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NCCIH Clinical Digest

for health professionals

Depression and Complementary Health Approaches

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October 2015
A man sits on the edge of his bed, tiredly holding his head in his hands.

© Comstock

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 and Summary of Current Evidence

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

St. John’s Wort (Hypericum perforatum)

Natural Product

There is some evidence that suggests St. John’s wort (Hypericum perforatum) may have an effect on mild to moderate major depressive disorder (MDD) for a limited number of patients, similar to standard antidepressants, but the evidence is far from definitive. Although some studies have demonstrated a slight efficacy over placebo, others contradict these findings.

The significant herb-drug interactions of St. John’s wort (Hypericum perforatum) are important safety considerations.

Read more about the evidence base of St. John’s wort for depression

S-Adenosyl-L-Methionine (SAMe)

Natural Product

Current scientific evidence does not support the use of SAMe for the treatment of depression.

Read more about the evidence base of SAMe for depression

Inositol

Natural Product

Current scientific evidence does not support the use of Inositol for the treatment of depression.

Read more about the evidence base of inositol for depression

Acupuncture

Mind and Body Practice

Current scientific evidence does not support the use of acupuncture for the treatment of depression.

Read more about the evidence base of acupuncture for depression

Music Therapy

Mind and Body Practice

There is some limited evidence that suggests music therapy may provide an improvement in mood.

Read more about the evidence base of music therapy for depression

Relaxation Training

Mind and Body Practice

Evidence suggests that relaxation training is better than no treatment in reducing symptoms of depression, but is not as beneficial as psychological therapies (e.g., cognitive-behavioral therapy).

Read more about the evidence base of relaxation training for depression

Scientific Literature

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.

Copyright

Content is in the public domain and may be reprinted, except if marked as copyrighted (©). Please credit the National Center for Complementary and Integrative Health as the source. All copyrighted material is the property of its respective owners and may not be reprinted without their permission.

This page last modified November 18, 2015