Can supplements really help with depression or anxiety?

St. John’s water “lifts the positive mood.” Valerian root reduces “anxiety and stress”. Lavender oil “calms the body and mind.”

If you are one of the tens of millions of people in the United States who suffer from depression or anxiety, it is easy to get caught up in the promise of uplifting supplements. Take these pills every day, their marketing offers, and you’ll often jump happily in green, sun-moist fields that require no prescription.

However, experts say that some mood-boosting supplements have been better studied than others, but the extensive evidence for their effectiveness is at least shocking. “I’m not saying there’s any evidence that these things are useless,” he said. Gerard Sanakora is a professor of psychiatry at Yale School of Medicine and director of the Yale Depression Research Program. This is again “the quality of the evidence is not at a level we can really trust.”

And compared to other treatments, such as traditional medicine or psychotherapy, experts say supplements are in short supply. Here we learn about the most common supplements sold for mental health.

St. John’s wort, omega-3 fatty acids, L-methylfolate, S-adenosyl methionine (SAMe) and N-acetylcysteine ​​(NAC) are some of the most common supplements used to treat depressive symptoms. But some have more research behind them than others.

St. John’s Wort. This flowering plant is among the best researched supplements as a treatment for depression, but not all studies offer benefits.

“In fact, a lot has been done in St. Petersburg. For years, John’s Wort, “said Dr. Sanakora,” but this is still not high-quality evidence to see a drug approved by the Food and Drug Administration. “

A review of 35 studies involving some 7,000 people in 2016, such as St. St. John’s wort was better than placebo to help people with mild to moderate depression; The 2008 review had similar results. However, two thorough studies published in 2001 and 2002 did not yield any results.

Omega-3 fatty acids. Some of the supplements that contain essential oils – albeit limited – have been shown to help with mild to moderate depression. “To date, data suggest that treatment may appear to be less and more modest, but this is not a definitive conclusion,” Dr. “I don’t call the evidence for this study high quality,” Sanakora added.

For example, a 2015 study of more than two dozen studies concluded that even if omega-3 supplements help with depression, the benefits may not be as great.

Dr. Dan Iosifescu, an associate professor of psychiatry at New York University’s Grossman School of Medicine, agreed. “It’s very mixed data and some studies don’t really see that much benefit,” he said. “The data is a bit controversial.”

L-methylfolate. There is some evidence to support the use of this metabolically active form of folate, an important form of vitamin B, in depression, Dr. Sanacora said, however, that the general data are contradictory and do not reach the quality of evidence based on FDA-approved drugs. It can only be beneficial to certain people, especially those who have problems with proper use or metabolism of folic acid in the body, he said.

Dr. Sanacora also noted that there is evidence that L-methylfolate is mostly taken in combination with standard antidepressants, not as a self-administered supplement, so people do not count on taking a single supplement for treatment.

Everything else. Evidence in favor of other supplements in the treatment of depression is rapidly declining, Dr. Said Sanakora. He and other experts said there had been research on SAMe and NAC supplements, but “there is no really strong data to support their use,” Dr. said. Said Sanakora. “And for the best, The data is questionable. “

The main additives used for anxiety, including lavender, kava and valerian root – there is less evidence than depression and they do not have strong, qualitative research, at least experts know. “That doesn’t mean they’re ineffective,” the doctor said. Said Sanakora. “There have been no rigorous studies done for drugs that normally refer to FDA guidelines.” Dr. Iosifescu believes that there is moderate evidence of the usefulness of coffee; however, he cautioned that kava could be a rare but serious risk of liver toxicity.

If some people think that taking a supplement for depression or anxiety doesn’t hurt, why not use it? But experts warn that there could be potential risks and downsides. Supplements can be expensive and can cause side effects or adverse drug interactions. And supplements are not as strictly regulated as FDA-approved drugs and over-the-counter medications and do not have to be safe and effective until they are sold. “There is not much control compared to traditional pharmaceuticals, which require the production of tablets in a consistent, consistent dosage,” the doctor said. Paul Nestadt, co-director of the Johns Hopkins Anxiety Clinic and John Hopkins Medical Assistant in Psychiatry and Behavioral Sciences.

Megan Olsen, chief adviser to the Council on Responsible Nutrition, a trade association for the supplement industry, told The New York Times that supplement companies were allowed to make “health-related claims about the structure or effects on their bodies.” the function of the body ”and those claims must be substantiated. However, Dr. Peter Cohen, an associate professor at Harvard Medical School, said additional companies will be held accountable for some health-related claims related to rare products. “They can say whatever they want,” he said, unless the manufacturer claims that their product cures or cures a specific disease.

Another potential danger of supplements is paradoxical: they can worsen mental health. Dr. Neshtadt said there is some evidence, such as St. Jones may have a manic episode in people with bipolar disorder.

Perhaps one of the biggest risks is that people may take supplements instead of seeking proven treatment for anxiety or depression. “I’m not afraid that someone will try to eat lavender or chamomile,” the doctor said. Said Sanakora. “I am more concerned about the risks associated with delaying effective treatment.”

If your depression or anxiety is severe, experts say supplements can’t help, and you should see a trained professional instead. In fact, experts recommend that you consult your healthcare provider before starting any supplement, no matter what treatment you need.

Experts say traditional medicine and psychotherapy, including antidepressants and cognitive behavioral therapy, have the highest quality evidence of benefits for anxiety and depression. They also suggested treatment with transcranial magnetic stimulation, a non-invasive method that stimulates certain areas of the brain with magnetic impulses; The FDA has approved treatment for depression and obsessive-compulsive disorder.

Exercise can also be helpful, experts say. Although there is no high-quality evidence like other methods, Dr. Sanacora said there is still very good data on its effectiveness for mild to moderate anxiety and depression. He added that, unlike supplements, exercise is free. “It’s always a balance between practicality and consistency and evidence.”

If you have thoughts of suicide, call the National Suicide Prevention Line at 1-800-273-8255 (TALC). Here’s what you can do if you are struggling to find help during a pandemic.

Annie Snyd is a research journalist who writes for Scientific American, Wired, Public Radio International and Fast Company.

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