Mindful Supplementation: Effectiveness, Safety, Quality

While diet and supplementation have not been shown to prevent mental illness, several supplements have been associated with symptom relief.

With the growing evidence that supplemental vitamins and nutrients are beneficial in some conditions, patients and health care providers are interested in evidence-based use of these products. Supplement use to prevent cardiovascular disease or treat hyperlipidemia is common. One area where vitamins and nutrients are just making inroads is mental health.

Is there supportive evidence that certain products have a role in the treatment of mental health disorders? Which products are safe and cost-effective? An article available free of charge in the June 2014 issue of Australian Prescriber answers these questions and also helps health care providers identify products whose claims may be exaggerated.

The authors lay the framework for their discussion by reminding readers that poor diet is a risk factor for mental health symptoms, and mentally ill people often eat poorly. While diet and supplementation haven’t been shown to prevent mental illness, several supplements have been associated with symptom relief. Among their findings are the following:

• Some patients may experience improved mood with supplemental omega-3 fatty acids (eicosapentaenoic acid in particular), St John’s wort, S-adenosyl-methionine, and zinc.
• Patients who have bipolar depression may derive some benefit (less depression) from N-acetyl cysteine, but only 1 study documents this effect. It may also have a beneficial role in the treatment of obsessive-compulsive disorder.
• The South Pacific root kava may lessen patients’ anxiety on a scale comparable with that of antidepressants, but it may cause hepatotoxicity and should not be used in patients who take benzodiazepines or drink alcohol regularly.

These authors acknowledge that some supplements may be costly or difficult to obtain. They also remind health care prescribers to ask patients about supplements they take, and be aware of quality issues with some products.