Thursday, January 29, 2009

10 Antidepressant Alternatives Proven to Work

If you are suffering from depression, but would prefer to try something natural before going the traditional pharmaceutical route, here are some remedies that have stood up to rigorous testing.

PLEASE NOTE: These are NOT my recommendations. I am merely posting them as an article that was published. My recommendations are below in my comment.


"If placebo can help depression, then, anything given with the patient knowing it will help them, is likely to work."

This post is for those who prefer to try something natural before going the traditional pharmaceutical route in the treatment of depression.

Nobody said that it is impossible to treat depression without medication. So why not to try?

However, you should be aware that non-drug treatments require more time and patience to bring results.

For those who prefer medications we may recommend to read our atrticles:

1. Cognitive behavioral therapy (CBT)

Cognitive Behavioral Therapy is a scientifically well-established and effective treatment for depression.

Cognitive therapy seeks to help people change how they think about things. Unlike more traditional forms of therapy, it focuses on the “here and now” problems and difficulties.

How effective is Cognitive behavioral therapy for depression?

Numerous clinical studies throughout the world have consistently demonstrated that cognitive behavioral therapy is as effective as antidepressant medication in the treatment of major depression9-11.

Within 20 sessions of individual therapy, approximately 75% of patients experience a significant decrease in their symptoms. The combination of cognitive therapy with medication, in some studies, increases the efficacy to 85%. Moreover, most patients in cognitive therapy maintain their improved mood on follow-up two years later. This advantage of “maintaining gains” is due to the fact that in cognitive therapy the patient should not only reduce his symptoms, but he should learn to understand the distortions in thinking and behavior which are associated with the depression and learn self-help rather than dependence.

User ratings and reviews of Cognitive Behavioral Therapy (CBT) for Depression on Revolution Health

Cognitive Behavioral Therapy Reviews on PsychCentral.com

2. St John’s wort

St John’s wort (Hypericum perforatum) is commonly used for the treatment of depression. It is a reasonable choice for patients who prefer natural medicines over standard antidepressants. St John’s wort is available in tablets, capsules and liquid form from supermarkets and health food shops.

Research suggests that St. John’s wort exerts its antidepressant action by inhibiting the reuptake of the neurotransmitters serotonin, norepinephrine, and dopamine.

How effective is St John’s wort for depression?

There is good evidence that St John’s wort improves symptoms of mild to moderate depression.

Numerous double-blind, placebo-controlled studies have examined the effectiveness of St. John’s wort for the treatment of mild to moderate major depression, and most have found the herb more effective than placebo2.

St John’s wort can be at least as effective as paroxetine (Paxil) in the treatment of moderate to severe depression in the short-term3.

User ratings and reviews of St. John’s Wort (Hypericum perforatum) for Depression on Revolution Health

3. S-Adenosylmethionine (SAMe)

Another potential alternative antidepressant is S-Adenosylmethionine (SAMe). SAMe is an amino acid derivative that occurs naturally in all cells.

SAMe plays a role in many biological reactions by transferring its methyl group to DNA, proteins, phospholipids and biogenic amines. This could result in SAMe indirectly influencing neurotransmitter metabolism and receptor function.

How effective is S-Adenosylmethionine (SAMe) for depression?

Several scientific studies indicate that SAMe may be useful in the treatment of depression4. However, it is not clear exactly how SAMe works to relieve depression.

4. Light Therapy

For years, light therapy has been used to treat seasonal affective disorder, a type of depression that afflicts about one in 10 people who live in places with short winter days and extended darkness.

A lack of exposure to sunlight is responsible for the secretion of the hormone melatonin, which could trigger a dispirited mood and a lethargic condition. Light therapy helps to regulate the body’s internal clock (sleep-wake cycles) in the same way that sunlight does.

How effective is Light therapy for depression?

Light therapy is an effective treatment for seasonal affective disorder and it may reduce the symptoms of non-seasonal depression12. Research suggests that some women who suffer from antepartum or postpartum depression may benefit from light therapy as well13.

Overall, the effectiveness of light therapy for depression depends on a number of things, including the type of depression, the brightness of the light, the duration of light exposure, and other factors.

5. Exercise

Exercise is an effective antidepressant. Exercise has the extra benefit of improving physical functioning as well.

Researchers have found that regular exercise, and the increase in physical fitness that results, alters serotonin levels in the brain and leads to improved mood and feelings of wellbeing. Some research indicates that regular exercise boosts body temperature, which may ease depression by influencing the brain chemicals.

How effective is Exercise for depression?

There is increasingly strong evidence for its use as a treatment for depression.

Study after study has shown that exercise promotes mental health and reduces symptoms of depression17-19. The antidepressant effect of regular physical exercise is comparable to the potent antidepressants like Sertraline18.

6. 5-Hydroxytryptophan (5-HTP)

5-Hydroxytryptophan (5-HTP) and tryptophan are also natural alternatives to traditional antidepressants

When the body sets about manufacturing serotonin, it first makes 5-HTP. The theory behind taking 5-HTP as a supplement is that providing the one-step-removed raw ingredient might raise serotonin levels.

How effective is 5-HTP for depression?

The evidence suggests 5-HTP and tryptophan are better than placebo at alleviating depression8.

7. Massage

Massage is one of the oldest of health practices, found in ancient Chinese medical texts written some 4,000 years ago. It has been practiced as a healing therapy for centuries in nearly every culture around the world.

One of the best-known benefits of massage therapy is its ability to enhance feelings of well-being. Massage produces chemical changes in the brain that result in a feeling of relaxation, calm and well-being. It also reduces levels of stress hormones - such as adrenalin, cortisol and norepinephrine - which in some people can trigger depression.

How effective is Massage for depression?

Massage therapy loweres levels of stress hormone cortisol by average 30%. Massage also increases serotonin and dopamine, neurotransmitters that help reduce depression20.

Massage therapy may be quite beneficial for pregnant women suffering from depression21.

8. Acupuncture

Acupuncture is a traditional Chinese treatment in which needles are inserted at specific points in the body and either manipulated or electrically stimulated (electroacupuncture).

Research suggests that acupuncture can decrease or eliminate the symptoms of depression. The main benefit of acupuncture is the absence of side effects which come along with chemical drugs.

How effective is Acupuncture for depression?

Evidence for acupuncture’s effectiveness for depression has been mixed.

In a study of 151 depressed patients, twelve sessions of acupuncture failed to prove more effective than fake acupuncture15. In a mathematical review of the results of 8 randomized trials1, the impact of acupuncture on depression was unconvincing.

Another 2008 review of 8 small-randomized controlled trials supported that acupuncture could significantly reduce the severity of disease in the patients with depression16.

User ratings and reviews of Acupuncture for Depression on Revolution Health

9. Yoga & Meditation

Yoga is an ancient system of relaxation, exercise, and healing with origins in Indian philosophy.

Practicing yoga can alter your brain chemistry. Some yoga positions are effective in stimulating the release of endorphins and reducing the level of stress hormon cortisol.

How effective is Yoga for depression?

Several human studies support the use of yoga for depression in both children and adults22-23. In addition, yoga postures have been specifically shown to increase levels of the neurotransmitter GABA, which may alleviate depression24.

10. B Vitamins

B vitamins play a role in the production of certain neurotransmitters, which are important in regulating mood and other brain functions.

However, the results of the recent 2008 Australian study showed that treatment with vitamin B12, folic acid, and B6 is no better than placebo in reducing the severity of depressive symptoms over a period of 2 years in older men6.

Folate

Folic acid deficiency has been noted among people with depression. Folic acid deficiency has also been linked to a poor response to antidepressant medication.

Recent UK study suggests that lower blood folate levels may be a consequence rather than a cause of depressive symptoms7.

Vitamin B6

Vitamin B6, or pyridoxine, is the cofactor for enzymes that convert L-tryptophan to serotonin and L-tyrosine to norepinephrine. Consequently, vitamin B6 deficiency might result in depression.

Vitamin B12

There is some evidence that people with depression respond better to treatment if they have higher levels of vitamin B12. It’s possible that vitamin B12 is needed to manufacture substances called monoamines. Another theory is that vitamin B12 deficiency results in the buildup of the amino acid homocysteine, which may enhance depression.

A study published in the American Journal of Psychiatry in December 2002 reported that older adults with vitamin B-12 deficiency were more likely to have depressive symptoms than those who were not deficient in vitamin B125.

References

  • 1. Wang H, Qi H, Wang BS, Cui YY, Zhu L, Rong ZX, Chen HZ. Is acupuncture beneficial in depression: a meta-analysis of 8 randomized controlled trials? J Affect Disord. 2008 Dec;111(2-3):125-34. Epub 2008 Jun 11. PubMed
  • 2. St John’s wort for major depression. Linde K, Berner MM, Kriston L. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD000448. Review. PubMed
  • 3. St John’s wort versus paroxetine for depression. Jurcic J, Pereira JA, Kavanaugh D. Can Fam Physician. 2007 Sep;53(9):1511-3. PubMed
  • 4. S-adenosylmethionine (SAMe) as treatment for depression: a systematic review. Williams AL, Girard C, Jui D, Sabina A, Katz DL. Clin Invest Med. 2005 Jun;28(3):132-9. Review. PubMed
  • 5. Vitamin B12, folate, and homocysteine in depression: the Rotterdam Study. Tiemeier H, van Tuijl HR, Hofman A, Meijer J, Kiliaan AJ, Breteler MM. American Journal of Psychiatry. 2002 Dec;159(12):2099-101.
  • 6. Vitamins B12, B6, and folic acid for onset of depressive symptoms in older men: results from a 2-year placebo-controlled randomized trial. Ford AH, Flicker L, Thomas J, Norman P, Jamrozik K, Almeida OP. J Clin Psychiatry. 2008 Aug;69(8):1203-9. PubMed
  • 7. Kendrick T, Dunn N, Robinson S, Oestmann A, Godfrey K, Cooper C, Inskip H; Southampton Women’s Survey Study Group. A longitudinal study of blood folate levels and depressive symptoms among young women in the Southampton Women’s Survey. Journal of Epidemiology and Community Health. 2008 Nov;62(11):966-72.
  • 8. Tryptophan and 5-hydroxytryptophan for depression. Shaw K, Turner J, Del Mar C. Cochrane Database Syst Rev. 2002;(1):CD003198. Review.
  • 9. Hollon SD, DeRubeis RJ, Shelton RC, Amsterdam JD, Salomon RM, O’Reardon JP, Lovett ML, Young PR, Haman KL, Freeman BB, Gallop R. Prevention of relapse following cognitive therapy vs medications in moderate to severe depression. Arch Gen Psychiatry. 2005 Apr;62(4):417-22.
  • 10. Melvin GA, Tonge BJ, King NJ, Heyne D, Gordon MS, Klimkeit E. A comparison of cognitive-behavioral therapy, sertraline, and their combination for adolescent depression. J Am Acad Child Adolesc Psychiatry. 2006 Oct;45(10):1151-61. PubMed
  • 11. DeRubeis RJ, Gelfand LA, Tang TZ, Simons AD. Medications versus cognitive behavior therapy for severely depressed outpatients: mega-analysis of four randomized comparisons. Am J Psychiatry. 1999 Jul;156(7):1007-13.
  • 12. Tuunainen A, Kripke DF, Endo T. Light therapy for non-seasonal depression. Cochrane Database Syst Reviews. 2004;(2):CD004050.
  • 13. Morning light therapy for postpartum depression. Corral M, Wardrop AA, Zhang H, Grewal AK, Patton S. Arch Womens Ment Health. 2007;10(5):221-4. Epub 2007 Aug 16.
  • 14. Systematic evaluation of therapeutic effect and safety of acupuncture for treatment of depression. Wang L, Sun DW, Zou W, Zhang JY. Zhongguo Zhen Jiu. 2008 May;28(5):381-6. Chinese. PubMed
  • 15. Allen JJ, Schnyer RN, Chambers AS, et al. Acupuncture for depression: a randomized controlled trial. J Clin Psychiatry. 2006;67:1665-1673.
  • 16. Wang H, Qi H, Wang BS, Cui YY, Zhu L, Rong ZX, Chen HZ. Is acupuncture beneficial in depression: a meta-analysis of 8 randomized controlled trials? J Affect Disord. 2008 Dec;111(2-3):125-34. Epub 2008 Jun 11. PubMed
  • 17. Blumenthal JA, Babyak MA, Doraiswamy PM, Watkins L, Hoffman BM, Barbour KA, Herman S, Craighead WE, Brosse AL, Waugh R, Hinderliter A, Sherwood A. Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosomatic Medicine 2007 Sep-Oct;69(7):587-96. Epub 2007 Sep 10.
  • 18. Brenes GA, Williamson JD, Messier SP, Rejeski WJ, Pahor M, Ip E, Penninx BW. Treatment of minor depression in older adults: a pilot study comparing sertraline and exercise. Aging Ment Health. 2007 Jan;11(1):61-8. PubMed
  • 19. Knubben K, Reischies FM, Adli M, Schlattmann P, Bauer M, Dimeo F. A randomised, controlled study on the effects of a short-term endurance training programme in patients with major depression. British Journal of Sports Medicine. 2007 Jan;41(1):29-33. Epub 2006 Oct 24.
  • 20. Field T, Hernandez-Reif M, Diego M, Schanberg S, Kuhn C. Cortisol decreases and serotonin and dopamine increase following massage therapy. Int J Neurosci. 2005 Oct;115(10):1397-413. PubMed
  • 21. Field T, Diego MA, Hernandez-Reif M, Schanberg S, Kuhn C.Massage therapy effects on depressed pregnant women. J Psychosom Obstet Gynaecol. 2004 Jun;25(2):115-22. PubMed
  • 22. Kozasa EH, Santos RF, Rueda AD, Benedito-Silva AA, De Ornellas FL, Leite JR. Evaluation of Siddha Samadhi Yoga for anxiety and depression symptoms: a preliminary study. Psychol Rep. 2008 Aug;103(1):271-4. PubMed
  • 23. Shapiro D, Cook IA, Davydov DM, Ottaviani C, Leuchter AF, Abrams M. Yoga as a Complementary Treatment of Depression: Effects of Traits and Moods on Treatment Outcome. Evid Based Complement Alternat Med. 2007 Dec;4(4):493-502.
  • 24. Streeter CC, Jensen JE, Perlmutter RM, Cabral HJ, Tian H, Terhune DB, Ciraulo DA, Renshaw PF. Yoga Asana sessions increase brain GABA levels: a pilot study. J Altern Complement Med. 2007 May;13(4):419-26.

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