The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta-review of meta-analyses of randomized controlled trials.
N-acetylcysteine
Nutrient supplements
adjunctive treatment
attention-deficit/hyperactivity disorder
depression
eicosapentaenoic acid
methylfolate
omega-3
polyunsaturated fatty acids
schizophrenia
vitamin D
Journal
World psychiatry : official journal of the World Psychiatric Association (WPA)
ISSN: 1723-8617
Titre abrégé: World Psychiatry
Pays: Italy
ID NLM: 101189643
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
entrez:
10
9
2019
pubmed:
10
9
2019
medline:
10
9
2019
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 31496103
doi: 10.1002/wps.20672
pmc: PMC6732706
doi:
Types de publication
Journal Article
Langues
eng
Pagination
308-324Subventions
Organisme : Department of Health
ID : ICA-CL-2017-03-001
Pays : United Kingdom
Informations de copyright
© 2019 World Psychiatric Association.
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