Depression and Complementary Health Approaches

Many individuals with depression turn to complementary health approaches as an adjunct to or in place of conventional treatment. Although these approaches are commonly used and readily available in the marketplace, many of these treatments have not been rigorously studied for depression. For this reason, it’s important that you understand the benefits and risks of these complementary approaches to advise your patients.

A Task Force on Complementary and Alternative Medicine of the American Psychiatric Association conducted a review in 2010 of complementary approaches in psychiatry and found that, based on the quality of available evidence, there is enough evidence to support further research on some complementary approaches, including omega-3 fatty acids, St. John’s wort (Hypericum perforatum), folate, S-adenosyl-l-methionine (SAMe), light therapy, physical exercise, and mindfulness-based therapies for augmenting current treatments of depression in adults. However, the Task Force noted the need for more rigorous and larger studies before employing these complementary approaches.

This issue of the digest provides the state of the science for several of these complementary health approaches.

Modality

Summary of Current Evidence

• Omega-3 Fatty Acids
• St. John’s Wort
• SAMe
• Inositol
• Acupuncture
• Music Therapy
• Relaxation Training
• Omega-3 Fatty Acids

Natural Product

Some evidence suggests that omega-3 fatty acid supplementation may provide a small effect in adjunctive therapy in patients with a diagnosis of major depressive disorder (MDD) and on depressive patients without a diagnosis of MDD. Most trials have been adjunctive studies. Although the data are promising, controlled trials of omega-3 fatty acids as a monotherapy are inconclusive compared to standard antidepressant medicines, and it remains unclear that a mechanism is present to suggest that a pharmacological or biological antidepressant effect exists.

Read more about the evidence base of omega-3 fatty acids for depression

Scientific Literature

• Systematic Reviews/Reviews/Meta-analyses (PubMed®)
• Randomized Controlled Trials (PubMed®)

Research Spotlights

• Omega-3 Fatty Acids May Reduce Inflammation and Anxiety in Healthy Young Adults (07/19/11)
• A Review of St. John’s Wort Extracts for Major Depression (10/08/08)
• Omega-3 fatty acids may be helpful in psychiatric care (12/01/06)
• Polyunsaturated Fatty Acids for Depression (05/01/06)
• Study Shows St. John’s Wort Ineffective for Major Depression of Moderate Severity (04/10/02)

Information for Your Patients

• 5 Tips: What You Should Know About the Science Behind Depression and Complementary Health Approaches
• St. John’s Wort and Depression
• St. John’s Wort: At a Glance
• S-Adenosyl-L-Methionine (SAMe): An Introduction
• Relaxation Techniques for Health: What You Need To Know
• What Medications Are Used To Treat Depression?  (NIMH)
• What Is Depression?  (NIMH)
• Placebo, Antidepressant May Lift Depression Via Common Mechanism
• Depression  (NIMH)

NCCIH Clinical Digest is a service of the National Center for Complementary and Integrative Health, NIH,DHHS. NCCIH Clinical Digest, a monthly e-newsletter, offers evidence-based information on complementary health approaches, including scientific literature searches, summaries of NCCIH-funded research, fact sheets for patients, and more.

The National Center for Complementary and Integrative Health is dedicated to exploring complementary health products and practices in the context of rigorous science, training complementary health researchers, and disseminating authoritative information to the public and professionals. For additional information, call NCCIH’s Clearinghouse toll-free at 1-888-644-6226, or visit the NCCIH Web site at nccih.nih.gov. NCCIH is 1 of 27 institutes and centers at the National Institutes of Health, the Federal focal point for medical research in the United States.

This information has been placed in the Public Domain.