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 .
Folinic acid (Leucovorin) as an adjunctive treatment for SSRI-refractory depression.
Low folate is associated with poorer response to selective serotonin reuptake inhibitors ( SSRIs ) in major depressive disorder ( MDD ) . Folate supplementation in MDD has been studied in other setting s with promising results . The objective of this study was to assess the efficacy of methylfolate as an adjunctive treatment among adults with MDD and inadequate response to an SSRI . Twenty-two adults ( 59 % female ; mean age 45.2 + /- 11.0 years ) with DSM-IV MDD , partial or nonresponse to an SSRI after at least 4 weeks of treatment , and a 17-item Hamilton Depression Rating Scale ( HAM-D-17 ) score > or = 12 were enrolled in this 8-week prospect i ve open trial . Exclusion criteria included current use of anticonvulsants or psychotropics other than an SSRI , or B12 deficiency .  Leucovorin ( folinic acid ) , which is metabolized to methylfolate , was added to SSRIs at 15 - 30 mg/day .  Folate levels rose from 28 + /- 19 ng/mL to 301 + /- 203 ng/mL ( p < 0.001 ) . HAM-D-17 scores among the 16 completers decreased from 19.1 + /- 3.9 to 12.8 + /- 7.0 ( p < 0.01 ) . However only 31 % of completers and 27 % of the intent-to-treat ( ITT ) sample achieved response ( > or = 50 % reduction in HAM-D-17 scores ) , and only 19 % of completers and 18 % of the ITT sample achieved remission ( HAM-D-17 < or = 7 ) . Leucovorin appears to be modestly effective as an adjunct among SSRI-refractory depressed individuals with normal folate levels . The application of leucovorin as an adjunct in the setting of refractory depression deserves further study
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 .