Vitamins and Depression

Folic acide deficiency has been found among people with depression and has been linked to poor response to antidepressant treatment. Folate supplements have been used for enhancing treatment repse to antidepressants. However, limited clinical research suggests that folic acid is not effective as a replacement for conventional antidepressant therapy. Depression, of course, should be treated by a qualified healthcare provider. Inositol is a simple polyol precursor in a second messenger system important in the brain. Cerebrospinal fluid inositol has been reported as decreased in depression. A double-blind controlled trial of 12 g daily of inositol in 28 depressed patients for four weeks was performed. Significant overall benefit for inositol compared to placebo was found at week 4 on the Hamilton Depression Scale. (http://www.biopsychiatry.com/inositol.htm) Studies suggest that folate may be associated with depression more than any other nutrient. Between 15% and 38% of people with depression have low folate levels in their bodies and those with very low levels tend to be the most depressed. Having low levels of folate may also affect treatment; some studies report that people with folate deficiencies tend to respond less effectively to the SSRI, fluoxetine, than those with normal amounts of folate. Therefore, folate supplementation (typically between 400 and 800 mg) may be useful in both treating depression and assuring the appropriate effects of some antidepressant medications. Many healthcare providers start by recommending a multivitamin (MVI) that contains folate, and then monitoring the homocysteine levels in the blood to ensure the adequacy of therapy. Elevated homocysteine levels indicate a deficiency of folate even if the levels of folate in the blood are normal. If the MVI alone is not enough to lower homocysteine and improve folate function, the provider may suggest additional folate along with vitamins B6 and B12. Omega-3 fatty acids Essential fatty acids, such as omega-3 and omega-6 fatty acids play a crucial role in the function of brain chemicals, particularly serotonin and dopamine. Studies have shown that low levels of omega-3 fatty acids (found in cold-water fish such as tuna and salmon), or a high ratio of omega-6 fatty acids (found in certain vegetable oils, such as corn and soybean oils) to omega-3 fatty acids, may be associated with depression. A typical American diet is high in omega-6 compared to omega-3 fatty acids. Eating foods rich in omega-3 fatty acids on a regular basis helps maintain an appropriate balance of omega-6 to omega-3 fatty acids, and although unproven, restoring this balance may help with feelings and symptoms of depression. S-Adenosinemethionine (SAMe) Some studies suggest that the dietary supplement SAMe may be just as effective as tricyclic antidepressants for treating depression, but with fewer side effects. SAMe appears to boost serotonin levels in the brain, but further research investigating the mechanism of action (how it works), safety, and effectiveness of SAMe for depression is warranted. Until more is understood, it is best to avoid using SAMe in conjunction with other antidepressants. Discuss its use with your healthcare provider who can help tailor your treatment accordingly. Tryptophan Tryptophan is an amino acid involved in the production of serotonin. Studies suggest that tryptophan depletion can lead to diminished serotonin levels, and in some cases, may increase a person's susceptibility to depression. Some research indicates that tryptophan, together with tricyclic medications, may produce better results than the medication alone. Tryptophan supplementation alone may not be enough to reduce symptoms of depression. However, while research results are intriguing, tryptophan use has been associated with the development of serious conditions such as liver and brain toxicity, and with eosinophilic myalgia syndrome (EMS), a potentially fatal disorder that affects the skin, blood, muscles, and organs. (An outbreak of EMS caused by a contaminated batch of tryptophan led to the removal of this supplement from the United States market in 1989.) In addition, given the possibility of adverse interactions, tryptophan should not be used in conjunction with MAOIs or SSRIs. 5-Hydroxytryptophan (5-HTP) Some studies suggest that a by-product of tryptophan known as 5-HTP may be as effective as SSRIs and tricyclic antidepressants in treating depression, but with fewer side effects. As with tryptophan, EMS has been reported in 10 people taking 5-HTP. Further research is necessary to determine whether supplementation with 5-HTP is safe and effective for the treatment of depression. Selenium Some reports indicate that the mineral selenium, found in wheat germ, brewer's yeast, liver, fish, shellfish, garlic, sunflower seeds, Brazil nuts, and grains, significantly affects mood. In one study of people with low levels of selenium, those who consumed a diet high in selenium reported decreased feelings of depression after 5 weeks. Inositol Inositol is a naturally occurring substance involved in the production of certain brain chemicals. In a few studies, levels of inositol were lower in the cerebrospinal fluid (fluid surrounding the brain and spinal column) of depressed people compared to healthy people. In addition, administration of inositol decreased signs of depression in two animal studies. Several small human studies suggest that inositol may be of value in the treatment of depression, particularly for those who do not respond to antidepressant medications. More clinical trials are necessary to draw definitive conclusions on this substance, however. Tyrosine A number of studies conducted in the 1970s showed encouraging results regarding the use of tyrosine to ease symptoms of depression. In one study from 1990, however, tyrosine failed to demonstrate any anti-depressant activity. More studies are needed in order to draw firm conclusions about the use of tyrosine to help treat mild to moderate depression. Melatonin In one study of only 10 people with seasonal affective disorder, those *****ceived melatonin supplements had significant improvement in their symptoms compared to those *****ceived placebo. Given the small size of this study, however, more research is needed before conclusions can be drawn regarding use of melatonin for either seasonal affective disorder or any other type of depression. Vitamin C Some healthcare professionals recommend vitamin C to reduce the symptom of dry mouth, a side effect experienced by many people taking antidepressant medications. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=%202682787&dopt=Abstract