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Tuesday 8 January 2019

Five for your body: supplements for depression

Mainstream antidepressants still have numerous side effects, including affecting driving abilities, a dry mouth, constipation and sexual dysfunction. But even aggressive behaviour and suicidal tendencies are reported. Furthermore, over time some patients no longer respond to antidepressants. This ‘Five for your body’ article shows that there is another way.

 

Crocus sativus

Several double-blind clinical studies involving people with mild to moderate depression have revealed that the antidepressant effect of Crocus sativus (saffron) is greater than placebo and comparable to that of fluoxetine and imipramine [1,2]. Analysis of bioactive fractions demonstrates that the ingredient crocine-1 is primarily responsible for the antidepressant effect. The mechanism of action behind this partly concurs with that of imipramine; both inhibit the reuptake of serotonin, norepinephrine and dopamine. As a result of this, these neurotransmitters remain active for longer in the synaptic cleft, which in many people is responsible for improved concentration and fewer depressive feelings. The initial effect is evident within just a week, but the effect is at its highest after approximately 6 weeks.


SAMe

SAM-e is converted in the body into ATP and methionine. Methionine is an important methylator of genes that are involved in the production of hormones and neurotransmitters. In this way, supplementation with SAM-e regulates the production of melatonin and dopamine. Melatonin has been found to be effective in the treatment of Seasonal Affective Disorder (SAD) (seasonable depression), and a sufficiently high level of dopamine increases motivation. In addition, methionine normalises the level of adrenaline, thereby reducing stress and anxiety in stressed and anxious people. A single study even revealed that SAM-e works better than generic medicines that are prescribed for depression [3].


Fish oil

There are clear epidemiological signs that a chronic DHA deficiency can lead to depression and cognitive deterioration. The intake of DHA from algae oil, at just a relatively low dose, increases the DHA and omega-3 index, which can reduce the risk of these adverse deficiency effects [4].  A decrease in the DHA level in the brain has also been linked to age-related cognitive deterioration and Alzheimer’s disease. There is increasing scientific proof that an increase in the intake of omega-3 fatty acids (particularly DHA) reduces the risk of age-related cognitive deterioration and delays (early) disease processes that culminate in vascular dementia or Alzheimer’s disease. In elderly people with depression and mild cognitive deterioration, depressive symptoms decreased by increasing the DHA or EPA intake, whilst improvements in thinking and perception of physical well-being were associated with a higher DHA intake [5].


Griffonia simplicifolia

A serotonin deficiency can cause depression, as well as insomnia, obsessive behaviour and excessive eating habits that lead to obesity. Various mainstream medicines are therefore channelled towards increasing the amount of serotonin available in the brain: either by intensifying the use of the available serotonin (SSRIs) or by inhibiting the breakdown thereof (MAO inhibitors). Griffonia simplicifolia is a natural source of 5-HTP, a precursor of serotonin; it is therefore able to increase the serotonin level in the brain [6]. Unlike many of the aforementioned medicines, there are almost no side effects. As well as for depression, griffonia seed extract is used to treat insomnia, eating disorders, fibromyalgia and chronic headache.


Mucuna pruriens

A dopamine deficiency can also give rise to depression. Dopaminergic depression is dealt with differently to serotonergic depression*. Instead of the serotonin level, the dopamine level must then be increased. Antidepressants that act on this mechanism are, however, very much in the minority in comparison to SSRIs. Nevertheless, these are being studied, including with Mucuna pruriens (velvet bean), that forms the raw material for the medicine given for Parkinson’s disease - L-DOPA. This study shows that, in any case, mucuna increases the dopamine level in the cortex of rats [7]. Supplementation with Mucuna must be built up gradually in order to avoid serious mood swings. When it is administered to improve the mental condition, a dose of 1 to 2 grams a day is sufficient [8]. Higher doses – that are, for example, given to patients with Parkinson’s (30 to 60 grams a day) – must be administered under the guidance of a doctor.


Sources

[1] Akhondzadeh S, Fallah-Pour H, Afkham K, Jamshidi AH, Khalighi-Cigaroudi F., Comparison of Crocus sativus L. and imipramine in the treatment of mild to moderate depression: a pilot double-blind randomized trial [ISRCTN45683816, .BMC Complement Altern Med. 2004 Sep 2;4:12.

[2] Akhondzadeh, Basti A, Moshiri E, Noorbala AA, Jamshidi AH, Abbasi SH, Akhondzadeh S., Comparison of petal of Crocus sativus L. and fluoxetine in the treatment of depressed outpatients: a pilot double-blind randomized trial., Prog Neuropsychopharmacol Biol Psychiatry. 2007 Mar 30;31(2):439-42. Epub 2006 Dec 15.

[3] Papakostas, George I. Evidence for S-adenosyl-L-methionine (SAM-e) for the treatment of major depressive disorder. Journal of Clinical Psychiatry 70.Suppl. 5 (2009): 18-22.

[4] Daniells S. Harvard meta-analysis supports benefits of algal DHA omega-3. Nutraingredients USA. 2011;12(16):1-2

[5] Sinn N, Milte CM, Street SJ et al. Effects of n-3 fatty acids, EPA v. DHA, on depressive symptoms, quality of life, memory and executive function in older adults with mild cognitive impairment: a 6-month randomised controlled trial. Br J Nutr. 2012;107(11):1682-93.

[6] Birdsall TC. 5-Hydroxytryptophan: a clinically-effective serotonin precursor. Altern Med Rev. 1998;3(4):271-80

[7] Manyam BV, Dhanasekaran M, Hare TA. Effect of antiparkinson drug HP-200 (Mucuna pruriens) on the central monoaminergic neurotransmitters. Phytother Res. 2004;18(2):97-101.

[8] http://naturafoundation.nl/monografie/Mucuna_pruriens.html