US EPA

3243003 

Journal Article 

Complementary and alternative medicine for the treatment of major depressive disorder 

Nahas, R; Sheikh, O 

2011 

Yes 

Canadian Family Physician
ISSN: 0008-350X
EISSN: 1715-5258 

57 

6 

659-663 

WOS:000291584700011 

Objective To review the clinical evidence supporting
complementary and alternative medicine interventions for treating major depressive disorder.
Quality of evidence PubMed was searched from January 1966 to February 2010 using the term
depressive disorder in combination with St John's wort, S-adenosylmethionine (SAM-e), exercise,
acupuncture, omega-3 fatty acids, and folate. Only relevant human trials were selected. Main
message In a large meta-analysis, St John's wort was found to be equivalent to antidepressant
drugs with fewer side effects. Exercise reduced depressive scores in 3 meta-analyses. Omega-3
fatty acids reduced depressive scores in a meta-analysis of 16 trials, but publication bias was
identified. Oral SAM-e monotherapy reduced depressive scores in 4 of 5 small randomized
controlled trials. Folate deficiency is associated with more severe and refractory depression,
and supplementation reduced depressive scores in 2 of 3 randomized controlled trials. Acupuncture
demonstrated limited efficacy in 1 meta-analysis and 5 other trials. Conclusion St John's wort
and regular exercise appear effective in the treatment of depression. Acupuncture appears
ineffective for depression, but it might offer other health benefits. Other promising therapies
include SAM-e, omega-3 fatty acid, and folic acid supplementation in selected patients; further
study is warranted.