Peripheral zinc and neopterin concentrations are associated with mood severity in bipolar disorder in a gender-specific manner.
“Two peripheral markers of the acute phase immune response, zinc and neopterin, are consistently associated with severity of depression in literature. We found that zinc concentrations were significantly lower in the BD group at baseline, and there was also a significant interaction between gender and zinc, associated with depression severity. Also, we found a significant interaction between gender and neopterin, associated with mania severity. We found that mania severity was associated with neopterin in men, while depression severity was positively associated with zinc in women
The Relationship between Fatty Acids and Different Depression-Related Brain Regions, and Their Potential Role as Biomarkers of Response to Antidepressants. Full pdf. “Diet impacts various aspects of health, including depression. The fatty acid composition of the Western diet, which has a high ratio of n-6:n-3 polyunsaturated fatty acids, is associated with increased incidence of depression. The brain is rich in lipids, and dietary fatty acids act within specific brain regions to regulate processes that impact emotional behavior. This manuscript reviews existing evidence demonstrating brain region-specific fatty acid profiles, and posits that specific fatty acids may serve as predictive biomarkers of response to antidepressants. Furthermore, increasing blood levels of certain fats, such as n-3s, via dietary intervention may serve as an adjunct to improve the efficacy of antidepressants.”
Zinc in the Monoaminergic Theory of Depression: Its Relationship to Neural Plasticity. Full pdf. “Preclinical and clinical studies have demonstrated that zinc possesses antidepressant properties and that it may augment the therapy with conventional, that is, monoamine-based, antidepressants. In this review we aim to discuss the role of zinc in the pathophysiology and treatment of depression with regard to the monoamine hypothesis of the disease. Particular attention will be paid to the recently described zinc-sensing GPR39 receptor as well as aspects of zinc deficiency. Furthermore, an attempt will be made to give a possible explanation of the mechanisms by which zinc interacts with the monoamine system in the context of depression and neural plasticity.”
Effect of magnesium supplementation on depression status in depressed patients with magnesium deficiency: A randomized, double-blind, placebo-controlled trial. “The aim of this study was to determine the effect of magnesium supplementation on the depression status of depressed patients suffering from magnesium deficiency. Daily consumption of 500 mg magnesium oxide tablets for ≥8 wk by depressed patients suffering from magnesium deficiency leads to improvements in depression status and magnesium levels. Therefore, assessment of the magnesium serum and resolving this deficiency positively influence the treatment of depressed patients.
Clinical Use of Curcumin in Depression: A Meta-Analysis. “Six clinical trials with a total of 377 patients were reviewed, comparing the use of curcumin to placebo. In patients with depression, the pooled standardized mean difference from baseline Hamilton Rating Scale for Depression scores support the significant clinical efficacy of curcumin in ameliorating depressive symptoms. Significant anti-anxiety effects were also reported in 3 of the trials. Notably, no adverse events were reported in any of the trials.”
Adjunctive low-dose docosahexaenoic acid (DHA) for major depression: An open-label pilot trial. “After 8 weeks, 54% of patients had a ≥50% reduction on the HAM-D, and 45% were in remission. No significant adverse reactions to DHA were found. Within the major limits of this open-label pilot study, the results suggest that DHA may provide additional adjunctive benefits in patients with mild- to -moderate depression.”
Dietary zinc and iron intake and risk of depression: A meta-analysis. “The present meta-analysis indicates inverse associations between dietary zinc and iron intake and risk of depression.”
Vitamin D and mental health in children and adolescents. “While vitamin D is known to be relevant for bone health, evidence has recently accumulated for an impact on mental health. Overall, results from 25 cross-sectional studies as well as from 8 longitudinal studies suggest a role of vitamin D in the pathogenesis of mental disorders in childhood and adolescence. Randomized controlled trials in childhood and adolescents are urgently needed to support the potential of vitamin D as a complementary therapeutic option in mental disorders.”
Curcumin for neuropsychiatric disorders: a review of in vitro, animal and human studies. Full pdf. “In this systematic review, in vitro, animal, and human studies investigating the potential of curcumin as a treatment for neuropsychiatric disorders such as major depressive disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), bipolar disorder, psychotic disorders, and autism are reviewed, and directions for future research are proposed. It is concluded that curcumin is a promising, natural agent for many of these conditions, however, further research utilising robust, clinical designs are essential. The problem associated with the poor oral bioavailability of standard curcumin also requires consideration. Currently the greatest support for the efficacy of curcumin is for the treatment of major depressive disorder.”
Clinical use of nutraceuticals in the adjunctive treatment of depression in mood disorders. “Our recent systematic reviews and meta-analyses of nutrient pharmacotherapies in the treatment unipolar depression revealed primarily positive results for replicated studies testing S-adenosyl methionine (SAMe), methylfolate, omega-3 (EPA or ethyl-EPA), and Vitamin D; with supportive isolated studies found for creatine and an amino acid combination. Mixed results were found for zinc, folic acid, Vitamin C, and tryptophan; and non-significant study results for inositol. In bipolar depression, omega-3 and N-acetyl cysteine (NAC) were found to have supportive evidence.”
Polyunsaturated fatty acids and recurrent mood disorders: Phenomenology, mechanisms, and clinical application. “A body of evidence has implicated dietary deficiency in omega-3 polyunsaturated fatty acids (n-3 PUFA), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), in the pathophysiology and etiology of recurrent mood disorders including major depressive disorder (MDD) and bipolar disorder. Meta-analyses provide strong evidence that patients with mood disorders exhibit low blood n-3 PUFA levels which are associated with increased risk for the initial development of mood symptoms in response to inflammation. Collectively, these findings implicate dietary n-3 PUFA insufficiency, particularly during development, in the pathophysiology of mood dysregulation, and support implementation of routine screening for and treatment of n-3 PUFA deficiency in patients with mood disorders.”
Association of Mood Disorders with Serum Zinc Concentrations in Adolescent Female Students. “The main objective of this study was to assess the correlation between serum zinc levels and mood disorders in high school female students. Each 10 μg/dL increment in serum zinc levels led to 0.3 and 0.01 decrease in depression and anxiety scores, respectively (p < 0.05). Serum zinc levels were inversely correlated with mood disorders including depression and anxiety in adolescent female students. Increasing serum levels of zinc in female students could improve their mood disorders.
Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis. “27 clinical trials with a total of 3808 patients were reviewed, comparing the use of St John’s wort and SSRI. In patients with depression, St John’s wort demonstrated comparable response and remission rate, and significantly lower discontinuation/dropout rate compared to standard SSRIs.” Before considering the use of St John’s wort, it is important to ensure that you are actually using a high quality herbal product. Many herbal products on the market are of very poor quality. See Supplements Buyer Beware and Supplements – The Plot Thickens.
Food and Mood: How do diet and nutrition affect mental wellbeing? “Healthy eating patterns, such as the Mediterranean diet, are associated with better mental health than “unhealthy” eating patterns, such as the Western diet. The effects of certain foods or dietary patterns on glycaemia, immune activation, and the gut microbiome may play a role in the relationships between food and mood.”
Magnesium, C-reactive protein, and cortisol in drug-naïve patients with short illness-duration, first episode major depressive disorder: possible immunomodulatory role for magnesium. “Plasma magnesium concentration alterations, hypercortisolaemia, and systemic inflammation are observed in major depressive disorder (MDD). This exploratory study examined whether, and to what extent, plasma magnesium is related to C-reactive protein (CRP) levels and cortisolaemia in MDD. The study supports the hypothesis linking hypercortisolaemia to systemic inflammation, with hypermagnesaemia exerting an immunomodulatory action at early stages of the disease.”
Polyunsaturated Fatty Acids and Suicide Risk in Mood Disorders: A Systematic Review. “The reviewed studies suggest that subjects with psychiatric conditions have a depletion of omega-3 PUFAs compared to control groups. This fatty acid depletion has also been found to contribute to suicidal thoughts and behavior in some cases.”
Tryptophan Intake in the US Adult Population Is Not Related to Liver or Kidney Function but Is Associated with Depression and Sleep Outcomes. “Tryptophan is an indispensable amino acid and is a precursor of the neurotransmitter serotonin. Tryptophan metabolites, such as serotonin and melatonin, are thought to participate in the regulation of mood and sleep and tryptophan is used to treat insomnia, sleep apnea, and depression. Tryptophan intake was inversely associated with self-reported level of depression and positively associated with sleep duration.”
Magnesium and depression. “It [magnesium] plays a vital modulatory role in brain biochemistry, influencing several neurotransmission pathways associated with the development of depression. Personality changes, including apathy, depression, agitation, confusion, anxiety, and delirium are observed when there is a deficiency of this element. Since the extracellular concentration of magnesium ions may not reflect their intracellular level, none of the current methods of evaluating magnesium status is regarded as satisfactory. The mood-improving potential of magnesium compounds have been confirmed by the results of numerous pre-clinical and clinical studies. It seems that magnesium supplementation is well-tolerated and enhances the efficacy of conventional antidepressant treatments, and as such could be a valuable addition to the standard treatments for depression.”
The effect of methylated vitamin B complex on depressive and anxiety symptoms and quality of life in adults with depression. Full pdf. “The formula used in the current study was well tolerated among all subjects. The Max Stress B formula showed modest improvements in mood and mental health, making our findings consistent with the prior studies. Thus, our study shows that a high quality, whole-food dietary supplement may oﬀer an opportunity for adults with depression to improve mood symptoms and quality of life.”
Manic switches induced by antidepressants: an umbrella review comparing randomized controlled trials and observational studies. A serious concern with patients on antidepressants, the possibility of them having a manic episode, especially if they have bipolar disorder. “Our results highlight an underestimation of the rates of manic switch under antidepressants in RCTs compared to the rates observed in observational studies.”