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Dietary Supplements and Natural Products as Psychotherapeutic Agents

From the Department of Health Care Sciences (A.F.-B.), George Washington University School of Medicine and Health Sciences, Washington, DC; and Adult Psychopharmacology Program (J.M.C.), National Institute of Mental Health, Rockville, MD.

Address reprint requests to: Jerry M. Cott, PhD, National Institute of Mental Health, 6001 Executive Blvd., room 7157, Bethesda, MD 20892-9635.

Alternative therapies are widely used by consumers. A number of herbs and dietary supplements have demonstrable effects on mood, memory, and insomnia. There is a significant amount of evidence supporting the use of Hypericum perforatum (St. John’s wort) for depression and Ginkgo biloba for dementia. Results of randomized, controlled trials also support the use of kava for anxiety and valerian for insomnia. Although evidence for the use of vitamins and amino acids as sole agents for psychiatric symptoms is not strong, there is intriguing preliminary evidence for the use of folate, tryptophan, and phenylalanine as adjuncts to enhance the effectiveness of conventional antidepressants. S-adenosylmethionine seems to have antidepressant effects, and omega-3 polyunsaturated fatty acids, particularly docosahexaenoic acid, may have mood-stabilizing effects. More research should be conducted on these and other natural products for the prevention and treatment of various psychiatric disorders.

Key Words: Ginkgo biloba • kava • St. John’s wort • vitamins • dietary supplements • omega-3 fattyacids

Abbreviations: ADAS-Cog = Alzheimer’s Disease Assessment Scale–Cognitionsubscale; CAM = complementary and alternative medicine; cAMP= cyclic adenosine monophosphate; DHA = docosahexaenoic acid; DSM = Diagnostic and Statistical Manual of MentalDisorders (3rd, 3rd revised, and 4th editions); EMS =eosinophilia-myalgia syndrome; EPA = eicosapentaenoic acid; GABA = -aminobutyric acid; HAM-A = Hamilton Anxiety RatingScale; HAM-D = Hamilton Depression Rating Scale; ICD =International Classification of Disorders; MAO = monoamineoxidase; OCD = obsessive-compulsive disorder; PAF =platelet-activating factor; PUFA = polyunsaturated fatty acids; SAMe = S-adenosylmethionine; SJW = St. John’swort; SRI = serotonin reuptake inhibitor; UV =ultraviolet; 5-HTP = 5-hydroxytryptophan.

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