Supplements for Treatment-Resistant Depression?

It’s natural to wonder if taking a supplement might bring you some relief from treatment-resistant depression (TRD). The short answer is: maybe. Certain supplements might help ease depression symptoms. Others may relieve related health issues like trouble sleeping. But a supplement isn’t meant to replace your main depression treatment. And it’s important to talk with your doctor before you try one to avoid possible health problems. With that in mind, here are supplements that might be helpful for some people with TRD to take along with their regular treatment.

The sunshine vitamin is key for more than your bone health. “Vitamin D may work as an antioxidant in the brain, providing anti-inflammatory support,” says Vanessa King, a spokesperson for the Academy of Nutrition and Dietetics. Being too low on vitamin D or certain other nutrients might make your TRD symptoms worse or limit the helpful effects of your treatment, King says. If tests show you have a vitamin D deficiency, your doctor may recommend a supplement. Take it with your heaviest meal of the day to help your body absorb  the vitamin.

These healthy fats are “an essential nutrient for nervous system and brain health,” says Yufang Lin, MD, an integrative medicine specialist at Cleveland Clinic. If you can’t get enough omega-3s from food (like salmon and flaxseed), your doctor might prescribe them as supplements to take along with your depression medication. That’s because TRD has been linked oxidative stress, King says, which means you have lower levels of antioxidants and higher levels of other molecules called free radicals. Since omega-3s work as antioxidants, taking an omega-3 supplement might help fix such an imbalance, she says.

If you’re too low in any of these nutrients, your doctor might recommend a supplement. Zinc contributes to brain development and function, and it’s found to be deficient in many people with TRD, King says. B12 plays a role in helping your body metabolize (process) brain chemicals that help control mood, and a deficiency contributes to mood disturbances, she says. Folate has a hand in various jobs that your nervous system does, and taking it in supplement form may help make TDR symptoms less severe, she adds.

Your gut communicates back and forth with your brain so much that it’s known as your “second brain.” Since the connection can affect your mood, some doctors and registered dietitians recommend specific strains of probiotic supplements to certain people with TRD. Probiotics are gut-friendly bacteria and yeasts that can affect the collection of microbes in your stomach. In some people with TRD, probiotics have been reported to improve symptoms after eight weeks when used with depression medication, King says. Doctors and dietitians recommend probiotics on a case-by-case basis to people with TRD, and more research is needed, she says.

About 3 in 4 people with depression may have trouble nodding off or staying asleep. If TRD keeps you from getting quality shut-eye, both of these supplements might help, Lin says. Magnesium is a mineral that can support muscle relaxation, which may help you drift off easier, she says. Melatonin is a lab-made version of the hormone that helps control your body’s sleep-wake cycle. It can help set your body's natural 24-hour clock (a.k.a. your circadian rhythm) and help you fall asleep, Lin adds.

It’s crucial to get your doctor’s OK before you try a new supplement. That way, they can check to see if the supplement might make your depression treatment less effective or cause serious side effects. Also, “keep in mind that there is little quality control in the supplement market,” Lin says. That’s because the FDA doesn’t regulate supplements as closely as it does with medications. So some products might make bogus health claims or include risky amounts of ingredients and filler ingredients.

“Only use products that have been third-party tested by reputable companies,” Lin says. You can check a supplement’s label to see if it’s been tested by an independent group like the U.S. Pharmacopeia (USP) or the National Sanitation Foundation (NSF). Also, “work with a registered dietitian and licensed health care providers to plan a safe and ideal dose,” King says. The right dose of a supplement for you depends on things like the current amount of the nutrient in your body, the medications you take, and the foods you eat, she says.