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Adjunctive nutraceuticals for depression: a systematic review and meta-analyses

Sarris, Jerome, Murphy, Jenifer, Mischoulon, David, Papakostas, George I., Fava, Maurizio, Berk, Michael and Ng, Chee H. 2016, Adjunctive nutraceuticals for depression: a systematic review and meta-analyses, American journal of psychiatry, vol. 173, no. 6, pp. 575-587, doi: 10.1176/appi.ajp.2016.15091228.

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Title Adjunctive nutraceuticals for depression: a systematic review and meta-analyses
Author(s) Sarris, Jerome
Murphy, Jenifer
Mischoulon, David
Papakostas, George I.
Fava, Maurizio
Berk, MichaelORCID iD for Berk, Michael orcid.org/0000-0002-5554-6946
Ng, Chee H.
Journal name American journal of psychiatry
Volume number 173
Issue number 6
Start page 575
End page 587
Total pages 13
Publisher American Psychiatric Association Publishing
Place of publication Arlington, Va.
Publication date 2016-06-01
ISSN 0002-953X
1535-7228
Keyword(s) augmentation strategies
nutraceuticals
depression
mental health
psychiatry
Science & Technology
Life Sciences & Biomedicine
PLACEBO-CONTROLLED TRIAL
SEROTONIN REUPTAKE INHIBITORS
RANDOMIZED CONTROLLED-TRIAL
FOLIC-ACID SUPPLEMENTATION
ADENOSYL-L-METHIONINE
DOUBLE-BLIND
MAJOR DEPRESSION
EICOSAPENTAENOIC ACID
S-ADENOSYLMETHIONINE
PROSTATE-CANCER
Summary OBJECTIVE: There is burgeoning interest in augmentation strategies for improving inadequate response to antidepressants. The adjunctive use of standardized pharmaceutical-grade nutrients, known as nutraceuticals, has the potential to modulate several neurochemical pathways implicated in depression. While many studies have been conducted in this area, to date no specialized systematic review (or meta-analysis) has been conducted. METHOD: A systematic search of PubMed, CINAHL, Cochrane Library, and Web of Science was conducted up to December 2015 for clinical trials using adjunctive nutrients for depression. Where sufficient data were available, a random-effects model analyzed the standard mean difference between treatment and placebo in the change from baseline to endpoint, combining the effect size data. Funnel plot and heterogeneity analyses were also performed. RESULTS: Primarily positive results were found for replicated studies testing S-adenosylmethionine (SAMe), methylfolate, omega-3 (primarily EPA or ethyl-EPA), and vitamin D, with positive isolated studies for creatine, folinic acid, and an amino acid combination. Mixed results were found for zinc, folic acid, vitamin C, and tryptophan, with nonsignificant results for inositol. No major adverse effects were noted in the studies (aside from minor digestive disturbance). A meta-analysis of adjunctive omega-3 versus placebo revealed a significant and moderate to strong effect in favor of omega-3. Conversely, a meta-analysis of folic acid revealed a nonsignificant difference from placebo. Marked study heterogeneity was found in a Higgins test for both omega-3 and folic acid studies; funnel plots also revealed asymmetry (reflecting potential study bias). CONCLUSIONS: Current evidence supports adjunctive use of SAMe, methylfolate, omega-3, and vitamin D with antidepressants to reduce depressive symptoms.
Language eng
DOI 10.1176/appi.ajp.2016.15091228
Field of Research 111502 Clinical Pharmacology and Therapeutics
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, American Psychiatric Association Publishing
Persistent URL http://hdl.handle.net/10536/DRO/DU:30083400

Document type: Journal Article
Collection: School of Medicine
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Created: Wed, 11 May 2016, 14:29:54 EST

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