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 .
A randomized double-blind comparison of fluoxetine augmentation by high and low dosage folic acid in patients with depressive episodes.
BACKGROUND Though encouraging evidence exists for the use of folic acid as an augmenting agent to antidepressants , evidence regarding its optimal dosage is lacking . METHODS Forty-two female out- patients with moderate ( with or without somatic syndrome ) or severe depressive episodes ( without psychotic symptoms ) diagnosed as per ICD-10 criteria , were r and omized in a double-blind fashion to receive either 20 mg fluoxetine and a relatively low dose folic acid ( 1.5 mg/day ; n=23 ; Group I ) or 20 mg fluoxetine and high dose folic acid ( 5 mg/day ; n=19 ; Group II ) . Primary outcome measures were weekly changes of scores on Hamilton Depression Rating Scale ( HDRS ) and Beck Depression Inventory ( BDI ) for 6 weeks . RESULTS Group II patients showed greater improvement in both HDRS [ Mean ( SD ) baseline HDRS score=21 ( 2.3 ) for group I and 20.0 ( 1.4 ) for group-II ; time X group interaction effect : p=0.01 ] and BDI [ Mean ( SD ) baseline BDI score=25.1 ( 5.2 ) for group-1 and 23.1 ( 2.7 ) for group-II ; time X group interaction effect : p=0.01 ] . With regard to HDRS , 7 ( 36.8 % ) group II patients remitted compared to 2 ( 8.7 % ) group I patients ( p=0.03 ) ; 9 ( 47.4 % ) patients of group II responded when compared to 6 ( 26.1 % ) from group I ( p=0.15 ) . When BDI was considered , 5 ( 26.3 % ) group II patients remitted when compared to 2 ( 8.7 % ) from group I ( p=0.13 ) ; 10 patients ( 52.6 % ) from group II responded when compared to 5 ( 21.7 % ) from group I ( p=0.04 ) . No adverse effects were noted in either group . LIMITATIONS Lack of a placebo arm and small sample size . CONCLUSION Compared to folic acid 1.5 mg/day , augmentation with 5 mg/day may be more beneficial in female patients with depressive episodes taking fluoxetine 20 mg/day
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 .