title: Adjuvant thiamine improved standard treatment in patients with major depressive disorder: results from a randomized, double-blind, and placebo-controlled clinical trial.
abstract: Given that antidepressants (ADs) work slowly, there is interest in means to accelerate their therapeutic effect and to reduce side effects. In this regard, thiamine (vitamin B1) is attracting growing interest. Thiamine is an essential nutrient, while thiamine deficiency leads to a broad variety of disorders including irritability and symptoms of depression. Here, we tested the hypothesis that adjuvant thiamine would reduce depression, compared to placebo. A total of 51 inpatients (mean age: 35.2 years; 53 % females) with MDD (Hamilton Depression Rating Scale score (HDRS) at baseline: >24) took part in the study. A standardized treatment with SSRI was introduced and kept at therapeutic levels throughout the study. Patients were randomly assigned either to the thiamine or the placebo condition. Experts rated (HDRS) symptoms of depression at baseline, and after 3, 6, and 12 weeks (end of the study). Between baseline and the end of the study, depression had reduced in both groups. Compared to placebo, adjuvant thiamine improved symptoms of depression after 6 week of treatment, and improvements remained fairly stable until the end of the study, though mean differences at week 12 were not statistically significant anymore. No adverse side effects were reported in either group. Results suggest that among younger patients with MDD adjuvant thiamine alleviated symptoms of depression faster compared to placebo. Importantly, improvements were observed within 6 weeks of initiation of treatment. Thus, thiamine might have the potential to counteract the time lag in the antidepressant effects of ADs.
authors.affiliation: Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Ghaleiha
authors.affiliation: Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Davari
authors.affiliation: Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Jahangard
authors.affiliation: Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Haghighi
authors.affiliation: Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medial Sciences, Hamadan, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ahmadpanah
authors.affiliation: Department of Social Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Seifrabie
authors.affiliation: Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hafez
authors.initials: H
authors.lastname: Bajoghli
authors.affiliation: Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, University of Basel, 4012, Basel, Switzerland.
authors.forename: Edith
authors.initials: E
authors.lastname: Holsboer-Trachsler
authors.affiliation: Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, University of Basel, 4012, Basel, Switzerland. serge.brand@upkbs.ch.|Department of Sport, Exercise, and Health; Sport Science Section, University of Basel, Basel, Switzerland. serge.brand@upkbs.ch.
authors.forename: Serge
authors.identifier: http://orcid.org/0000-0003-2175-2765
authors.initials: S
authors.lastname: Brand
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013831:Thiamine / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014803:Vitamin B Complex / Q000627:therapeutic use*
chemical_list: D000928:Antidepressive Agents; D014803:Vitamin B Complex; D013831:Thiamine
keywords: Major depressive episode; Mood; Randomized clinical trial; Thiamine