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 .
Omega-3 augmentation of sertraline in treatment of depression in patients with coronary heart disease: a randomized controlled trial.
CONTEXT Studies of depressed psychiatric patients have shown that antidepressant efficacy can be increased by augmentation with omega-3 fatty acids . OBJECTIVE To determine whether omega-3 improves the response to sertraline  in patients with major depression and coronary heart disease ( CHD ) . DESIGN , SETTING , AND PARTICIPANTS R and omized controlled trial . Between May 2005 and December 2008 , 122 patients in St Louis , Missouri , with major depression and CHD were r and omized . INTERVENTIONS After a 2-week run-in period , all patients were given 50 mg/d of sertraline and r and omized in double-blind fashion to receive 2 g/d of omega-3 acid ethyl esters ( 930 mg of eicosapentaenoic acid [ EPA ] and 750 mg of docosahexaenoic acid [ DHA ] ) ( n=62 ) or to corn oil placebo capsules ( n=60 ) for 10 weeks . MAIN OUTCOME MEASURES Scores on the Beck Depression Inventory ( BDI-II ) and the Hamilton Rating Scale for Depression ( HAM-D ) . RESULTS Adherence to the medication regimen was 97 % or more in both groups for both medications . There were no differences in weekly BDI-II scores ( treatment x time interaction = 0.02 ; 95 % confidence interval [ CI ] , -0.33 to 0.36 ; t(112 ) = 0.11 ; P = .91 ) , pre-post BDI-II scores  ( placebo , 14.8 vs omega-3 , 16.1 ; 95 % difference-in-means CI , -4.5 to 2.0 ; t(116 ) = -0.77 ; P = .44 ) , or HAM-D scores ( placebo , 9.4 vs omega-3 , 9.3 ; 95 % difference-in-means CI , -2.2 to 2.4 ; t(115 ) = 0.12 ; P = .90 ) . The groups did not differ on predefined indicators of depression remission ( BDI-II < or = 8 : placebo , 27.4 % vs omega-3 , 28.3 % ; odds ratio [ OR ] , 0.96 ; 95 % CI , 0.43 - 2.15 ; t(113 ) = -0.11 ; P = .91 ) or response ( > 50 % reduction in BDI-II from baseline : placebo , 49.0 % vs omega-3 , 47.7 % ; OR , 1.06 ; 95 % CI , 0.51 - 2.19 ; t(112 ) = 0.15 ; P = .88 ) . CONCLUSIONS Treatment of patients with CHD and major depression with sertraline and omega-3 fatty acids did not result in superior depression outcomes at 10 weeks , compared with sertraline and placebo . Whether higher doses of omega-3 or sertraline , a different ratio of EPA to DHA , longer treatment , or omega-3 monotherapy can improve depression in patients with CHD remains to be determined . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00116857
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 .