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 .
Current evidence supports adjunctive use of SAMe , methylfolate , omega-3 , and vitamin D with antidepressants to reduce depressive symptoms
OBJECTIVE There is burgeoning interest in augmentation strategies for improving inadequate response to antidepressants .
The adjunctive use of st and ardized 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 .
Eicosapentaenoic acid as an add-on to antidepressant medication for co-morbid major depression in patients with diabetes mellitus: a randomized, double-blind placebo-controlled study.
BACKGROUND Depression is common in individuals with diabetes . The present study is the first r and omized controlled trial to test the efficacy of omega-3 ethyl-eicosapentaenoic acid ( E-EPA ) as adjuvant to antidepressant medication in the treatment of depression in adults with diabetes mellitus . METHODS In the VU University Medical Center , we conducted a 12-week , placebo-controlled , double-blind , parallel-group intervention study of E-EPA ( 1g/day ) versus placebo in 25 diabetes patients meeting DSM-IV criteria for major depressive disorder , who were already using antidepressant medication . The primary outcome was severity of depressive symptoms , assessed by the Montgomery Asberg Depression Rating Scale ( MADRS ) at baseline and 12-week follow-up at two-weekly intervals . Blood sample s were collected at baseline and at 12-week follow-up to determine EPA levels in erythrocyte membranes . Data were analyzed with ANOVA for repeated measures . RESULTS Thirteen participants were r and omly assigned to  E-EPA ; 12 participants were given  placebo . At 12-week follow-up , erythrocyte membranes from patients receiving E-EPA contained tripled levels of EPA , while no changes were noted in participants receiving placebo . In both groups , depressive symptoms significantly decreased over time ( F=21.14 , p<0.001 ) , yet no significant differences were found between those treated with E-EPA versus placebo ( F=1.63 , p=0.17 ) . LIMITATIONS Although having sufficient study power , this study had a relatively small sample size . Small effects could not be detected , and dose-dependent effects could not be studied . CONCLUSIONS No evidence was found for the efficacy of adding E-EPA to antidepressants in reducing depressive symptoms in diabetic patients with co-morbid depression
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 .
Current evidence supports adjunctive use of SAMe , methylfolate , omega-3 , and vitamin D with antidepressants to reduce depressive symptoms
OBJECTIVE There is burgeoning interest in augmentation strategies for improving inadequate response to antidepressants .
The adjunctive use of st and ardized 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 .