Depression Supplements: Do They Work?

Depression can be treated with medications and/or psychological therapies. The type of treatment depends on the severity of the depressive symptoms.

Antidepressant drugs are generally effective for more severe depression. They work by changing the action of chemical neurotransmitters that allow nerve cells to communicate with each other. Different antidepressants affect neurotransmitters in different ways.

The first line of treatment is usually selective serotonin reuptake inhibitors (SSRIs), which include fluoxetine (Prozac) and citalopram. As the name suggests, these drugs inhibit the reuptake of the neurotransmitter serotonin. The exact mechanism of action is unknown, but they help the symptoms of depression in many people.

Although these drugs are better tolerated than the older ones tricyclic antidepressantssome research has highlighted adverse effects, such as insomnia, agitation, gastrointestinal symptoms, sexual dysfunction and suicidal ideation, particularly in adolescents.

If SSRIs are ineffective, doctors may prescribe other antidepressants, but some of them have an even greater effect risk of side effects.

Psychological therapies it can also be very effective for depression, used alone or in combination with antidepressants. They to include cognitive behavioral therapy (CBT), interpersonal therapy e supportive care.

However, people often find it difficult to access these therapies, with an Oxford University study reporting that less than 5% of people with depression and anxiety were receiving them in the UK.

Some 68% of people are unresponsive to first-line antidepressant treatment and 1530% will be unresponsive after two adequate studies. So could vitamin, mineral or probiotic dietary supplements help relieve symptoms or improve the effectiveness of antidepressants?

There is some evidence to suggest that some dietary supplements may have a beneficial effect in relieving depressive symptoms. However, it’s important to note that supplements should not be considered a stand-alone treatment for depression, and their effectiveness can vary between individuals.

Sebnem Unluisler, genetic engineer at the London Regenerative Institute

Evidence for the benefits of supplements varies widely, with some showing no benefit and studies suggesting that others may have a beneficial effect in treating depression.

The MooDFOOD study looked at supplements and depression in 1,000 overweight and obese people at high risk for depression.

In 2019, it concluded that taking dietary supplements containing folic acid, vitamin D, zinc, and selenium daily was no better at preventing major depressive episodes than a placebo.

Instead, they suggested that for people with overweight and obesity, losing weight and following a healthy diet, such as the Mediterranean diet, could help with symptoms of depression.

Some supplements, however, have been shown to help relieve symptoms, particularly when used in addition to other treatments, such as psychological therapies or antidepressants.

A 2022 meta-analysis of 41 studies suggested that vitamin D might benefit people with depression. Although there were variations between studies, overall, 50 micrograms or more of vitamin D per day was more effective than a placebo at relieving symptoms of depression.

Unluisler explained to Medical News Today because vitamin D could have a positive effect.

One possible mechanism is that vitamin D may affect the production and regulation of neurotransmitters, such as serotonin, which play a role in regulating mood, he told us. Additionally, vitamin D receptors are present in brain regions associated with depression.

Another study have shown that high doses of vitamin B6 may have a small beneficial effect on depression. However, the study sample size was small, and most of the people included had self-reported anxiety, which B6 was more effective against, rather than depression.

Studies have also suggested that low iron can accentuate depressive symptoms, with links seen between anemia and depression.

One Study 2016 found a significant association between iron deficiency anemia and depression. Research suggests that low iron impairs dopamine metabolism and may also affect serotonin levels, both of which can result in mood changes.

Iron deficiency doesn’t always cause anemia, but it can still cause other symptoms including depression, so for those with low iron levels and depression, iron supplementation may be beneficial.

Other studies have looked at the effect of pro- and prebiotic foods and dietary supplements on improving a person gut microbiome. Recent research has highlighted the importance of the gut-brain axis and the effects of the gut microbiota mood and mental health.

Prebiotics and probiotics can modulate the gut microbiota, which in turn can influence the production of neurotransmitters and other signaling molecules that influence brain function and mood. Additionally, the anti-inflammatory effects of prebiotics and probiotics may contribute to their potential impact on mental health.

Sebnem Unluisler

A 2019 review of studies concluded that pre- and probiotics might have some benefit in managing depression. The researchers suggest that, pending further investigation, such dietary supplements could be used as an adjunctive treatment for people with depression.

Now, a study published in June 2023 provides more evidence that probiotics can help treat depression. Although it had a small sample size, this double-blind study of people failing antidepressant treatment found a marked improvement in symptoms in those taking probiotics.

In the 8-week study, half of the sample (24 people) received capsules 4 times a day containing 14 different probiotics. The rest received identical placebo capsules.

There was some reduction in symptoms of depression in both groups, but after 4 weeks of treatment, the probiotic group showed a greater response.

Because the probiotic was well tolerated, with no serious adverse effects, the researchers suggest it could be a useful adjunctive therapy for sufferers of major depressive disorder.

There is some evidence that supplements may be helpful for people with depression, but Dr Thomas MacLaren, consultant psychiatrist at Re:Cognition Health, cautioned:

It is important that you do not take supplements as a substitute for medical treatment of your depression. However, they can be considered a complementary approach in conjunction with medical treatment, such as medication or therapy.

Research into the use of supplements for depression is ongoing. Recent studies have provided conflicting results, highlighting the need for more investigation to determine the efficacy and safety of specific supplements, he added.

Even natural supplements can have safety concerns, particularly for those taking other medications. Education found that the herbal remedy St. John’s Wort may be as effective as SSRIs for treating mild to moderate depression, but may have similar adverse effects and must not be taken with a number of commonly prescribed drugs.

Other supplements that have shown some benefit in studies can also have negative effects. Vitamin D AND vitamin B6 it can be toxic in high doses, and too much iron can cause liver damage.

Dr. MacLaren advised: People should be aware of potential side effects, drug interactions, and the lack of sufficient scientific evidence to support the benefits of supplements for depression. It is vital that you consult a healthcare professional before starting any new supplement.

Unluisler agreed that consulting a doctor is critical: Healthcare professionals need to be aware of any supplements a person is taking to assess their safety and potential interactions with prescribed medications. Some supplements can interact with certain antidepressants or other medications, affecting their effectiveness or causing adverse effects.

It appears that the strongest evidence of benefit without risk of side effects is for probiotics, but eating a healthy and varied diet rich in fruits, vegetables and fermented foods may also have beneficial effects by encouraging a healthy microbiome.

Some people may find taking a supplement reassuring, and if it has any actual benefit, the placebo effect may be enough to relieve symptoms. Provided people follow their doctor’s advice, supplements are unlikely to do any harm.

However, as Dr. MacLaren told us: The overall evidence is still inconclusive. It is therefore important to think twice before investing money in a special supplement. Focus on a balanced and healthy diet.