It is possible that you still may feel depressed while on antidepressant therapy. Researchers found that adding a low-cost supplement to your regimen may help to reduce depressive symptoms.
Those individuals battling depression know that some, if not many days feel like a chore. Despite being common, depression can be a finicky state to treat. Many consult with doctors, seek therapy, or are prescribed antidepressants. Antidepressants may not work the first time around, and some may find themselves on 2 or more medications in an effort for the drugs to augment each other. Often times, side effects are felt before a drug starts working making it difficult to continue. The days can seem long when waiting for a specific therapy to work or feeling like a regimen is not working at all.
Needless to say, treatment for depression can be a frustrating process. Strides in research are being made daily to maximize therapy and help depressed individuals feel “normal” again, especially through augmentation strategies. Simply put, adding another medication may enhance the benefits of the first medication and result in better therapy.
One research article was recently published in the American Journal of Psychiatry. The review noted that some nutriceuticals, or supplements, taken with prescribed antidepressants may help to augment therapy by reducing depressive symptoms. A variety of supplements were studied, but the article noted the greatest benefit was seen with:
SAMe
Omega-3s
Vitamin D.
SAMe
SAMe is a supplement that has been available in the US since 1999, however the molecule is also naturally found in the body. SAMe is used to make certain chemicals that affect depression and pain, and the supplement is often used for a variety of symptoms and illnesses. Many studies have shown that taking SAMe by mouth may be just as effective as some prescribed antidepressants, so it is no wonder that the study found beneficial effects when taken in combination.
*It is extremely important to first discuss taking SAMe alongside a prescription antidepressant with a healthcare professional, despite the results of this study.
SAMe, like most other antidepressants, can increase levels of seratonin in the body. Too much seratonin can be extremely harmful and cause heart disturbances, anxiety, and mental status changes. In fact, boxed warnings on SAMe supplements advise against using it with other prescribed antidepressants due to this potentially life-threatening drug interaction. Again, it is crucial to discuss with your doctor the risks of taking SAMe together with an antidepressant to decide if the benefit would be greater. The study reviewed varied dosing of SAMe, but was generally either 800mg or 1600mg per day.
Omega-3s
The study also saw benefits with omega-3s when taken with an antidepressant, specifically those containing EPA. EPA is a long-chain omega-3 that is not significantly produced by the human body. EPA is found in a lot of fatty fish, like salmon or tuna. The easiest way to obtain omega-3s is from a supplement. The benefit on depression that was seen from omega-3s in this study may be attributed to its effects on various chemicals in the brain, such as seratonin, norepinephrine, and dopamine. The study advises that using high doses of omega-3s may pose some health risks, such as bleeding.
Vitamin D
Vitamin D has been postulated for years for playing a role in depression, but the mechanism is not fully understood. In fact, many of us are deficient in vitamin D whether it be due to lifestyle or insufficient dietary intake. Lack of foods naturally rich in this nutrient, dairy allergies, or a strict vegan diet may be to blame. The optimal daily requirements change from time to time and varies for different ages and diseases states, but is generally around 200 IU/day for most men and women. Many healthcare professionals advocate for much higher doses, so it is important that a doctor evaluate your circumstance and recommend a dose he or she feels comfortable with. Vitamin D can be a very cost-effective way to enhance well-being and other disease states besides depression and adding a supplement warrants consideration.
The study also evaluated zinc, tryptophan, vitamin c, and inositol (a “B” vitamin), but found either mixed results or no significant benefit. Many of these supplements were well tolerated, with the most common side effect being stomach pain accompanied by either constipation or diarrhea.
It is important to remember that further research is needed in this field, but it does not hurt to talk to your doctor about possibly adding a supplement if you feel your antidepressant is not reaching full potential. However, even before having this discussion, your doctor will evaluate the possibilities of why your current medication may not be working. Briefly, a few reasons exist that may explain inadequate treatment.
Compliance
Your doctor may want to check that you are taking the medication every day and not accidentally forgetting to take it. Many antidepressants take several weeks to see any benefit. Disruptions in therapy may lead to delayed potential.
Dosing
There may be room to increase a dose for a particular antidepressant. Only your doctor can safely increase the dose to ensure proper benefit.
Drugs may not be for everyone
It is very possible that depression can be treated with therapy alone or in conjunction with other modalities such as exercise, yoga, light therapy, or even pet therapy. Some studies exist that report non-drug options are as superior or work even better than prescribed antidepressants. Depending on the severity and type of depression, these options may be considered instead.
Genetics
Only time and future research will hold the answer to how most drugs work with an individual’s genetic makeup, however much evidence already exists to prove a link. Using genetic testing, knowing how and why an individual responds to a particular medication can greatly predict the response and possible side effects. This is a very individualized approach that has yet to be mainstreamed into current practice and is not without some drawbacks. However, this genetic consideration reminds us that depression treatment does not take on a “one-size-fits-all” approach.
References:
Sarris J, et al. Adjunctive nutraceuticals for depression: A systematic review and meta-analyses. AJP in Advance. 2016
National Institute of Mental Health: Depression
WebMD: SAMe and Fish oil
Penckofer S, et al. Vitamin D and Depression: Where is all the sunshine? Issues in Mental Health Nursing. 2010
Penn E, et al. The drugs don’t work? Therapeutic Advances in Psychopharmacology. 2012
