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Online Library: Depression

The following pages provide an overview of the most recent research and clinical studies about the health benefits of micronutrients in fighting depression. This collection of scientific facts proves that anyone who privately or publicly questions the health value of micronutrients does not serve YOUR health, or the health of the people, but rather the multi-billion dollar investment 'business with disease' based on patented pharmaceutical drugs.

We encourage you to forward the link to this important online library on natural health – one of the largest ones in the world – to your friends. You may also print out the articles you find most important for your own health condition and share them with your doctor. Any responsibly acting health professional will be grateful to receive such science-based health education.

Vitamin D intake from foods and supplements and depressive symptoms in a diverse population of older women

Source: The American journal of clinical nutrition 2011;94(4):1104-12.

Author: Bertone-Johnson ER, Powers SI, Spangler L, et al.

Affiliation: University of Massachusetts, MA.

Abstract: The authors conducted a cross-sectional and prospective analysis of vitamin D intake from foods and supplements and risk of depressive symptoms. Study participants were 81,189 members of the Women's Health Initiative (WHI) Observational Study who were aged 50-79 y at baseline. Vitamin D intake at baseline was measured by food-frequency and supplement-use questionnaires. Depressive symptoms at baseline and after 3 y were assessed by using the Burnam scale and current antidepressant medication use. Conclusions: Overall, findings support a potential inverse association of vitamin D, primarily from food sources, and depressive symptoms in postmenopausal women. Additional prospective studies and randomized trials are essential in establishing whether the improvement of vitamin D status holds promise for the prevention of depression, the treatment of depression, or both.

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

Source: British journal of nutrition 2011 Sept; FirstView Article : pp 1-12

Author: Sinn N., Milte CM, Street SJ, Buckley JD et al

Affiliation: School of Health Sciences, Sansom Institute for Health Research, Nutritional Physiology Research Centre, University of South Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia

Abstract: Depressive symptoms may increase the risk of progressing from mild cognitive impairment (MCI) to dementia. Consumption of n-3 PUFA may alleviate both cognitive decline and depression. The aim of this study was to investigate the benefits of supplementing a diet with n-3 PUFA, DHA and EPA, for depressive symptoms, quality of life (QOL) and cognition in elderly people with MCI. The authoers conducted a 6-month double-blind, randomised controlled trial. A total of fifty people aged >65 years with MCI were allocated to receive a supplement rich in EPA, DHA or the n-6 PUFA linoleic acid. Treatment allocation was by minimisation based on age, sex and depressive symptoms (Geriatric Depression Scale, GDS). Physiological and cognitive assessments, questionnaires and fatty acid composition of erythrocytes were obtained at baseline and 6 months. Improved self-reported physical health was associated with increased DHA. There were no treatment effects on other cognitive or QOL parameters. Increased intakes of DHA and EPA benefited mental health in older people with MCI. Increasing n-3 PUFA intakes may reduce depressive symptoms and the risk of progressing to dementia. This needs to be investigated in larger, depressed samples with MCI.

Depression is associated with decreased 25-hydroxyvitamin D and increased parathyroid hormone levels in older adults

Source: Archives of general psychiatry 2008 May;65(5):508-12

Author: Hoogendijk WJ, Lips P, Dik MG, Deeg DJ, Beekman AT, Penninx BW

Affiliation: Research Institute Neurosciences and the Center for Neurogenomics and Cognitive Research, VU University Medical Center, Vrije Universiteit Amsterdam, The Netherlands.

Abstract: Depression has incidentally been related to altered levels of 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH), but this relation has never been studied systematically. This study was conducted to determine in a large population-based cohort whether there is an association between depression and altered 25(OH)D and PTH levels. Therefore 1.282 community residents aged 65 to 95 years, were included in a population-based cohort study (Longitudinal Aging Study Amsterdam) in the Netherlands. Depression was measured using self-reports (Center for Epidemiologic Studies-Depression scale)* and diagnostic interviews (Diagnostic Interview Schedule)*. Levels of 25(OH)D and PTH were assessed. Potentially confounding factors (ie, age, sex, smoking status, body mass index, number of chronic conditions, and serum creatinine concentration*) and explanatory factors (ie, season of data acquisition, level of urbanization, and physical activity) were also measured. Levels of 25(OH)D were 14% lower in 169 persons with minor depression and 14% lower in 26 persons with major depressive disorder compared with levels in 1087 control individuals. Levels of PTH were 5% and 33% higher, respectively. Depression severity (Center for Epidemiologic Studies Depression Scale) was significantly associated with decreased serum 25(OH)D levels and increased serum PTH levels. Conclusion: The results of this large population-based study show an association of depression status and severity with decreased serum 25(OH)D levels and increased serum PTH levels in older individuals.

* The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales.
* The Diagnostic Interview Schedule is an interview schedule used as the basis of a structured interview.
* The serum creatinine level is often used to determine how well the body's kidneys are functioning.

Serum 25-hydroxyvitamin D and depressive symptoms in older women and men

Source: The Journal of clinical endocrinology and metabolism 2010 Jul;95(7):3225-33.

Author: Milaneschi Y, Shardell M, Corsi AM, Vazzana R, Bandinelli S, Guralnik JM, Ferrucci L

Affiliation: Longitudinal Studies Section, National Institute on Aging, Clinical Research Branch, Harbor Hospital Center, Baltimore, USA.

Abstract: Hypovitaminosis D and depressive symptoms are common conditions in older adults. The authors examined the relationship between 25-hydroxyvitamin D [25(OH)D] and depressive symptoms over a 6-year follow-up in a sample of older adults. This research is part of a population-based cohort study (InCHIANTI Study) in Tuscany, Italy. A total of 531 women and 423 men aged 65 year and older participated. Serum 25(OH)D was measured at baseline. Depressive symptoms were assessed at baseline and at 3- and 6-year follow-ups using the Center for Epidemiological Studies-Depression Scale (CES-D). Depressed mood was defined as CES-D of 16 or higher. Analyses were stratified by sex and adjusted for relevant biomarkers and variables related to sociodemographics, somatic health, and functional status. Women with 25(OH)D less than 50 nmol/liter compared with those with higher levels experienced increases in CES-D scores of 2.1 and 2.2 points higher at, respectively, 3- and 6-year follow-up. Women with low vitamin D (Vit-D) had also significantly higher risk of developing depressive mood over the follow-up. In parallel models, men with 25(OH)D less than 50 nmol/liter compared with those with higher levels experienced increases in CES-D scores of 1.9 and 1.1 points higher at 3- and 6-year follow-up. Men with low Vit- D tended to have higher risk of developing depressed mood. Conclusion: These findings suggest that hypovitaminosis D is a risk factor for the development of depressive symptoms in older persons. The strength of the prospective association is higher in women than in men. Understanding the potential causal pathway between Vit- D deficiency and depression requires further research.

Association between low serum 25-hydroxyvitamin D and depression in a large sample of healthy adults: the Cooper Center longitudinal study

Source: Mayo Clinic proceedings 2011 Nov; 86(11):1050-5.

Author: Hoang MT, Defina LF, Willis BL, Leonard DS, Weiner MF, Brown ES

Affiliation: Department of Psychiatry, UT Southwestern Medical Center at Dallas, USA.

Abstract: The aim of this study was to investigate the association between serum vitamin D levels and depression in a large database of patients from the Cooper Clinic. Therefore the authors conducted a cross-sectional study of 12,594 participants seen at the Cooper Clinic from November 27, 2006, to October 4, 2010. Serum 25-hydroxyvitamin D [25(OH)D] was analyzed, and depression was defined as a Center for Epidemiologic Studies Depression Scale (CES-D) score of 10 or more. Those with and those without a history of depression represented 2 distinct populations with respect to CES-D scores; accordingly, they were analyzed separately. In the total sample, higher vitamin D levels were associated with a significantly decreased risk of current depression based on CES-D scores. The finding was stronger in those with a prior history of depression and not significant in those without a history of depression. Conclusion: The authors found that low vitamin D levels are associated with depressive symptoms, especially in persons with a history of depression. These findings suggest that primary care patients with a history of depression may be an important target for assessment of vitamin D levels.

Associations between n-3 PUFA concentrations and cognitive function after recovery from late-life depression

Source: The American journal of clinical nutrition 2012 ajcn.015784

Author: Chiu CC, Frangou S, Chang CJ, Chiu WC, Liu HC, Sun IW, et al

Affiliation: Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; the King's College London, Institute of Psychiatry, Section of Neurobiology of Psychosis and Section of Epidemiology, London, United Kingdom.

Abstract: Lower concentrations of n-3 PUFAs have been reported to be associated with cognitive impairment and dementia, but also with depression—itself a potential risk factor for cognitive decline. The aims of this study were to investigate associations between n-3 PUFA concentrations in erythrocyte membrane or plasma and cognitive function in an at-risk sample of older people with previous major depression and to explore specificity with respect to cognitive domains. A cross-sectional sample of 132 eligible participants who had recovered from major depression (mean ± SD age: 67.8 ± 6.6 y) were enrolled from outpatient psychiatric services. A series of cognitive tests and a structured questionnaire were administered. Fasting blood samples were collected for n-3 PUFA measurements. Higher EPA and total n-3 PUFA concentrations and a lower ratio of arachidonic acid to EPA in erythrocyte membranes were associated with a higher cognitive composite score: independent of age and sex, but no longer significant after adjustment for education. No associations were found with plasma concentrations of any fatty acid. Considering individual cognitive tests, the strongest and most consistent correlations were found between immediate recall and concentrations of total n-3 PUFAs and a-linolenic acid (ALA) in erythrocytes, which were observed only in participants with recurrent depression. Conclusions: Total erythrocyte n-3 PUFA concentrations are positively associated with cognitive function, particularly immediate recall, in older people with previous depression. Lower concentrations of n-3 PUFAs or ALA in erythrocyte membranes may be good predictors for cognitive impairment in older people with previous recurrent depression.

Efficacy and Safety of Curcumin in Major Depressive Disorder: A Randomized Controlled Trial

Source: Phytotherapy Research 2013; doi: 10.1002/ptr.5025. [Epub ahead of print]

Author: Sanmukhani J, Satodia V, Trivedi J, Patel T, Tiwari D, Panchal B, Goel A, Tripathi CB.

Affiliation: Department of Pharmacology, Government Medical College, Bhavnagar, Gujarat, India

Abstract: Curcumin, an active ingredient of Curcuma longa Linn (Zingiberaceae), has shown potential antidepressant-like activity in animal studies. The objectives of this trial were to compare the efficacy and safety of curcumin with fluoxetine in patients with major depressive disorder (MDD). Herein, 60 patients diagnosed with MDD were randomized in a 1:1:1 ratio for six weeks observer-masked treatment with fluoxetine (20 mg) and curcumin (1000 mg) individually or their combination. The primary efficacy variable was response rates according to Hamilton Depression Rating Scale, 17-item version (HAM-D17 ). The secondary efficacy variable was the mean change in HAM-D17 score after six weeks. We observed that curcumin was well tolerated by all the patients. The proportion of responders as measured by the HAM-D17 scale was higher in the combination group (77.8%) than in the fluoxetine (64.7%) and the curcumin (62.5%) groups; however, these data were not statistically significant (P = 0.58). Interestingly, the mean change in HAM-D17 score at the end of six weeks was comparable in all three groups (P = 0.77). This study provides first clinical evidence that curcumin may be used as an effective and safe modality for treatment in patients with MDD without concurrent suicidal ideation or other psychotic disorders.

The effect of 2 different single injections of high dose of vitamin D on improving the depression in depressed patients with vitamin D deficiency: a randomized clinical trial.


Author: Mozaffari-Khosravi H, Nabizade L, Yassini-Ardakani SM, Hadinedoushan H, Barzegar K.

Affiliation: Department of Nutrition, Faculty of Health, Yazd, Iran, et al.

Abstract: The correlation between vitamin D deficiency and depression has recently been put forward and resulted in controversial findings. The present study was conducted to find out the effect of 2 single injections of 150,000 and 300,000 IU of vitamin D on improving the depression in depressed patients with vitamin D deficiency. This clinical trial study was carried out during 2011-2012 in Yazd, Islamic Republic of Iran. A total of 120 patients who had a Beck Depression Inventory II score of 17+ and were affected with vitamin D deficiency were randomly assigned to 3 groups of 40. They included G300, G150, and NTG. G300 and G150 received an intramuscular single dose of 300,000 and 150,000 IU of vitamin D, respectively, and the NTG group received nothing. After 3 months of intervention, the depression state, serum vitamin D, calcium, phosphorus, and parathormone were measured. The median of serum vitamin D after intervention were 60.2, 54.6, and 28.2 nmol/L for the G300, G150, and NTG, respectively. Percentages of vitamin D deficiency after intervention were 18, 20, and 91.2 for the groups, respectively. The serum calcium mean showed a statistically significant increase in just the 2 test groups receiving vitamin D. There was only significant difference in mean of Beck Depression Inventory II test score between G300 and NTG. Conclusion: The results of the study revealed that first, the correction of vitamin D deficiency improved the depression state, and second, a single injection dose of 300,000 IU of vitamin D was safe and more effective than a 150,000-IU dose.

Efficacy of vitamin C as an adjunct to fluoxetine therapy in paediatric major depressive disorder: a randomized, double-blind, placebo-controlled pilot study.


Author: Amr M, El-Mogy A, Shams T, Vieira K, Lakhan SE.

Affiliation: Department of Psychiatry, Mansoura University, Mansoura, Egypt.

Abstract: Current antidepressants used to treat paediatric patients have the disadvantage of limited efficacy and potentially serious side effects. The purpose of this study was to assess the efficacy of vitamin C as an adjuvant agent in the treatment of paediatric major depressive disorder in a six-month, double-blind, placebo-controlled pilot trial. The study group (n=12) was given fluoxetine (10-20 mg/day) plus vitamin C (1000 mg/day) and control group (n=12) administered fluoxetine (10-20 mg/day) plus placebo. The data were analysed by ANOVA and t-test for independent samples. Both groups demonstrated significantly improved scores on the Children's Depression Rating Scale (CDRS), the Children's Depression Inventory (CDI), and the Clinical Global Impression (CGI). ANOVA was significantly different on all clinical measurements (group effect, time effect, and interaction), with the exception of group effect and interaction for CGI. Patients treated for six months with fluoxetine and vitamin C showed a significant decrease in depressive symptoms in comparison to the fluoxetine plus placebo group as measured by the CDRS and CDI, but not CGI. No serious adverse effects were observed. Conclusion: These preliminary results suggest that vitamin C may be an effective adjuvant agent in the treatment of MDD in paediatric patients.

A review of current evidence for acetyl-l-carnitine in the treatment of depression.

Source: Journal of Psychiatric Research 2014 Jun;53:30-7. doi: 10.1016/j.jpsychires.2014.02.005. Epub 2014 Feb 15.

Author: Wang SM, Han C, Lee SJ, Patkar AA, Masand PS, Pae CU.

Affiliation: Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, College of Medicine, Korea University, Republic of Korea; Department of Psychiatry and Behavioural Sciences, Duke University Medical Center, Durham, NC, USA; Global Medical Education, New York, NY, USA; Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea; Department of Psychiatry and Behavioural Sciences, Duke University Medical Center, Durham, NC, USA. Electronic address:

Abstract: Despite numerous antidepressants available, many patients with depression do not achieve adequate response rendering needs for novel antidepressants with different mechanism of actions. Acetyl-l-carnitine (ALC) is a potential antidepressant with novel mechanism of action because of its diverse functions related with neuroplasticity. Animal and cellular models suggest that ALC's neuroplasiticity effect, membrane modulation, and neurotransmitter regulation may play an important role in treatment of depression. Four randomized clinical studies (RCT) demonstrated the superior efficacy of ALC over placebo (PBO) in patients with depression. Two RCTs showed its superior efficacy over PBO in dysthymic disorder, and 2 other RCTs showed that it is equally effective as fluoxetine and amisulpride in treatment of dysthymic disorder. ALC was also effective in improving depressive symptoms in patients with fibromyalgia and minimal hepatic encephalopathy. It was also found to be equally tolerable to PBO and better tolerable than fluoxetine and amisulpride. In conclusion, ALC may be potentially effective and tolerable next treatment option with novel action mechanisms for patients with depression, in particular older population and patients with comorbid medical conditions who are vulnerable to adverse events from antidepressants. However, more clinical trial data with adequately-powered, well-designed and advanced methodology will be mandatory to conclude whether ALC as a monotherapy or augmentation agent may be efficacious and clinically beneficial for depression.