only one study 31 had a low risk of bias score on all the items on Cochrane tool for the assessment of intervention studies, the rest were classified as having high risk of bias. Six studies used observational designs and were suitable for quality assessment using the tool proposed in the protocol.…”