Tuesday, August 4, 2020

High-Dose Vitamin D Supplements Do Not Prevent Depression in Older Adults, Study Finds

Long-term use of a high-dose daily vitamin D3 supplement does not appear to be any more effective than placebo at preventing depression in adults aged 50 years or older, according to a study appearing today in JAMA.

Although observational studies have suggested individuals with lower levels of vitamin D may be at higher risk of late-life depression, “the findings do not support a role for supplemental vitamin D3 in depression prevention among adults,” wrote Olivia I. Okereke, M.D., S.M., of Massachusetts General Hospital and colleagues.  

Okereke and colleagues analyzed data collected from a subset of adults who were participants in the Vitamin D and Omega-3 Trial (VITAL)—a randomized clinical trial examining the effects of vitamin D3 and fish oil supplements on the prevention of cancer and cardiovascular disease in 25,871 adults in the United States. Participants were excluded from the current study (called Vitamin D and Omega-3 Trial-Depression Endpoint Prevention, or VITAL-DEP) if they had clinically relevant depressive symptoms, defined as an eight-item Patient Health Questionnaire (PHQ-8) score of ≥10; had core features of depression for two or more weeks within the past two years; were currently receiving treatment for depression; had alcohol or substance use disorder within the past year; or had schizophrenia or psychotic disorder, bipolar disorder, or another major psychiatric or neurological condition.

In total, the VITAL-DEP study included 18,353 middle aged and older adults (mean age 67.5 years) without depression at baseline who were randomly assigned to take either vitamin D3 (2,000 IU/d of cholecalciferol) or placebo daily for the duration of the trial (median 5.3 years). 

Each year the participants were mailed questionnaires that asked for updates on major illnesses or adverse events, health and lifestyle factors, and study adherence. The PHQ-8 was included in six annual questionnaire forms. Okereke and colleagues specifically focused on the participants’ reports of receiving a depression diagnosis, new treatment (medication, counseling, or both) for depression, or presence of clinically relevant depressive symptoms (PHQ-8 score ≥10 points). The participants were followed up until the occurrence of depression or clinically relevant depressive symptoms, death, or the end of the trial, whichever came first.

There were no significant differences between groups in risk of depression or clinically relevant depressive symptoms (609 cases of depression or clinically relevant depressive symptoms in vitamin D3 group; 625 in the placebo group), the authors reported. Additionally, there was no significant difference between treatment groups for change in mood scores over time (average PHQ-8 scores rose by 0.20 points in the vitamin D3 group and 0.16 points in the placebo group).

More information on nutritional supplements appears in the book The APA Publishing Textbook of Psychiatry, Seventh Edition in the chapter “Complementary and Integrative Psychiatry.”

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