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Supplements for Depression and Anxiety
Question: Which supplements help with depression and anxiety?
Answer: A wide variety of supplements have shown some benefit in reducing anxiety and/or depression, as summarized below (with links to more details -- including dosage -- within our reports).
Fish oil has been found to be helpful for both depression and anxiety. Supplementing with fish oil with a high percentage of the omega-3 fatty acid EPA has been shown to improve symptoms in moderate and major depression (although not in mild depression) and may help to improve the effectiveness of various antidepressant medications. Similarly, fish oil high in EPA has been shown to significantly reduce anxiety.
Certain strains of probiotics have been found to reduce symptoms of depression and anxiety in short term studies, and one prebiotic product has been shown to lower levels of the "stress" hormone cortisol, as well as improve responses in a test associated with anxiety and depression.
A small clinical study in people already taking prescription medication for major depression found daily supplementation with curcumin significantly reduced depressive symptoms after four weeks and the effect was greater in those with atypical depression. The study found that anxiety was also reduced in those taking curcumin, although this reduction did not reach statistical significance.
A saffron extract was found to decrease self-reported symptoms of depression and anxiety (including separation anxiety, social phobia, panic, obsession and compulsions) compared to placebo in a two-month study of 80 adolescent boys and girls with mild-to-moderate anxiety and/or depression. Those who took the extract reported an average decrease in symptoms of 33%, compared to a 17% reduction in those who took a placebo. The dose of the extract (affron® -- standardized to 3.5% lepticrosalides) was 14 mg taken twice daily. Parents of those taking the saffron extract reported a 40% reduction in symptoms, compared to a 26% reduction perceived by parents of those taking placebo. (See the Encyclopedia article about saffron). The study was funded by the manufacturer of the extract, Pharmactive Biotech Products (Lopresti, J Affect Disord 2018).
One study found 5-HTP to be as effective as fluvoxamine (Luvox) for depression, with fewer side-effects; it was also found to be effective in people suffering from anxiety disorders, although not as effective as the prescription medication clomipramine.
There is evidence for a number of other supplements that may be helpful specifically for depression, including St. John's wort, SAMe, DHEA, and Rhodiola rosea. In women, daily supplementation with folic acid has been shown to increase the effectiveness of the antidepressant SSRI drug fluoxetine (Prozac) and increase the rate of recovery from depression compared to treatment with Prozac alone.
Some, but not all research suggests that L-theanine, an amino acid found in black and green tea (also sold in tablet and capsule form) may reduce stress and anxiety without causing drowsiness.
Having low blood levels of vitamin D is associated with a higher risk and severity of depression. One study found that supplementation with high-dose vitamin D significantly improved mood in women with type 2 diabetes who had serious depressive symptoms.
Having low blood levels of magnesium, and having a low intake of magnesium from foods are also each associated with an increased risk of depression. One small clinical study suggests magnesium supplementation may help reduce symptoms of depression.
In one clinical study, taking ashwagandha daily, in addition to a multivitamin, was shown to significantly reduce anxiety compared to treatment with a weekly psychotherapy session and a placebo. It has also been shown to reduce symptoms of anxiety mixed with depression and panic disorder. NAC has been shown to significantly reduce the anxiety-related compulsion to pull hair, known as trichotillomania. The herbs passionflower and lemon balm may also be helpful for anxiety. Although melatonin and valerian are sometimes promoted for anxiety, there is not enough evidence to support their use for this purpose. There is weak evidence, however, that valerian may produce calming effects in stressful situations.
A number of studies suggest kava may reduce symptoms of anxiety; however, be aware there are potential safety issues and drug interactions. (See the Encyclopedia article about Kava for more information).
In addition to their potential as stand-alone agents, a review of clinical studies investigating the use of supplements along with antidepressant medications (including SSRI drugs such as fluoxetine and sertraline and tricyclic drugs such as amitriptyline) found that SAMe, EPA from fish oil, methylfolate and vitamin D may increase the benefits of these drugs (Sarris, Am J Psychiatry 2016). Deficiency in B-3 (niacin), B-6, and/or B-12 can cause depression and some studies show that giving B-6, B-12, or folate may help with depression, particularly among those deficient in these vitamins.
However, if you are taking a prescription medication to treat depression or anxiety, consult your physician before taking any of the supplements mentioned above as there could be a risk of drug interactions. For more about this, see the extensive Drug Interactions section of our website. Consult with a qualified health professional for any serious symptoms of anxiety or depression.
Learn more about supplements for depression, anxiety and stress: