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Dietary Supplements for Depression

What Does the Research Really Show?
  -- By Becky Hand, Licensed & Registered Dietitian
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. <pagebreak>

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: 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.