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Medscape
2 days ago
- Health
- Medscape
Most Promising OTC Products for Depression Flagged
Among over-the-counter (OTC) products for depression, St. John's wort, saffron, probiotics, and vitamin D have the strongest evidence of efficacy, new research showed. However, folic acid and lavender also show promise and should be prioritized in future research, the investigators noted. Rachael Frost, PhD As more patients turn to OTC products to manage depressive symptoms, it's important to answer questions about the state of the related research, study investigator Rachael Frost, PhD, Senior Lecturer in Health and Social Care, School of Public and Allied Health, Liverpool John Moores University, Liverpool, England, who is herbal practitioner, told Medscape Medical News . Frost said her team aimed to map the current evidence base for OTC products for depression — asking whether research has focused too narrowly on a few supplements, whether other promising options are being overlooked, and how future studies and consumer guidance could be better directed. The findings were published online on July 15 in Frontiers in Pharmacology . Mapping the Research The prevalence of major depressive disorder (MDD) ranges from 2% to 21%, depending on the country and the measures used, and rates continue to rise — prompting some experts to describe depression as a growing epidemic. Many patients are reluctant to take antidepressants and face long wait times for psychological therapies, said Frost. 'There's a strong drive for people to self-manage, particularly if they have mild or moderate symptoms of depression,' she noted. Part of a larger project summarizing existing evidence on OTC products — including herbal medicinal products (HMPs), vitamins and minerals, and homeopathic preparations — for depression, anxiety, and insomnia, the goal of the current review was to 'map' the full research landscape on OTC products for depression in adults aged 18-60 and identify gaps where further study is needed, said Frost. The review included 209 trials assessing 64 different products. Most studies were conducted in Iran, followed by Germany, the US, Australia, the UK, and China. Double-blind designs were the most common. Sample sizes varied widely, with a median of 62 participants per study. All trials used depression rating scales as either primary or secondary outcomes. The most frequently used were the Hamilton Depression Rating Scale, the Montgomery-Aberg Depression Rating Scale, and the Clinical Global Impression Scale. Dietary supplements were evaluated in 114 trials, HMPs in 94 trials, and one trial — outside these categories — investigated aspirin. Evidence Gaps In the HMP category, most studies focused on products in capsule form. Frost found this somewhat surprising given the popularity, affordability, and ease of incorporating herbal teas into daily life. She suggested the lack of research on teas may be due to practical challenges — such as the difficulty of creating a placebo tea for controlled trials. Notably, none of the studies evaluated homeopathic products for depression. 'Homeopathic trials just focused on well–being, rather than looking at people who had symptoms or a diagnosis of depression,'saidFrost. Few studies examined multivitamins, which can be challenging to evaluate due to varying combinations of vitamins, minerals, and sometimes added herbal extracts or probiotics, Frost explained. Dietary supplements were more often compared to placebo (86%) than HMPs (67%), whereas HMPs were more frequently compared to prescription drugs (32%) than dietary supplements (5%). Additionally, supplements were more likely to be tested as adjuncts to other depression treatments, most commonly antidepressants — compared to HMPs. Very few studies evaluated OTC products vs psychotherapy. This, said Frost, is despite psychological therapies being 'quite popular' and often a first–line treatment for depression. 'Whether psychological therapies are better than OTC products or if there would be additive effects if people take both at the same time, is a question that needs answering,' she said. Products With Potential Products supported by evidence from more than 10 trials included St. John's wort, saffron, probiotics, and vitamin D. Within these categories, a variety of products, extracts, and dosages were tested. Most studies on St. John's wort favored its use compared with placebo and showed effects comparable to or better than prescription antidepressants. While the evidence for St. John's wort is strong, caution is advised due to potential interactions with antidepressants, contraceptive pills, and other medications, said Frost. Saffron products also showed generally positive effects compared with placebo. When evaluated alongside antidepressants, saffron demonstrated similar benefits and could be a promising new option to recommend, said Frost. Results for both probiotics and vitamin D favored the intervention compared with placebo. 'Given that probiotics and vitamin D also might provide benefits for things like the gut, bone health, and immunity, they are probably worth recommending,' Frost noted. Potential mechanisms by which these OTC products may alleviate depressive symptoms include reducing inflammation, mitigating oxidative stress, modulating the microbiota-gut-brain axis, suppressing hyperactivity of the hypothalamic-pituitary-adrenal axis, and regulating neurotransmitter activity. The review included several trials on omega-3 supplements, most comparing them to placebo. Frost noted that these studies were more likely to report null findings, indicating that omega-3 may not be a strong recommendation for depression. Among products with emerging evidence (two to nine trials), the review identified folic acid, lavender, zinc, tryptophan, rhodiola, and lemon balm as the most promising. Bitter orange, Persian lavender (Nepeta menthoides), and chamomile each showed positive results in two trials. These promising products, Frost said, warrant further evaluation to better understand their potential benefits. While some emerging OTC products show promise, Frost cautions that their effectiveness is not guaranteed. She stresses the importance of doctors having open, honest discussions with patients to ensure any supplements do not interfere with existing health conditions or medications. The study on aspirin showed no evidence of efficacy for depression. Many trials lacked sufficient safety data; however, among those that reported safety outcomes, most products demonstrated a favorable safety profile, Frost noted. Experts Weigh In Commenting on the research for Medscape Medical News , Jonathan Burgess, MD, clinical assistant professor at Lifestyle Psychiatry Clinic, Stanford University, in Stanford, California, said the review gives him 'quite a bit of homework,' as he plans to examine several of the original studies. However, he pointed out that the review did not differentiate between eicosapentaenoic acid (EPA)-predominant and docosahexaenoic acid-predominant omega-3 formulations. Contrary to the review's suggestion that omega-3s are ineffective for depression, Burgess noted that multiple meta-analyses have shown that EPA-predominant formulas are convincingly effective for depression. He said that beyond advising a healthy diet, regular exercise, and good sleep hygiene, EPA-predominant omega-3s, St. John's wort, saffron, and probiotics are his 'go-to's' for patients with depression who want to try OTC treatments. Burgess agreed that lavender and folate show considerable promise but cautioned that, like any effective treatment, they can have side effects. He cited cases where patients overused lavender and experienced suicidal thoughts, warned that excessive zinc intake can disrupt copper balance, and highlighted the risk of serotonin syndrome—a potentially life-threatening condition — in patients taking tryptophan alongside St. John's wort. Also commenting for Medscape Medical News was David Mischoulon, MD, PhD, director of the Depression Clinical and Research Program at Massachusetts General Hospital and professor of Psychiatry at Harvard Medical School, both in Boston, who has extensively researched natural remedies. He said the review offers a useful snapshot of the current state of the field and aligns with his overall understanding of the evidence base. However, he questioned why the review included so few studies on S-adenosyl-methionine (SAMe), a compound involved in the synthesis of neurotransmitters such as serotonin, dopamine, and norepinephrine. The review cited only two parallel randomized controlled trials on SAMe, one of which he coauthored. 'I'm surprised because it's one of the better studied natural products. The review seems to underestimate how much has been done with regard to that particular product,' said Mischoulon. Mischoulon said he is 'a lot more comfortable' recommending SAMe for patients with depression than many other OTC products, largely due to its strong safety profile. Aside from occasional nausea or indigestion at higher doses, SAMe is generally well tolerated. Unlike St. John's wort — which can interact with immunosuppressants, antiretrovirals, cancer therapies, antidepressants, and hormonal contraceptives — SAMe does not interact with other medications, he noted. In addition to SAMe, Mischoulon also considers omega-3 supplements a viable OTC option for depression. However, he emphasized the importance of directing future research toward emerging products. He noted that well-studied options like St. John's wort and omega-3s have already been thoroughly reviewed and suggested that greater attention should be given to lesser-known supplements such as lavender and folic acid.
BBC News
10-07-2025
- Health
- BBC News
'Double weapon' found in chemotherapy hair loss laboratory research
Scientists say they have discovered a "powerful double weapon" in efforts to prevent cancer patients losing hair during method combines scalp cooling, where a patient wears a cold cap, with a lotion containing antioxidants to help limit the damage caused by cancer drug side Sheffield Hallam University study also suggests the most effective scalp temperature for keeping hair, with cooling to 18C preventing follicle damage for some. Those behind the project now hope the laboratory research will soon be trialled on cancer patients. The technique works by restricting blood flow to the scalp, which reduces the amount of medication reaching hair found that when combined with cooling, the use of topical antioxidants could "transform the ability of cooling to protect" against hair Nik Georgopoulos, associate professor of cell biology at Sheffield Hallam, described hair loss as "the face of cancer"."People get hair loss because at the base of the hair follicles are rapidly-dividing cells that are actually feeling the toxicity of chemotherapy drugs," he explained."Chemotherapy drugs kill rapidly-dividing cancer cells, but they cannot discriminate between cancer cells and rapidly-dividing normal cells in the body."In the study, published in Frontiers in Pharmacology, hair follicles were isolated from the scalp and grown in the lab before being treated with Georgopoulos said the team found cooling the cells can help protect them from damage. Explaining why cooling worked for some patients but not others, he added: "Some heads, I call them stubborn, they don't cool enough."But adding the topical antioxidant formed a "powerful double weapon" based on lab results, researchers are now said to be finalising the antioxidants used in the topical added: "Our ongoing work will ensure that efficacy is as high as possible with the belief that a topical agent will not only dramatically enhance the efficacy of scalp cooling, but also significantly accelerates hair recovery post chemotherapy." Listen to highlights from South Yorkshire on BBC Sounds, catch up with the latest episode of Look North
Yahoo
10-07-2025
- Health
- Yahoo
Scientists May Have Accidentally Found a Way to Reverse Hair Loss Without Drugs
Here's what you'll learn when you read this story: New research suggests the cure to male pattern baldness might be sugar. The team simulated testosterone-based balding in mice and treated them with deoxyribose sugar, which stimulated blood vessel formation and ultimately caused hair regrowth. Researchers say that the sugar treatment is just as effective as minoxidil (the active ingredient in Rogaine), a hair loss treatment currently on the market. Hereditary-patterned baldness affects roughly 40 percent of people—and no, it's not exclusive to men, despite the fact that the condition is more commonly referred to as male pattern baldness. While the average person loses about 100 hairs a day, individuals suffering from hereditary-patterned baldness lose even more (sometimes entire chunks at a time), and that hair loss typically begins in someone's 20s or 30s, though the condition often expresses itself after menopause in women. Perhaps most shockingly, the idea that the baldness gene comes from the mother's side is actually false—hereditary-patterned baldness is dependent on genetic factors from both parents. Infomercial channels are riddled with the next-best hair-loss solution, but those toupees, ointments, and hair plugs might soon be unnecessary. According to a new study published in Frontiers in Pharmacology, the cure for hereditary-patterned baldness might be... sugar? Well, one specific type of sugar, known as deoxyribose sugar. Our bodies naturally produce the substance, and it plays a key role in DNA stability and replication. Along with phosphate groups, deoxyribose makes up the backbone of DNA (deoxyribose nucleic acid). When the double helix unwinds during replication, deoxyribose provides the structure for our biological machinery to copy the genetic code. And on top of being a building block of life, the sugar could apparently be the cure for hair loss. 'Male pattern baldness is such a common condition, affecting men all over the world, but at the moment there are only two FDA licensed drugs to treat it,' Sheila MacNeil, an author of the paper, said in a press release. 'Our research suggests that the answer to treating hair loss might be as simple as using a naturally occurring [deoxyribose] sugar to boost the blood supply to the hair follicles to encourage hair growth.' Interestingly, the 8-year-long study didn't start as an attempt to cure hair loss. The team was originally studying mice to understand if and how sugar could help heal wounds by encouraging new blood vessels to form. But in the process, the researchers noticed that the hair around the wounds was growing back faster in mice that had been treated with the sugar than those who hadn't. To further investigate, the team simulated testosterone-based hair loss—a common cause of hair loss in men—on unwounded mice, and found that small doses of the sugar again encouraged blood vessel formation that stimulated hair growth. According to the press release, the sugar treatment is just as effective as minoxidil, which is one of the most well-known topical hair loss treatments on the market (it's the active ingredient in Rogaine). Currently, minoxidil products retail for around $30 to $40—a price that begins to feel steep when you're applying the product twice daily for months. Muhammed Yar, another author of the paper, said in the press release that the naturally occurring sugar is inexpensive and stable. Even better, Yar explained that the sugar is deliverable in several forms, making it an 'attractive candidate' for further research. MacNeil states that despite the excitement surrounding this discovery, there's still much more work to be completed. 'The research we have done is very much early stage, but the results are promising and warrant further investigation,' MacNeil said in the release. 'This could offer another approach to treating this condition, which can affect men's self-image and confidence.' Get the Issue Get the Issue Get the Issue Get the Issue Get the Issue Get the Issue Get the IssueGet the Issue Get the Issue You Might Also Like The Do's and Don'ts of Using Painter's Tape The Best Portable BBQ Grills for Cooking Anywhere Can a Smart Watch Prolong Your Life?
