Finding a non-pharmacologic treatment that works for you
This post is offered as a brief re-cap of highlights in my recent series of posts on complementary and alternative ways to fight the winter blues. Research studies consistently report the mood enhancing benefits of regular exercise, and two unique molecules that occur naturally in the human body that can be safely taken as supplements alone or in combination with an antidepressant: S-adenosylmethionine (SAMe) and dehydroepiandrosterone (DHEA). Below I briefly review the evidence for all three approaches. You can find detailed discussions of antidepressant mechanisms, analysis of research findings including links to studies cited, and comments on safety in my recent posts. On my website you can find practical information on a broad range of complementary, alternative and integrative ways to fight the winter blues, several full-text papers I’ve published over the years, and links to my books and e-books.
Regular exercise as an ‘antidepressant’ therapy
Findings of controlled trials report consistent mood-enhancing effects of regular exercise including both aerobic exercise and non-aerobic strengthening exercise. Regular aerobic exercise may improve cognitive functioning in chronically depressed individuals who often experience difficulties with thinking and memory. Meta-analyses of studies on exercise show consistent mood-enhancing benefits from exercise alone and improved response to antidepressants. Regular exercise may be as effective as St. John’s wort and other alternative treatments of depressed mood.
SAMe: effective for depressed mood and may reduce sexual side effects of antidepressants
Meta-analyses of placebo-controlled studies show that SAMe is as effective as many widely prescribed antidepressants when taken alone and improves overall response and may accelerate response rate when taken with an antidepressant. An important study published in the American Journal of Psychiatry reported that SAMe may also have significant mood enhancing benefits in individuals who do not respond to antidepressants. Combining SAMe with an antidepressant is a safe integrative way to treat depressed mood that may permit a reduction in the dose of a prescription antidepressant by as much as 30% in some cases. In addition to improving the efficacy of antidepressants, there is evidence that the adjunctive use of SAMe may reduce sexual side effects frequently caused by SSRIs and other antidepressants. Finally, taking SAMe 400mg twice daily together with an antidepressant may improve memory and other cognitive problems that often accompany depressed mood.
DHEA: mood enhancing and cognitive benefits and may improve sexual functioning
Like SAMe, DHEA taken alone may reduce the severity of depressed mood and can be safely used in conjunction with antidepressants increasing their efficacy. DHEA levels in the body and brain decline with normal aging, which may help explain some cases of late onset depression. Many individuals who respond to DHEA report improvements in sexual functioning.
DHEA may be an effective treatment of depressed mood individuals with HIV/AIDS, and may reduce symptoms of psychosis, anxiety and cognitive impairment all of which can occur together with depressed mood. Finally, there is some evidence that DHEA supplementation may reduces the rate of cognitive deterioration in Alzheimer’s disease and may improve anxiety and reduce the severity of psychotic symptoms in individuals diagnosed with schizophrenia.
If you’ve been struggling with depression, have had a disappointing response to antidepressants, or are looking for safe and effective non-pharmacologic approaches to boost the effectiveness of your antidepressant, think about adding exercise to your daily routine, or finding a quality brand of SAMe or DHEA. Before starting either supplement please take time to read the more detailed blogs posted in recent weeks.