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Natural Supplements That Work

Alternative Medicines for Improving Mental Health

Even the best available medical treatments don’t work for everyone. Roughly four in 10 Americans in a given year—and as many as half of those with psychiatric disorders—use herbal supplements and other types of complementary or alternative medicines (often called “CAM”) as another source of relief.

The following is a quick review of safe—and often effective—natural therapies used for a variety of mental health problems from the Massachusetts General Hospital (MGH) Department of Psychiatry.

Folic Acid
(Depression)
SAMe
(Depression)
Ginkgo
Biloba
Valerian
(Anxiety
& Sleep)
Omega-3
Fatty Acids
(Depression)
St. John's
Wort
(Depression)
Melatonin
(Sleep)

Folic Acid

What it is	Folic acid is a synthetic form of folate, a B vitamin found in green leafy vegetables, citrus fruits, beans, and fortified breads and cereals. It is available as a vitamin supplement or as a prescription medication (leucovorin or L-methylfolate).
What it’s for	Depression.
Who may benefit	When combined with an antidepressant, folic acid supplements can boost symptom relief — especially in women.
How much to take	Federal guidelines recommend 400 micrograms (mcg) per day of folic acid for adults. This is the amount in a standard multiple vitamin. Some research suggests that women of childbearing age should take 800 mcg per day. This amount can be achieved through a healthy diet and a daily multivitamin. The usual dosage of L-methylfolate is 15 milligrams (mg) per day when combined with antidepressants.
Words to the wise	Folic acid supplements won’t work as a stand-alone treatment for depression. Do not take more than the safe upper limit of 1,000 mcg of folic acid per day.

SAMe

What it is	S-adenosyl-L-methionine (SAMe) is a substance made naturally in the body that boosts production of several neurotransmitters – chemical messengers in the brain --involved in regulation of mood.
What it’s for	Depression.
Who may benefit	Used on its own, SAMe works as well as older tricyclic antidepressants (TCAs). As an add-on treatment, it can boost the effectiveness of a selective serotonin reuptake inhibitor (SSRI) or a selective serotonin and norepinephrine reuptake inhibitor (SNRI).
How much to take	Adults may benefit from 400 to 1,600 mg per day, although some people will need to take 3,000 mg per day to alleviate symptoms.
Words to the wise	Combining SAMe with an antidepressant is safe, for the most part, but in very rare cases may cause serotonin syndrome — a potentially deadly complication that causes agitation, anxiety, confusion, nausea, vomiting, and palpitations. SAMe can also trigger mania in people with bipolar disorder.

Ginkgo Biloba

What it is	This herbal supplement is derived from leaves of the ginkgo tree.
What it’s for	Alzheimer’s disease and antidepressant-related sexual problems.
Who may benefit	Taken alone, ginkgo biloba is modestly effective at slowing cognitive decline in people with Alzheimer’s disease — similar in impact to taking a cholinesterase inhibitor, but better tolerated. As an add-on therapy, ginkgo biloba can boost the effectiveness of cholinesterase inhibitors. Antidepressants can cause sexual side effects in some people. Ginkgo biloba may help to alleviate antidepressant-induced sexual problems.
How much to take	Aim for 120 to 240 mg per day.
Words to the wise	Don’t expect fast results from Ginkgo biloba. It takes at least eight weeks, and perhaps as much as one year, to notice any cognitive benefit. This supplement does not work as well for people with vascular dementia (the type associated with heart disease). Stressed-out baby boomers and other people without dementia do not get a clear cognitive boost from this supplement.

Valerian

What it is	This herb is derived form the root of a pink flower, Valeriana officinalis.
What it’s for	Anxiety and sleep problems.
Who may benefit	Valerian may be an option for older adults, as it does not cause as many memory and thinking problems as benzodiazepines (sedative medications) do. Valerian may also help children who have problems falling asleep and may reduce anxiety and improve sleep in children with attention deficit hyperactivity disorder (ADHD).
How much to take	Adults can take 450 to 600 mg per day. Check with a doctor about dosing for children.
Words to the wise	Valerian often causes headaches and upset stomach. It is not clear whether this herb is safe to use during pregnancy, as it has not been studied for this use. Valerian takes a while to work, so it is not a quick fix for insomnia.

Omega-3 Fatty Acids

What it is	These naturally occurring fatty acids are most abundant in cold-water fish such as salmon, sardines, and anchovies. People who can’t eat fish can also obtain them in fish oil capsules. Look for supplements that contain both EPA and DHA.
What it’s for	Bipolar depression and major depression.
Who may benefit	Omega-3 supplements may boost the effectiveness of antidepressants. These supplements may provide a stand-alone treatment option for people concerned about side effects of antidepressants, such as older adults, people with multiple medical conditions, and women who are pregnant or breast-feeding. In people with bipolar disorder, omega-3 fats may be helpful for treating depression, but can trigger mania, so it’s important to take these supplements along with a mood stabilizer.
How much to take	Like the American Heart Association (which recommends omega-3 fats as a good way to protect against heart disease), the American Psychiatric Association recommends that all adults consume fish at least twice a week. Individuals with mood, impulse control, or psychotic disorders should take a daily 1- to 2-gram supplement containing both EPA and DHA.
Words to the wise	Additional omega-3 fatty acid supplements may be helpful for people with depression, but don’t exceed 3 grams per day, as this increases risk of gastrointestinal bleeding and stomach upset.

St. John's Wort

What it is	This herbal supplement is produced from an extract of the plant Hypericum perforatum.
What it’s for	Depression.
Who may benefit	Used on its own, St. John’s wort may help people with mild or moderate symptoms of depression, but is unlikely to help those with severe symptoms. St. John’s wort may also be an alternative to medication for children and adolescents.
How much to take	Adults can take 900 to 1,800 mg in a 24-hour period, ideally by taking two or three capsules over the course of a day.
Words to the wise	St. John’s wort can reduce the effectiveness of many drugs, so check with your doctor before using it. Do not take with an antidepressant, as the combination can cause serotonin syndrome — a rare but potentially deadly complication that causes agitation, anxiety, confusion, nausea, vomiting, and palpitations.

Melatonin

What it is	This naturally occurring substance regulates circadian rhythms in the body, such as the sleep/wake cycle.
What it’s for	Sleep problems.
Who may benefit	Melatonin improves sleep quality in people with schizophrenia, major depression, and seasonal affective disorder. This supplement may be an alternative to drugs, especially for children and the elderly.
How much to take	Dosages of 0.25 to 0.3 mg per day can improve sleep.
Words to the wise	Begin with low doses of Melatonin, as taking too much can cause daytime sleepiness or confusion. Read product labels, as some preparations contain as much as 5 mg of melatonin per pill.

Things to consider

Although herbal treatments can be a serious option, be careful not to assume that a treatment is safer or more effective just because it is labeled "natural" or "herbal."

These substances are considered non-prescription, dietary supplements, meaning the manufacturer doesn’t have to prove that they are effective for any specific illness. (Prescription and over-the-counter drugs do have to prove this.) While this makes them easier to obtain, the trade off is, your doctor has less evidence to guide you on important issues such as:

How effective they are
What doses are best
What side effects they have
How they interact with other medications you might be taking

Be sure to discuss any herbal or dietary supplements with your doctor before you begin taking them. Even if your doctor has limited knowledge about herbal treatments, he or she can likely give you advice about major benefits and risks, and will be able to connect you with trusted information to help you make a safe treatment decision.

Adapted with permission from the Harvard Mental Health Letter: October 2011, published by Harvard Health Publications.

©Helpguide.org. All rights reserved. This reprint is for information only and NOT a substitute for professional diagnosis and treatment. Helpguide.org is an ad-free non-profit resource for supporting better mental health and lifestyle choices for adults and children.

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