Supplements For Depression: What Works, What Doesn't

The multibillion-dollar market for dietary supplements is filled with products that claim to boost mood or improve depression. Some products are even billed as an alternative to prescription antidepressants.

Don't believe everything you read on a label. Often the claims made by supplement manufacturers aren't backed up by solid scientific evidence, and the potency and contents of supplements can vary widely. (Some are anything but "natural.") Serious depression generally requires professional help, whether or not that includes antidepressant medication.

That said, some supplements--such as St. John's wort and SAMe (pronounced "sammy")--have been tested fairly extensively and may improve your symptoms if you experience mild depression or related conditions such as seasonal affective disorder.

Below, we break down the evidence (or lack thereof) supporting the most popular supplements used to treat depression and mood.

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Folic Acid

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What it is: The synthetic form of folate, a B vitamin (B9) found in fruits, leafy vegetables, and other foods, that affects the neurotransmitters known as monoamines. Folic acid is sold in stores as a capsule or tablet. The evidence: Folate deficiency is common among depressed people, especially those who don't respond to antidepressants. Folic acid has never been tested as a stand-alone treatment for depression, but it has been compared with placebo as an addition to Prozac. In one study, patients who received folic acid responded better than those who received placebo--but only the female patients. Nearly 95% of the women who received folic acid responded to the combo treatment, compared to about 60% of the women who received the placebo. Other forms of folate that are more chemically complex have been tested on their own. In one early '90s study involving elderly depressed patients, a type of folate known as 5-methyltetrahydrofolate (5-MTHF) was found to be roughly as effective as the antidepressant trazodone. The bottom line: The evidence for the use of folic acid in depression is limited and inconclusive. (The Natural Standard Research Collaboration, an independent research group, has given the evidence a "C" grade.) 5-MTHF and a related form of folate called L-methylfolate--which is available as the "prescription medical food" Deplin--may be helpful as an addition to antidepressants, but you should be wary of nonprescription products that list 5-MTHF, L-methylfolate, or "optimized folate" as the main ingredient. More from Health.com: 10 No-Cost Strategies to Fight Depression The 10 Most Depressing Jobs Foods to Boost Your Mood

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What it is: The synthetic form of folate, a B vitamin (B9) found in fruits, leafy vegetables, and other foods, that affects the neurotransmitters known as monoamines. Folic acid is sold in stores as a capsule or tablet.

The evidence: Folate deficiency is common among depressed people, especially those who don't respond to antidepressants. Folic acid has never been tested as a stand-alone treatment for depression, but it has been compared with placebo as an addition to Prozac. In one study, patients who received folic acid responded better than those who received placebo--but only the female patients. Nearly 95% of the women who received folic acid responded to the combo treatment, compared to about 60% of the women who received the placebo.

Other forms of folate that are more chemically complex have been tested on their own. In one early '90s study involving elderly depressed patients, a type of folate known as 5-methyltetrahydrofolate (5-MTHF) was found to be roughly as effective as the antidepressant trazodone.

The bottom line: The evidence for the use of folic acid in depression is limited and inconclusive. (The Natural Standard Research Collaboration, an independent research group, has given the evidence a "C" grade.) 5-MTHF and a related form of folate called L-methylfolate--which is available as the "prescription medical food" Deplin--may be helpful as an addition to antidepressants, but you should be wary of nonprescription products that list 5-MTHF, L-methylfolate, or "optimized folate" as the main ingredient.

More from Health.com:
10 No-Cost Strategies to Fight Depression
The 10 Most Depressing Jobs
Foods to Boost Your Mood

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Comments

[NancyPeske]

09:07 AM on 04/02/2011

More studies need to be done on 5-HTP. I'm surprised that wasn't on the list.

[Greg Sureck]

10:30 PM on 04/01/2011

"Solid medical evidence" isn't all that solid. "Evidence based therapy" is an inside joke among providers who just spout this stuff for consumers. A particular treatment many only help one out of a hundred but it really does help that person. Behavioral health is very individual!

[menscience]

04:41 PM on 03/31/2011

Omega 3s are great for lifting your mood. There's pretty much nothing that they aren't good for: heart health, depression, skin... it's a no-brainer to supplement your diet with more fish or even a fish oil supplement.

http://www.mensciencemagazine.com/omega-3-fish-oil-fatty-acids

[Sayer Ji]

09:41 PM on 03/27/2011

For those looking for a strictly scientific evaluation of the positive data on natural substances for depression, this website takes peer-reviewed biomedical literature from the National Library of Medicine and attributes a numerical value to those substances which it finds have the most data supporting their use. On the top of the list are Kava Kava, Trytophan and Saffron, with 26 other substances listed http://www.greenmedinfo.com/disease/depression-unipolar

[TheBlondeRaven]

08:46 PM on 03/23/2011

St.Johns wort interfer with many common medications, for instance with birth control and anti depressants, so be very careful before taking the wort.

[Trittydi]

03:45 AM on 03/19/2011

We cured my brother's years-long depression with Vitamin D3. He was suicidal (had made an attempt) and under the care of the state. They asked us to let him live with us while they set up his housing. We started giving him VD3. Withing two weeks he had started laughing again. We increased his dose. Within about 3 months it was as if he were back to normal ... aside from losing his house and not having a job I mean.

He's on his own now and keeps taking his VD3.
*

[Chuck Bluestein]

06:40 PM on 03/17/2011

The last that I heard was that saffron was $150 a pound. That is a lot cheaper than gold, but a lot more than sillver. Many Americans do not get enough omega-3 and that is also important to prevent heart attacks, strokes and to prevent cancer.

[LovingFit]

09:10 PM on 03/15/2011

I saw this amazing eye opening documentary called Food Matters. It officially confirmed for me that you can treat illnesses with good nutrition. One of the doctors who was featured in the documentary said that you can treat depression with Niacin, dosage depends on the severity. Also cashiew nuts are also very helpful in treating depression.

[Judson Wallace]

05:52 AM on 03/13/2011

As someone who suffered from moderate to severe depression ... Vitamin D has been very helpful.

Its actually not a vitamin... its a hormone. It can be very helpful.

[Montana 123]

08:50 PM on 03/18/2011

Does that work for persons with Bipolar? My husband has BPII.

[Judson Wallace]

02:25 AM on 03/19/2011

This is a listing of some studies on Vitamin D and mental disorders...

http://www.vitamindcouncil.org/researchMentalIllness.shtml

Vitamin D is incredibly cheap... just sit out in the sun and its completely free. Even if you have to buy it because its the winter or you dislike sunlight... you can easily hunt around and get a 3 month supply for about $5-7 ...its the cheapest drug/prescription/supplement/health food craze Ive ever come across.

Some of the studies listed above are really interesting. I believe the Dr who originally started that organization is a psychologist and has a lot of information relating to mental issues aggregated on that site. Some of the original studies that provoked interest were done on large inmate and hospital populations encompassing many disorders. Others were more specific to a particular illness or symptom set, but you would probably find it all useful.

Best of luck to you and your husband.

[farmilyman]

06:51 PM on 03/08/2011

Good resource for psych drug effects:

http://www.cchrint.org/

[GodlessHeathen23]

09:41 PM on 03/13/2011

I've got a GREAT psych drug effect for you...the drugs I'm on keep me from losing my mind and eventually harming myself. I'd say that's the BEST effect anyone could ask for.

[farmilyman]

08:12 AM on 03/14/2011

Just stop watching Faux news.

[Phillip Barnhart]

12:55 PM on 03/07/2011

If we are looking at dietary ways to combat depression, why are we not studying what we traditionally use in the West? For example, if someone is upset - don't we offer them a cup of coffee? Surely we could get Starbucks (which rivals saffron in price) to underwrite it. How about chocolate? Cheesecake? Cans of cream cheese frosting (okay - the dosage on that last one is a bit rough to guestimate and the risk of overdose is quite high). My favorite remedy - BACON!! Seriously, its hard to feel depressed when assembling a BLT. Nothing beats winter blues like spicy hot apple cider.

Seriously, why are we only studying extracts and supplements that can be sold for a huge markup? Oh, yeah . . . $$$$$$$

[SheDAISY]

05:28 PM on 03/05/2011

I find that taking Magnesium (when needed) before bedtime really helps with anxieties and/or the 'winter blues'. It also helps me sleep very soundly.

http://www.health-supplements-advisor.com/magnesium-for-anxiety.html

[Bucket-Of-Love]

02:02 AM on 03/05/2011

A friend of mine recently nailed it when he said "Depression is a disease of loneliness". I believe that for many, this is entirely true. Many forces and beliefs cover up this truth.