Anytime anyone establishes a "gold standard" in medicine, it's worthy of a second look. A new Australian study published in World Psychiatry does that and it’s the world's largest review of studies conducted so far. It found strong evidence that some supplements really can be an effective additional treatment for mental disorders.
Emphasis on additional: Except in one case, the supplements studied were used along with conventional medications, such as SSRIs for depression or anti-psychotics for schizophrenia. Supplements alone are not sufficient treatment for mental health disorders.
Now that that’s out of the way, back to the report. The study, from the NICM Health Research Institute at Western Sydney University, looked at 33 meta-analyses of randomized-controlled trials and used data from almost 11,000 people with a variety of mental disorders, including depression, stress and anxiety disorders, bipolar disorder, personality disorders, schizophrenia, and attention-deficit/hyperactivity disorder (ADHD).
Most supplements the research team analyzed didn't significantly improve mental health, but the study clearly delineated the ones that did:
- Omega-3s got the highest marks when used with antidepressants, reducing symptoms more than the medication used alone. The omegas were also found to have "small benefits" for ADHD, but weren't really helpful for schizophrenia and other conditions.
- Emerging research around the amino acid N-acetylcysteine also showed that it can help mood disorders and schizophrenia as an adjunct treatment
- Folate, a natural form of vitamin B9, helps as an add-on for major depression and schizophrenia, they said, but folic acid, which is a synthetic version of folate, does not.
And about vitamins and minerals: The research showed a "lack of compelling evidence" for them when it came to any mental disorder.
The authors shared that the supplements had "good safety profiles," including when they were used with psychiatric medications.
How Supplements Support Good Nutrition
They also noted that people with mental disorders tend to eat excessive amounts of high-fat, high-sugar foods, missing those critical nutrient-dense foods that most people eat.
"Inadequate nutrition appears to be present even prior to psychiatric diagnoses," they say, noting three other main points.
Antioxidant and anti-inflammatory properties of some supplements could help treat psychiatric conditions caused by heightened inflammation and oxidative stress, which is associated with many mental disorders. Oxidative stress occurs with too many free radicals (usually unstable oxygen molecules) damage cells.
Other studies show that psychotic and mood disorders are associated with reduced levels of essential nutrients, so supplementing those could improve outcomes.
- There's some evidence that mental disorders could be connected to dysfunction of the gut microbiome—the millions of microbes that live in our gut, including bacteria, fungi, and more.
How You Can Use This Study
The National Center for Complementary and Integrative Health in the United States reminds us that rules for manufacturing and distributing dietary supplements are, in fact, less strict than those for prescription or over-the-counter drugs. As a result, it warns that:
- The label may not "tell all" about what's in the product.
- Some dietary supplements aren’t safe for people with certain medical conditions and may interact with prescriptions or over-the-counter medications.
- More cases of liver disease are being reported from supplements.
- "Natural" doesn't equate to being "safe."
- Certain terms like "standardized" don't translate to quality or consistency.
You can bring this study up and ask your providers if taking a supplement might be appropriate for you. In short, before you take any supplement, for any reason, check with your doctor, and if you're seeing a psychiatrist, make sure to check with them, too. And if one is recommended, be sure to choose one that’s been verified by the U.S. Pharmacopeia (USP).