Sanity Break

Help for depression and anxiety

Some 38 million American adults self-treat with supplements for a variety of conditions. Although some supplements are made of natural elements and are very effective, they can be potentially more hazardous, as the U.S. Food and Drug Administration (FDA) holds them to a far lower standard than prescription drugs. Everyday Health’s Chris Iliades highlighted a few of them in a recent post:

St. John’s wort. According to a review of eight studies on this natural remedy for depression published in Archives of Internal Medicine, there is some evidence that taking 300 milligrams (mg) of St. John’s wort two to three times a day is as good as taking an antidepressant drug for mild or moderate depression. But there are important cautions, too. “This herb acts like an antidepressant medication, but you need to be careful because the active extract isn’t regulated and can interfere with many prescription medications, including birth control,” says Murali Rao, MD, chairman of the department of psychiatry and behavioral neurosciences at Loyola University Medical Center in Chicago.

SAMe. This dietary supplement has been shown to increase the brain chemical dopamine, which may be low in people with depression. Some studies have found a beneficial effect of SAMe on symptoms of depression with 1,600 mg a day, but other studies have not, so the jury is still out. SAMe can interact with prescription antidepressant medications, so be sure to let your doctor know if you take it.

Omega-3 fatty acids. These healthy fats, found in fish oil supplements, have had mixed results as a natural remedy for depression. Some studies have found that, when 3 to 9 grams a day are taken along with antidepressant medications, omega-3s increase the response to the antidepressants. Other studies have found no benefit in omega-3s for depression. High doses of omega-3s can increase your risk of bleeding. Avoid this supplement if you are on blood thinners.

Vitamins. Vitamin B6 may relieve premenstrual depression in women, but the evidence isn’t strong. Folic acid, B12, and vitamin D have all been found to be low in some people with depression, so it makes sense that supplementing these vitamins could help — but again, no solid evidence exists.

Karen Swartz, Director of Clinical Programs at Johns Hopkins Mood Disorders Clinic comments on two more supplements, Kava Kava and valerian in a Johns Hopkins Depression & Anxiety Bulletin:

Kava kava (Piper methysticum) is purported to promote relaxation without compromising mental sharpness; a review of six randomized, placebo-controlled trials found that it was an effective option for anxiety. But in 2002, after adverse effects were widely reported, the FDA issued a warning about kava kava’s potential for severe liver damage. Since then, research into the herb’s benefits has sharply declined, and some countries (not the United States) have banned its use.

Valerian, which comes from the Valeriana officinalis plant, appears to be fee of major adverse effects. Some randomized, placebo-controlled studies how it to be helpful for insomnia, though they are faulted for their small sample sizes or other biases. Overall, the evidence for the sleep-inducing effects of valerian remains inconclusive.

Therese Borchard

Therese J. Borchard is the author of Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes and The Pocket Therapist: An Emotional Survival Guide. She is Associate Editor at Psych Central,…read more