From saffron to St John’s Wort – scientists reveal the supermarket depression treatments that REALLY work

IF you experience persistent low mood, you might expect to be prescribed some antidepressants and a course of talking therapy.

However, it’s becoming increasingly common to try over-the-counter remedies to combat symptoms of depression.

But do these treatments really work?

Dr Rachael Frost, senior lecturer at Liverpool John Moores University, said: “Many of us know someone who struggles with minor or moderate levels of depression, or we may struggle from depressive symptoms ourselves.

“Often, we will try many things to help, such as antidepressants, talking therapies, meditation, or exercise.

“One common treatment people try is OTC products which are widely available and accessible from supermarkets, pharmacies, health food shops, and online.  

“Once you start looking into which product might be helpful, the list becomes endless.

“This is particularly the case if you read online blogs or look at social media promotion of various products.

“How do we know what is evidence-based? What products are effective? Are they safe?”

To answer these questions, researchers reviewed studies on 64 different herbal products and dietary supplements available in supermarkets and high street pharmacies.

They had been taken by adults aged 18 to 60 for at least one week across 209 clinical trials.

Evidence was strongest for St John’s Wort and saffron, which “often showed effects similar to prescription antidepressants”.

St John’s Wort is a plant which increases the activity of brain chemicals such as serotonin and noradrenaline that are thought to play an important part in regulating our mood.

Saffron is a spice known for its bright yellow-orange colour and distinct flavour. It’s popular in curries, risottos and stews.

It was used for decades in traditional Chinese medicine, then pain relief in the 16th to 19th centuries, and now in some cultures for depression.

The trials also suggested that probiotics and vitamin D are more likely to reduce depressive symptoms than a placebo treatment.

Probiotics are thought to help restore the natural balance of bacteria in the gut, while vitamin D helps to regulate the amount of calcium and phosphate in the body.

Our study has pioneered an exploration into what research is needed to further assess such widely used health care products

Dr Rachael Frost

Scientists also identified 18 products for which there is “emerging evidence”.

The most promising were folic acid, lavender, zinc, tryptophan, rhodiola, and lemon balm.

“Further research into these could help determine whether they can help people with depression,” Dr Frost said.

Bitter orange, Persian lavender, and chamomile tea also showed positive effects in two trials each.

Some trendy products, such as melatonin, magnesium, and curcumin, showed mixed effects on depression across multiple clinical trials.

Results were also mixed for cinnamon, echium, vitamin C, and a combination of vitamin D plus calcium.

Prebiotics, which support the good bacteria in our gut, and a supplement called SAMe did not seem to be better than a placebo. 

The majority of trials looking at omega-3s found it did not affect depression.

Few products presented safety issues, whether used alone or alongside antidepressants.

But the team stressed that patients should speak to their GP before starting any supplements for mental health problems.

Dr Frost said: “It’s good news that very few safety concerns arose from any of these products, whether they were taken alone or in combination with antidepressants.

“However, a healthcare professional should always be consulted on whether a product might interact with something else you are taking.

“A higher standard of safety reporting in trials is essential – only 145 (69 per cent) of the examined studies fully reported any side effects from the products.

“Overall, what we have is relatively conclusive evidence for some products.

“Our study has pioneered an exploration into what research is needed to further assess such widely used health care products.”

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Experts warned anyone considering supplements for depression to speak to their GP first[/caption]

Professor Stella Chan, from the University of Reading, who was not involved in the study, added: “It is crucially important for readers to understand that this was a narrative review paper, meaning that it was only a summary of the findings reported from existing research papers.

“These papers would inevitably vary in terms of their scientific quality, including some that might report biased or misleading findings due to limitations such as small sample sizes and poor designs.

“Meta-analyses (that is, analyses that involve combining all existing data into a single dataset) need to be conducted before conclusive statements can be made about the effectiveness of these products.

“Additionally, this review paper excluded studies on individuals with more complicated co-morbid conditions.

“Individuals with more complex mental health needs should be particularly vigilant and avoid making personal health decisions based solely upon narrative review papers.”

Depression is increasingly common, to the extent that it is sometimes described as an epidemic.

In the UK, about 11 per cent of people report mild depressive symptoms, four percent consider them moderate, and three per cent say they are severe.

An estimated 8.7million people received antidepressant prescriptions in the UK in 2023/24 – a 2.1 per cent increase on the previous year.

It is unclear exactly how many people take OTC products, but the supplement industry as a whole is said to be worth £3.6billion.