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 .
Enhancement of the antidepressant action of fluoxetine by folic acid: a randomised, placebo controlled trial.
BACKGROUND A consistent finding in major depression has been a low plasma and red cell folate which has also been linked to poor response to antidepressants . The present investigation was design ed to investigate whether the co-administration of folic acid would enhance the antidepressant action of fluoxetine . METHODS 127 patients were r and omly assigned to receive either 500 microg folic acid or an identical looking placebo in addition to 20 mg fluoxetine daily . All patients met the DSM-III-R criteria for major depression and had a baseline Hamilton Rating Scale ( 17 item version ) score for depression of 20 or more . Baseline and 10-week estimations of plasma folate and homocysteine were carried out . RESULTS Patients receiving folate showed a significant increase in plasma folate . This was less in men than in women . Plasma homocysteine was significantly decreased in women by 20.6 % , but there was no significant change in men . Overall there was a significantly greater improvement in the fluoxetine plus folic acid group . This was confined to women where the mean Hamilton Rating Scale score on completion was 6.8 ( S.D. 4 . 1 ) in the fluoxetine plus folate group , as compared to 11.7 ( S.D. 6 . 7 ) in the fluoxetine plus placebo group (P<0.001).A percentage of 93 . 9 of women , who received the folic acid supplement , showed a good response ( > 50 % reduction in score ) as compared to 61.1 % of women who received placebo supplement ( P<0.005 ) . Eight ( 12.9 % ) patients in the fluoxetine plus folic acid group reported symptoms possibly or probably related to medication , whereas in the fluoxetine plus placebo group 19 ( 29.7 % ) patients reported such symptoms ( P<0.05 ) . LIMITATIONS AND CONCLUSIONS Folic acid is a simple method of greatly improving the antidepressant action of fluoxetine and probably other antidepressants . Folic acid should be given in doses sufficient to decrease plasma homocysteine . Men require a higher dose of folic acid to achieve this than women , but more work is required to ascertain the optimum dose of folic acid
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 .