了解针对成人抑郁症状评估的非处方草药产品、膳食补充剂和药物的研究现状：一项范围综述。

Understanding the research landscape of over-the-counter herbal products, dietary supplements, and medications evaluated for depressive symptoms in adults: a scoping review.

作者信息

Frost Rachael, Zamri Aiman, Mathew Silvy, Salame Adriana, Bhanu Cini, Bhamra Sukvinder K, Bazo-Alvarez Juan Carlos, Heinrich Michael, Walters Kate

机构信息

School of Public and Allied Health, Liverpool John Moores University, Liverpool, United Kingdom.

Department of Primary Care and Population Health, University College London, London, United Kingdom.

出版信息

Front Pharmacol. 2025 Jul 15;16:1609605. doi: 10.3389/fphar.2025.1609605. eCollection 2025.

DOI:10.3389/fphar.2025.1609605

PMID:40735481

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12303899/

Abstract

BACKGROUND

Over-the-counter (OTC) products such as herbal medical products (HMPs) or dietary supplements are a valued part of preventative and supportive self-care for depressive symptoms, but there is a wide array of products available, with differing levels of clinical evidence. It is unclear what the optimal directions for future research in this field are.

AIM

We aimed to explore the size and nature of the evidence base available for OTC products for depression in adults aged 18-60.

METHODS

We carried out a scoping review following Joanna Briggs Institute guidance. We searched MEDLINE, Embase, PsycINFO, AMED, and CENTRAL from inception to December 2022, and 10% of the results were screened by two authors and the remainder by one author. We included randomised controlled trials of products commonly available OTC in multiple countries in participants with symptoms or a diagnosis of depression. Results were narratively summarised by the product and volume of evidence available.

RESULTS

Out of 23,933 records found, we screened 1,367 full texts and included 209 trials. The largest volume of evidence was for omega-3s, St John's Wort, saffron, probiotics, and vitamin D. Among a range of herbal medical products with promising evidence, those most commonly used and thus warranting further research were lavender, lemon balm, chamomile, and Echium. For 41 products, we found only single trials. Few products presented safety issues, whether used alone or adjunctively with antidepressants.

CONCLUSION

Products with limited but promising evidence included folic acid, lavender, zinc, tryptophan, Rhodiola, and lemon balm, and future research should focus on these products. There is a need for further evaluation of herbal medical products as adjuncts to antidepressants and for exploring their potential benefits when used adjunctively with psychological therapies to support a more integrative approach. Safety reporting in these trials needs to be further improved.

SYSTEMATIC REVIEW REGISTRATION

https://osf.io/rkm57/.

摘要

背景

非处方（OTC）产品，如草药产品（HMPs）或膳食补充剂，是预防和辅助自我护理抑郁症状的重要组成部分，但市场上有大量此类产品，其临床证据水平各不相同。目前尚不清楚该领域未来研究的最佳方向是什么。

目的

我们旨在探索18至60岁成年人使用的治疗抑郁症的非处方产品的证据基础的规模和性质。

方法

我们按照乔安娜·布里格斯研究所的指导方针进行了一项范围综述。我们检索了MEDLINE、Embase、PsycINFO、AMED和CENTRAL数据库，检索时间从建库至2022年12月，10%的结果由两位作者筛选，其余结果由一位作者筛选。我们纳入了多个国家常见的非处方产品针对有抑郁症状或诊断为抑郁症的参与者的随机对照试验。结果按产品和可用证据量进行了叙述性总结。

结果

在检索到的23933条记录中，我们筛选了1367篇全文，纳入了209项试验。证据量最大的是ω-3脂肪酸、圣约翰草、藏红花、益生菌和维生素D。在一系列有前景证据的草药产品中，最常用且因此值得进一步研究的是薰衣草、柠檬香蜂草、洋甘菊和紫锥菊。对于41种产品，我们仅发现了单项试验。很少有产品出现安全问题，无论是单独使用还是与抗抑郁药联合使用。