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RESEARCH PRODUCT

The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta‐review of meta‐analyses of randomized controlled trials

Lee SmithFelipe Barreto SchuchKelly AllottDan SiskindJerome SarrisJerome SarrisJack CotterJoseph FirthJoseph FirthJoseph FirthMarco SolmiWolfgang MarxNicola VeroneseAndré F. CarvalhoDavy VancampfortMichael BerkBrendon StubbsBrendon StubbsScott B Teasdale

subject

eicosapentaenoic acidNutrient supplements polyunsaturated fatty acids omega-3 eicosapentaenoic acid methylfolate vitamin D N-acetylcysteine depression schizophrenia attention-deficit/hyperactivity disorder adjunctive treatmentvitamin Dlaw.invention0302 clinical medicineRandomized controlled triallawL-METHYLFOLATEVITAMIN-D SUPPLEMENTATIONOXIDATIVE STRESSPsychiatryMAJOR DEPRESSIVE DISORDERPOLYUNSATURATED FATTY-ACIDSattention-deficitGUT MICROBIOTAPsychiatry and Mental healthNutrient supplementsCARDIOVASCULAR-DISEASESchizophreniadepressionhyperactivity disorderMajor depressive disorderomega-3Pshychiatric Mental HealthLife Sciences & Biomedicinepolyunsaturated fatty acidsmedicine.medical_specialtyDEFICIT HYPERACTIVITY DISORDERattention-deficit/hyperactivity disorder03 medical and health sciencesmedicineAttention deficit hyperactivity disorderPsychiatryAdverse effectIntensive care medicineScience & Technologybusiness.industrymethylfolateadjunctive treatmentResearch Reportsmedicine.diseaseNUTRITIONAL MEDICINEMental healthN-acetylcysteine030227 psychiatryschizophreniaMood disordersAdjunctive treatmentbusiness030217 neurology & neurosurgery

description

The role of nutrition in mental health is becoming increasingly acknowledged. Along with dietary intake, nutrition can also be obtained from "nutrient supplements", such as polyunsaturated fatty acids (PUFAs), vitamins, minerals, antioxidants, amino acids and pre/probiotic supplements. Recently, a large number of meta-analyses have emerged examining nutrient supplements in the treatment of mental disorders. To produce a meta-review of this top-tier evidence, we identified, synthesized and appraised all meta-analyses of randomized controlled trials (RCTs) reporting on the efficacy and safety of nutrient supplements in common and severe mental disorders. Our systematic search identified 33 meta-analyses of placebo-controlled RCTs, with primary analyses including outcome data from 10,951 individuals. The strongest evidence was found for PUFAs (particularly as eicosapentaenoic acid) as an adjunctive treatment for depression. More nascent evidence suggested that PUFAs may also be beneficial for attention-deficit/hyperactivity disorder, whereas there was no evidence for schizophrenia. Folate-based supplements were widely researched as adjunctive treatments for depression and schizophrenia, with positive effects from RCTs of high-dose methylfolate in major depressive disorder. There was emergent evidence for N-acetylcysteine as a useful adjunctive treatment in mood disorders and schizophrenia. All nutrient supplements had good safety profiles, with no evidence of serious adverse effects or contraindications with psychiatric medications. In conclusion, clinicians should be informed of the nutrient supplements with established efficacy for certain conditions (such as eicosapentaenoic acid in depression), but also made aware of those currently lacking evidentiary support. Future research should aim to determine which individuals may benefit most from evidence-based supplements, to further elucidate the underlying mechanisms. ispartof: WORLD PSYCHIATRY vol:18 issue:3 pages:308-324 ispartof: location:Italy status: published

yearjournalcountryeditionlanguage
2019-10-01World Psychiatry
https://doi.org/10.1002/wps.20672