Certain places intimidate the heck out of me, like the supplement aisle at any health food store. Whoa.

I just wish I had some Harvard expert telling me whether Omega-3s, St. John’s Word, SAM3 and folate would help my depression.

Voila! Next thing I know I’m at a fundraiser for psychiatric research at Harvard and Massachusetts General Hospital  in this oceanfront mansion in Palm Beach, (also very intimidating) listening to Dr. Marlene P. Freeman, an associate professor at Harvard Medical School and expert in Complementary and Alternative Medicine.

Lord knows I wasn’t there as a philanthropist. I’m a journalist – I used my last buck to tip the valet. But every year Michelle and Howard Kessler, who own the intimating, oceanfront mansion, invite me to their fundraiser because they believe – regardless of how much money you have or do not have – “no family goes untouched.”

Since these are the heavy hitters in the world of philanthropy, Mass General brings in its best researchers – like Dr. Freeman.  Among all of Dr. Freeman’s titles, positions and research, she chaired the American Psychiatric Association’s Task Force on Complementary and Alternative Medicine (CAM) – which focused on the potential benefits of Omega-3 fatty acids, St. John’s Wort, SAMe, folate, light therapy, acupuncture, exercise and mindfulness based psychotherapies in treating psychiatric disorders.

First of all, it’s pretty cool that the APA is taking CAM so seriously. Second, this whole event could not have happened at a better time because I am about to run out of my Omega-3 supplement and was wondering whether it was worth investing in some more.

And the answer is…yes.

According to Dr. Freeman’s presentation, meta-analysis of Omega-3 fatty acids, studied as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA but not the plant source alpha-linolenic acid) show benefit over placebo for unipolar and bipolar depression. Meta-analysis pools together the results of all available clinical trials because the size of individual clinical trials is too small to reliably draw a conclusion.

What does this mean? It means that Omega-3 fatty acids are important to neurocognitive development. It means that adults should consume fish, which is high in Omega-3 fatty acids at least twice a week. Dr. Freeman also recommends that patients with mood, impulse-control or psychotic disorders should consume 1 g of EPA + DHA daily. In addition, supplements may be useful in patients with mood disorders between 1-9 g per day but doses greater than 3 g per day should be monitored by a physician.

And now, a word about B vitamins and Omega-3 fatty acids. Vitamin B6 negates the effects of Omega-3s, Dr. Freeman said, who also recommended against taking B vitamins 3, 6 and 9.

As for the other complementary and alternative medicines:

• Studies of St. John’s Wort have not been positive, Dr. Freeman said. However, there have been some favorable results in randomized controlled trials of major-depressive disorders, especially in mild to moderate major-depressive disorder. A major concern with St. John’s Wort is that it can have significant and potentially dangerous interactions with other drugs, Dr. Freeman said.

• People with treatment resistant major depression saw significant benefits from SAMe and the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services has found enough evidence to support further research.

• Folate has been shown to boost the response of SSRIs, such as Prozac, especially in women
• Bright light therapy has shown significant benefit in treating Seasonal Affective Disorder but can also “rev-up the risk of mania,” Dr. Freeman said.
• Systematic reviews and meta-analysis of acupuncture have “failed to demonstrate consistently positive results over control conditions.” While the pool of evidence is limited because of flawed methodology, there is “very inconclusive evidence at this time for efficacy,” Dr. Freeman said.
• Finally, my favorite, exercise: “Epidemiological studies support benefits for decreased risk of depression.” In other words, just do it.

The best news of all – at least for me – is that Dr. Freeman believes we “desperately need research in Complementary and Alternative Medicine.” Amen.

So, let us walk down the supplement aisle with confidence! Let us eat fish and get off the couch and exercise! Let us take Dr. Freeman’s advice and most of all, let us be happy!

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    Last reviewed: 28 Feb 2012