What Over-the-Counter Medicine for Depression Can I take?

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Over-the-counter medicine can be taken in depression only if the depression is mild to moderate. If the depression is severe along with, say, suicidal thoughts, then you should consult a psychiatrist immediately and start taking prescription medicines. There are several herbs and natural supplements that seem to work reasonably well as over-the-counter antidepressants in depression, but not all of them are recommended for use in depression by the FDA.

Mayo Clinic warns that the FDA does not closely monitor herbal, nutritional and dietary supplements. So, you cannot be always sure of their ingredients and their safety. It is advisable to do some research of your own before starting any herbal or dietary supplement. Buy the supplements only from a reputable company, and check out the ingredients. Before starting to take these over-the-counter antidepressants, always talk to your doctor because they can cause serious interactions when taken along with some prescription medications (Hall-Flavin, 2018).

Photo of leaves and flowers of St. John's wort
St. John’s wort – leaves and flowers

1. Dehydroepiandrosterone

Dehydroepiandrosterone (DHEA) is a hormone made by the body. It has been claimed to enhance mood, energy, and sexual vigor. It is used over the counter in many older patients, taken as a dietary supplement. A few studies back up the claims of efficacy of DHEA in the treatment of major depression, minor depressive symptoms, and dysthymia. DHEA made from wild yam or soy is not effective. However, use caution because it can enhance the growth of sex-steroid tumors and may have virilizing effects in women (Sadock, et al., 2017).

2. St. John’s Wort

St. John’s wort (botanical name Hypericum perforatum) has been in use since ancient times. A 2008 review on St. John’s wort published in the Cochrane Library found that the plant was just as effective for treating mild to moderate depression as antidepressants, with fewer side effects. A 2019 review of medical literature has backed its claims of being an effective over-the-counter remedy for depression, but the FDA hasn’t yet approved the herb to treat depression. Always inform your doctor before taking this herb.

It supposedly works by increasing the amount of serotonin in the body. Serotonin is a neurotransmitter naturally occurring in the body and regulates mood. The dosage depends upon the formulation. So, consult the product literature.

Side effects of this herb are minor and rare and include dry mouth, confusion, dizziness, and gastrointestinal symptoms, including constipation. It can interact with certain prescription medications, such as blood thinners, birth control pills, chemotherapy medications, HIV/AIDS medications, and drugs used after an organ transplant. Do not use this herb along with prescription antidepressants because it can lead to serious side effects. Be sure to use a sunscreen because it makes you sensitive to sunlight (Schimelpfening, 2019) (Nall, 2017).

3. Omega-3 Fatty Acids

Since our bodies can’t make omega-3 fatty acids from scratch, they must be obtained from the foods we consume. These fats are found in fish such as salmon, trout, and sardines, flaxseed, flax oil, and walnuts, among other foods. Omega-3 supplements are still under scrutiny regarding possible treatment for depression and for depressive symptoms in people with bipolar disorder. A 2017 review says that while promising, the research results on omega-3 fatty acids for depression are mixed.

No dosage has been prescribed, but it is advisable not to take more than 3 g/day due to an increased risk for bleeding. If you prefer to obtain it directly from fish rather than as supplements, then take two to three servings of fish per week (Nall, 2017) (Schimelpfening, 2019) (Hall-Flavin, 2018).

4. SAM-e

SAM-e (S-adenosylmethionine) as a dietary supplement is available over the counter and is a synthetic form of a chemical found in the body. Our bodies also produce SAM-e from the amino acid methionine and the energy-chemical adenosine triphosphate (ATP). SAM-e is also thought to regulate neurotransmitters like the mood-regulating serotonin, because it may be involved in their methylation, hence its possible efficacy in depression.

Consult your doctor or the product insert for the dosage. You shouldn’t take SAM-e along with prescription antidepressants. It should be used with caution in bipolar depression because it can trigger mania. Its side effects include dizziness, loss of appetite, sleeplessness, upset stomach, and constipation when taken in large quantities (Nall, 2017) (Schimelpfening, 2019) (Hall-Flavin, 2018).

5. Saffron

Saffron is a spice derived from a flower in the iris family. According to a study, taking saffron stigma (a portion of the flower) is effective in improving the symptoms of mild to moderate depression, but more study is needed. High doses can cause significant side effects (Nall, 2017) (Hall-Flavin, 2018).

6. 5-HTP

5-hydroxytryptophan (5-HTP) is an amino acid made by our body from l-tryptophan obtained from food. A 2016 review of animal studies cites its potential as an antidepressant therapy. It may improve serotonin levels, a mood-regulating chemical, but more research is needed. It can be supplemented in pill form available over the counter.

There is a safety concern that it may cause a severe neurological condition, and could increase the risk of serotonin syndrome if taken with certain prescription antidepressants (Hall-Flavin, 2018) (Schimelpfening, 2019) (Galan, 2019).

7. Ginseng

This over-the-counter supplement comes from the root of the American or Asian ginseng plant. Ginseng has been used in Chinese medicine for thousands of years to help improve mental clarity, increase energy, and reduce stress.

Hence, ginseng is thought to help with the low energy and motivation that can occur with depression. However, the National Center for Complementary and Integrative Health (NCCIH) does not recommend it (Galan, 2019).

8. Chamomile

A 2012 study reviewed data about its role in helping to manage depression and anxiety. The results show that chamomile was more effective than a placebo. However, further studies are necessary (Galan, 2019).

9. Lavender

Lavender oil is a popular essential oil, used for relaxation, and reducing anxiety and mood fluctuations. A 2013 review suggested that it might significantly reduce anxiety and improve sleep.

However, there is little high-quality evidence supporting its effectiveness as a treatment for depression (Galan, 2019).

10. Vitamins and Minerals

A wide variety of vitamins and minerals have been investigated for their potential role in depression. Generally speaking, a well-balanced diet will provide all of the necessary vitamins and minerals. Still, vitamin and mineral supplements may be used.

Taking 500 micrograms of folic acid has been linked with improving the effectiveness of other antidepressant medications. Folate-rich foods include beans, lentils, avocados, fortified cereals, sunflower seeds, and dark leafy greens.

According to Biological Psychiatry analysis, low levels of zinc in the blood are associated with depression. Taking a 25-milligram zinc supplement daily for 12 weeks can reduce the symptoms of depression. An added benefit is that zinc supplements can also increase the omega-3 fatty acids in the body (Schimelpfening, 2019) (Nall, 2017).

References

Galan, N., 2019. 8 herbs and supplements for depression. [Online]
Available at: https://www.helpguide.org/articles/depression/antidepressant-medication.htm
[Accessed 15 Oct 2019].

Hall-Flavin, D., 2018. Natural remedies for depression: Are they effective?. [Online]
Available at: https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/natural-remedies-for-depression/faq-20058026
[Accessed 15 Oct 2019].

Nall, R., 2017. 6 Herbs and Supplements for Depression. [Online]
Available at: https://www.healthline.com/health/depression/herbs-supplements
[Accessed 15 Oct 2019].

Sadock, B. J., Sadock, V. A. & Ruiz, P., 2017. Kaplan and Sadock’s Comprehensive Textbook of Psychiatry. 10th ed. Philadelphia: Wolters Kluwer.

Schimelpfening, N., 2019. Over-the-Counter Antidepressants. [Online]
Available at: https://www.verywellmind.com/over-the-counter-antidepressants-1066678
[Accessed 15 Oct 2019].

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What Over-the-Counter Medicine for Depression Can I Take?
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What Over-the-Counter Medicine for Depression Can I Take?
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Over-the-counter medicine can be taken in depression only if it is mild to moderate. Several herbs and natural supplements seem to work well in depression.
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