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April 20, 2024
By Joie Meissner ND, BCB
The anti-anxiety benzodiazepines like Xanax (alprazolam) and Klonopin (clonazepam) are extremely sedating, can be addictive if used regularly and are associated with a number of serious health risks including potentially life-threatening withdrawal symptoms if abruptly discontinued.
Doctors routinely prescribe SSRIs pharmaceuticals like Zoloft and Lexapro for people with depression or anxiety. But there’s a major controversy surrounding the safety and efficacy of SSRIs. “Our results show that the harmful effects of SSRIs versus placebo for major depressive disorder seem to outweigh any potentially small beneficial effects,” concluded a 2017 systematic review of every available randomized clinical trial of six commonly prescribed SSRIs including unpublished trials in U.S. FDA and European Medicines Agency files.1
With all the risks associated with pharmaceuticals, it’s no wonder there’s a market for natural supplements for anxiety and depression.
What’s the Difference?
Just like drugs, some supplements can be beneficial and carry very little risk. Others may not carry much risk, but may not be that beneficial. And some carry a lot of risk for modest benefits. And then there’s everything in between.
A main difference between supplements and pharmaceutical drugs is that most of what we know about the vast majority of supplements comes from traditional use or research that was not reviewed by the U.S. Food and Drug Administration (FDA).
Once a dietary supplement is on the market, the FDA tracks side effects reported by consumers, supplement companies, and others. The FDA can take action against adulterated or misbranded dietary supplements only after the product is on the market.
Some dietary supplements have undergone very little study. While others have been studied quite a bit. In general, supplements tend not to be studied in certain populations and hence there is greater level of risk for certain people who may be considering taking supplements. These populations include pregnant or breastfeeding women, infants and children.
Combinations & Interactions
For people already taking medications or supplements, there’s risk in adding either another pharmaceutical drug or another supplement. They can interact with what is already being taken. Such interactions can be more frequent in older people or those with decreased kidney or liver function.
All medications, supplements, and even some foods like grapefruit can interfere with the metabolism of other drugs and supplements being taken, which may lead to serious side effects or reduce the efficacy of critically important meds such as chemotherapy or organ transplant rejection drugs. Even routine maintenance drugs like birth control pills, anti-diabetic or blood pressure meds can be thrown off if combined with certain pharmaceuticals or supplements.
Always talk to your prescribing physician and/or pharmacist. Some supplements are much less likely to interact than others, such as valerian root. Some are notorious for their potential to interact with medications, such as St. John’s wort.
Some supplements work best when combined with other supplements. The safety of plant -based medicines—when combined with other botanicals or supplements like vitamins—must be judged separately based on the safety data of each individual component of the combination, its dose and a patient’s specific medical situation. It’s important to consult a physician or pharmacist with training in herbal medicine and nutrients to know if a specific supplement or a combination of supplements are safe for you.
Another aspect to consider is that unlike most drugs, many supplements require other nutritional cofactors and healthy gut flora in order to work properly. As we will see, the sleep aid tryptophan is a great example of a supplement that can be ineffective when the the gut microbiota and dietary nutrients are inadequate.
Buyer Beware
Because supplements aren’t regulated, they don’t have to prove that what’s on the label is what’s in the bottle. And there are a number of manufacturers who have been caught selling supplements that contain none or too little of what is supposed to be in the bottle. Some have been found to contain harmful impurities.
But that doesn’t mean that all supplements are bogus. Some companies do third-party testing to ensure purity and potency. Reputable companies have strict quality-control standards, test raw materials, as well as batches of finished product for medicinal identity, purity, potency and consistency. They use standardization methods that allow one to know how much their products contain of the various constituents.
Some companies provide certificates of analysis (CoA) from third-party labs that test their products before they come to market. Some distributors even require CoAs. Thus, in a buyer-beware market, if you do your homework, you can obtain supplements from companies that offer high quality-control standards. Quality control comes at a price. That’s why buying a cheap supplement isn’t always a bargain.
In our pill-based culture, we often forget that treatments that don’t use tablets or capsules can be more effective than those that do. For example, Cognitive Behavioral Therapy is more effective for anxiety and depression than any drug or supplement you can buy.
Supplements Commonly Taken for Anxiety and Depression:
- Cannabis (Cannabinoids & CBD)
- Kava kava root (Piper methysticum)
- St. John’s wort (Hypericum perforatum)
- Valerian root (Valeriana officinalis)
- 5-HTP (5-hydroxytryptophan)
- Tryptophan (L-Tryptophan)
Information on this website is not a substitute for medical advice. Always consult a qualified healthcare provider for medical advice.
Links to Info on Supplements Commonly Taken for Anxiety & Depression:
Cannabis:
Tryptophan:
5-HTP (5-Hydroxytryptophan):
St. John’s Wort:
Valerian Root:
Kava:
Care informed by the understanding that emotional and physical wellbeing are deeply connected
To learn more about how Mood Change Medicine helps people with anxiety and depression, click links below:
Citation
- Jacobsen, J.C., Katakam, K.K., Schou, A. et al. “Selective serotonin reuptake inhibitors versus placebo in patients with major depressive disorder. A systematic review with meta-analysis and Trial Sequential Analysis.” BMC Psychiatry. 17, 58 (2017). doi.org/10.1186/s12888-016-1173-2 ↩︎
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