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Dietary Supplements for Depression

What Does the Research Really Show?

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It's becoming more and more common for consumers to forgo medication when looking for a "natural" alternative to treating conditions like depression. No matter what method you choose, it's important to get all the facts. SparkPeople recommends working closely with your health care provider to find a treatment plan that works for you. The following article will help separate the facts from the falsities when it comes to supplements that claim to treat depression.

The U.S. Food and Drug Administration (FDA) does not regulate dietary supplements, which means that supplements with little to no research on safety or effectiveness are sold in stores and online every day. "Natural" or not, supplements can lead to overmedication, drug interactions, and serious side effects. It probably isn't a good idea to forgo your conventional medical treatment and rely on supplements alone. It's extremely important to always tell your doctor if you are using a dietary supplement or if you are even thinking about combining a dietary supplement with your conventional medical treatment. Discuss the following supplements with your doctor to decide which ones might be right for you.

A derivative of the amino acid tryptophan, 5-HTP (5-hydroxy-L-tryptophan), is converted into the neurotransmitter serotonin in the brain. Supplementing 5-HTP is possibly effective in helping to increase the levels of serotonin in the brain, which helps regulate mood, sleep and appetite. However, additional research is needed. Side effects include: nausea, constipation, gas, drowsiness, and reduced libido. In high doses, 5-HTP may cause liver problems and aggravate asthma.

A number of studies indicate that fish oil supplements, which are high in omega-3s, may be effective at treating depression—when combined with medical treatment. All fish oil supplements are different, so it's important to read labels and discuss them with your doctor. Specifically, the fatty acid EPA (eicosapentaenoic acid), which is found in fatty fish and fish oil, is the most beneficial. According to research, taking 1-2 grams of EPA orally (along with standard antidepressant therapy), improves depression symptoms. In contrast, DHA (docosahexaenoic acid), which is also found in fatty fish and fish oil, does not appear to have these same effects.

Folic Acid is a B-vitamin. Taking folic acid (folate) supplements with conventional antidepressant medication might improve the treatment response for those with depression. However, current research suggests that folic acid is not an effective replacement for antidepressant medication therapy.

Saffron hasn't been widely studied. One study of a specific saffron extract (from the Novin Zaferan Company in Iran) showed that when taken orally, saffron seemed to improve symptoms of major depression. However, one study isn't enough to prove safety or effectiveness.

SAM-e (short for S-adenosylmethionine) is a molecule that naturally occurs within cells and is believed to influence chemicals involved in depression. In several small clinical studies, the dietary supplement SAM-e was shown to be a helpful treatment for major depression when given intravenously or intramuscularly to patients. SAM-e seems to reduce the symptoms of major depression when taken orally as well. Large scale studies are still needed to clarify the true effects of SAM-e in treating depression. SAM-e can have many side effects including nausea, diarrhea, anxiety, headache, and intense mood swings.

The plant St. John’s Wort (Hypericum perforatum) has been used for centuries to treat depression. It is sold in the U.S. as a dietary supplement. Research indicates that St. John’s Wort improves mood, and decreases the anxiety, physical symptoms, and insomnia related to mild to severe depression. St. John’s Wort, however, has never been shown to be more effective or significantly better-tolerated than conventional antidepressant medications. St. John’s Wort may cause drug interactions. Side effects include: skin rash with sun exposure, insomnia, vivid dreams, agitation, upset stomach, diarrhea, fatigue, dry mouth, dizziness and headache.

When it comes to treating depression, there is insufficient evidence or limited research to support the following supplements:
  • Acetyl-L-Carnitine
  • Chromium
  • DHA (docosahexaenoic acid)
  • DHEA
  • Inositol
  • KAVA (this has also been associated with liver failure)
  • Lavender
  • L-Tryptophan
  • Melatonin
  • Phenylalanine
  • Phosphatidylserine
  • Tyrosine
There's nothing wrong with looking for alternatives to treating depression. While many people are opposed to prescription medications, possibly fearing adverse side effects, it's important to remember that prescription drugs are tightly regulated, tested, and evaluated and approved for use by the FDA. No supplements are tested as thoroughly as medications are. Using supplements, vitamins, and herbs involves risks as well. Always discuss supplementation with your health care provider before making a decision on your own.

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Member Comments

  • Good information. I see a lot of patients who have tried many of these supplements to treat their depression.
  • Very interesting and informative.
  • I don't fight my depression, I know that it is just what is for now. When the doctors get everything figured out I know my mental health will be restored. I have no means of getting enough sleep because of pain so I take melatonin, it's great, but doesn't work every time.
    I don't think a "normal" person expects to be happy all the time,
    It's an unreal concept.
    Being depressed is just a moment in my life,
    My life that God gave me and I accept it and know that He is God and
    He of course knows what is best for me.
  • FOXGLOVE999
    I get so tired of people with no real life experience with major psychiatric disorders telling me that depression/anxiet
    y or whatever are made up diagnosis. Suicide is a major problem in this country, that is fueled by this kind of ignorance. I realize that for people who have never experienced this kind of pain, it might be difficult to understand, but that doesn't make it fake.
  • PLASMID203
    Great article (I especially appreciated the quick list of things to skip on the last page.) I would love to hear more about antioxidants like alpha lipoic acid, N-acetyl-cysteine (NAC) and the like. I kinda place them in the same "supportive care" column as salmon or an extra of helping of vegetables with regard to treating depression. Some supplements like NAC have been used for years clinically/with a prescription to treat cancer, liver failure, (see http://www.mskcc.
    org/cancer-ca
    re/herb/n-ace
    tylcysteine for info on this) but are also sold as supplements and touted as having potential use with regard to depression and anxiety.

    Anyway, I'd love to see more articles regarding drugs/supplements that are well characterized and useful for treating other medical conditions that are now studied for the treatment of depression.
  • Not that the drug companies or the FDA are innocent, far from it, but it is impossible to assume a supplement is going to have a consistent level of quality and potency. Products from plants and animals are notoriously variable, and I speak as a person with years of experience in the food industry. Quality control is extremely problematic the closer you get to a natural product. All you have to do is walk around your produce department or farmers' market to see the truth in that statement.

    I'm just saying this, "Make your judgment on depression treatment based upon your needs and your lifestyle, tempered with a lot of independent information. And don't believe everything you read on the internet."
  • Wow, this article is simply shocking! It's basically pushing pharmaceutical drugs for depression. The statement toward the end of the article professing that drugs are very tightly regulated is actually laughable. The drug companies hide the negative aspects of their studies and submit the positive ones. There are all sorts of research out there now to prove that. The black box warnings on depression drugs goes on and on and yet these drugs are tightly regulated? That makes no sense at all. After doing hordes of research myself on these drugs after ending up in the emergency room with life threatening side affects from one, I am absolutely convinced that the drug companies and psychiatrists are now trying to make up disorders to sell their drugs. Psychiatric drugs alone kill over 50 thousand people a year and 150,000 end up like me, in an ER with horrible reactions to them. They cause violence, mania, suicidal tendency, etc, and yet we are to be afraid of supplements? Makes no sense. This idea that depression is a disease is quite ridiculous promoted by the drug companies to sell their drugs. There are no tests, none, that would ever confirm the disease of depression. Drugs only cover up the symptoms of depression, they do not cure it (but they do create a patient for life, since once on them, it's hell getting off). I'll try anything else first! There are new studies and new evidence that drugs are ineffective for mild to moderate depression and no better than a placebo. We have become a nation of pill poppers and the drug companies are raking in billions from it and the FDA is being driven by it as well.
  • I also tried impramine as well as a bunch of other drugs many years ago and found they did nothing really but give me dry mouth and shaking hands. SJW did nothing. Valerian gave me bad dreams, and is really too strong for most long-term applications.

    Vitatmin B, D and calcium seem to help, and I take them right along with my fish oil and multi every morning.

    I used to take hops extract, but now I just have a beer with dinner when I'm feeling stressed out. Works like a charm. It is not just the alcohol that relaxes you. They used to make hops pillows to calm the nerves, but most people say they rustle a lot.

    I use passion flower tea also when I need to smooth my mood. I hear that parents who don't want to use drugs use it for treating ADD or ADHD often use passion flower because it's also very safe and tastes good. Meditation, strategic naps, and exercise on a regular basis really help a lot, too. I also notice that eating cleanly (little white sugar, flour and processed foods) makes me more consistent in mood.

    None of these things by themselves make an earth shattering difference, but together they add up significantly.
  • Maybe it's just me, but having an ad for a new anti-depressant drug on an article seemingly showing vitamins in a negative light makes me wonder about the information contained in the article itself. That being said, I'm sure the author wrote the article honestly and really had no control over the ad that was placed on the same page.I certainly don't mean to imply in any way that she was dishonest in order to retain advertising. I'm POSITIVE that wasn't the case. I guess I'm just trying to make the point that it just doesn't look right to have that ad along with this particular article.

    I've been dealing with major depressive disorder since 2002 and am honestly sick of trying new prescription medication. I was hoping to find something in here that I could try instead. After having passed out three times in the first-and only-night since trying the last new prescription one week ago, I'm afraid to try any others.
  • I have suffered from severe depression and anxiety since I was about 4 or 5 years old. I tried lexapro when I was 18 and it didn't change my symptoms much, so I went off of meds for a few years. When I was 22 I was perscribed with Cymbalta. Cymbalta was the miracle worker for me, but it is more expensive. I would love to try any natural alternatives for my severe symptoms, does anybody have any suggestions?
  • Attention! St. John īs wort can interact with the anti-conception meds!!! Not all doctors think of it, since it is no real medication- but it is better to be well aware of the fact. If taking St.Johnīs Wort always look for anti-conception alternatives.
  • This is a well written article, however I would like to just add that both myself and I have family members who have lifetime health issues to do some of those medications that are so strictly monitored by the FDA. So I think it's equally important to consider carefully EVERYTHING we put into our bodies, not only those prescription medications that are regulated. REgulated does not necessarily mean "safe".

    That is pretty clear from all of commercials on television and in magazine articles about medications.
  • I had been on 100mg zoloft (and briefly tried Lexapro) for several years, after the birth of my children - my dr originally seemed to think it was post partum depression but it has continued. Both drugs were very hard on my stomach and I just couldn't take it anymore. I switched to St John's Wort and I've been very happy with it for the last year. I take double the recommended dosage on the bottle (still well within acceptable dosages being prescribed in Europe for centuries) and I get the same benefits w/o the side effects on my digestive system. LOVE it! I only take well known brands, my current favorite is Origins (2 pills 3x daily), a close second is the time released version by NatureMade. I have also noticed that working out has helped as well - but I recently tried going off of the SJW and had to go back on it after a few weeks - so I still obviously need it.

    Don't let this article talk you out of trying alternative methods! Personally I think the big drug companies promote a lot of the "counter intelligence" on drug alternatives, just to discourage people from trying other options. Just do your research, try only major brands or those recommended by a dr AND discuss possible drug interactions with the pharmacist or your dr first! Remember SJW is a prescription only drug (hypercurium) in Europe ...just because it's available OTC here, doesn't mean you should overlook possible side effects or drug interactions!

    (PS look online for coupons and combine with B1G1Free sales to get them even cheaper!!)
  • I know alot of people, myself included, that gained easily with the taking of A.D.s I've had to work hard (w/SP) not to gain anymore.... I had been gaining cont. since May 2009, which is when I first started taking them.
  • Very helpful. Wondering if any of these antidepressants help w/ weight loss. I've put on alot of weight and now have about 12lbs to lose. I've heard antidepressants can actually put on weight. I'm on Bupropion HCL and Lorazepam, I'm hoping neither of them do.

About The Author

Becky Hand Becky Hand
Becky is a registered and licensed dietitian with almost 20 years of experience. A certified health coach through the Cooper Institute with a master's degree in health education, she makes nutrition principles practical, easy-to-apply and fun. See all of Becky's articles.