TABLE 1.
Data summary of experimental trials assessing polyphenols in depressed participants1
| Author | Year | Country | Study design | Intervention | Subjects | Depression scale | Other measurements | Results |
|---|---|---|---|---|---|---|---|---|
| Sathyapalan et al. (22) | 2010 | England | Randomized placebo-controlled trial. Duration: 8 wk of the initial intervention followed by a 2-wk washout period followed by 8 wk of the crossover intervention. | 1: Polyphenol-rich chocolate with 85% cocoa solids. 2: Placebo chocolate. | 10 subjects (n = 6 women; n = 4 men). Condition: chronic fatigue. | HADS | Chalder fatigue scale and London handicap scale | Depression scores improved after the high-polyphenol chocolate but deteriorated after the placebo chocolate. Cocoa group HADS median scores: baseline = 10, conclusion = 5.5. Placebo: baseline = 6, conclusion = 12. However, the results were nonsignificant: Wilcoxon's signed rank sum test Z value: −2.68 (SD: 0.01). |
| Bergman et al. (23) | 2013 | Israel | Randomized, double-blinded, placebo-controlled, pilot clinical trial. Duration: 5 wk. | 1: 500 mg curcumin/d plus antidepressant. 2: Placebo plus antidepressant. | 40 subjects (n = 23 women; n = 17 men) | HAM-D and MADRS | Global Impression Severity Scale | Both groups had a significant improvement in depressive symptoms. MADRS score for the curcumin group 95% CI: 7.2, 13.7; P ≤ 0.001 and placebo group 95% CI: 2.1, 8.5; P ≤ 0.01. Although no significant differences were observed between the intervention and placebo, the curcumin group displayed a more rapid improvement in symptoms than the placebo. Curcumin group MADRS mean scores: baseline = 34.4, conclusion = 14.0. Placebo: baseline = 32.8, conclusion = 15.4. |
| Nina Estrella et al. (24) | 2014 | Dominican Republic | Pilot randomized clinical study. Duration: 3-mo with 4 intervention arms. | 1: 10 mg fluoxetine /d. 2: 100 mg soy isoflavones concentrate/d. 3: 50 mg sertraline/d. 4: 100 mg soy/d and 50 mg sertraline/d. | 40 women aged 45–55 y. Condition: menopausal depressive. | ZSDS. HAM-D | Not reported | ANOVA for both ZSDS and HAM-D showed statistically significant differences between groups (F = 24.06, P ≤ 0.0001 and (F = 31.73, P ≤ 0.0001, respectively). Soybean has an antidepressant effect and may increase the effects of antidepressants. |
| Atteritano et al. (25) | 2014 | Italy | Double-blinded RCT. Duration: 2 y. | 1: Isoflavone genistein (45 mg/d). 2: Placebo. | 262 women. Condition: osteopenic postmenopausal. | ZSDS | HRQL assessed via Italian version of Short Form-36 | The genistein group saw a decrease in depression scores after 1 and 2 y. The difference between groups was statistically significant (P ≤ 0.01 vs. placebo). Genistein group ZSDS mean scores: baseline = 41, conclusion = 36. Placebo: baseline = 41, conclusion = 43. |
| Lopresti et al. (26) | 2014 | Australia | Randomized double-blinded, placebo-controlled trial. Duration: 8 wk. | 1: 500 mg curcumin twice daily. 2: Placebo. | 56 subjects (n = 40 women; n = 16 men) | IDS-SR 30 | Spielberger State-Trait Anxiety Inventory | From week 4 to week 8 the curcumin group demonstrated significantly more efficacy than placebo. IDS-SR total score: F1,53 = 4.22, P = 0.045; and mood score: F1,53 = 6.51, P = 0.014. Curcumin group IDS-SR total mean scores: baseline = 33, conclusion = 22.7. Placebo: baseline = 33, conclusion = 25.8. |
| Sanmukhani et al. (27) | 2014 | India | Double-blinded RCT. Duration: 6 wk. | 1: 20 mg fluoxetine/d. 2: 1000 mg curcumin/d (500 mg twice daily). 3: 20 mg fluoxetine/d plus 1000 mg curcumin/d (500 mg twice daily). | 40 subjects (n = 24 women; n = 16 men) | HAM-D17 | Clinical Global Impression—severity of illness scale | A greater response was observed in the combined fluoxetine and curcumin group (77.8%) than in the fluoxetine group (64.7%) and the curcumin group (62.5%). However, the differences between groups were statistically nonsignificant (P = 0.58). Group 1 HAM-D mean scores: baseline = 21, change from baseline at conclusion = −13.6. Group 2 baseline = 19.3, change at conclusion = −13.3. Group 3 baseline = 21.9, change at conclusion = −14.6. |
| Esmaily et al. (28) | 2015 | Iran | Double-blind, crossover, placebo-controlled RCT. Duration: 4 wk with a 2-wk washout between groups. | 1: 1 g curcumin/d. 2: Placebo. | 30 subjects (n = 24 women; n = 6 men). Condition: obese. | BDI | Beck Anxiety Inventory | No significant differences in BDI scores were observed for the curcumin group (P ≥ 0.05). |
| Panahi et al. (29) | 2015 | Iran | Open-label RCT. Duration: 6 wk. | 1: Standard antidepressant therapy. 2: Standard antidepressant therapy plus 1000 mg curcuminoids/d and 10 mg piperine/d. | 111 subjects (n = 60 women; n = 51 men) | HADS and BDI | Not reported | Significantly reduced HADS and BDI scores in the curcumin group compared with the control group. HADS score, P ≤ 0.001; BDI score, P ≤ 0.001. Curcuminoids group BDI mean scores: baseline = 38.66, conclusion = 29.66. Placebo: baseline = 40.44, conclusion = 37.60. Curcuminoids group HADS mean scores: baseline = 42.59, conclusion = 30.90. Placebo: baseline = 38.82, conclusion = 36.10. |
| Yu et al. (30) | 2015 | China | Double-blinded, placebo-controlled, pilot RCT. Duration: 6 wk. | 1: 1000 mg curcumin/d. 2: Placebo soybean powder. | 108 male subjects | Chinese version of the 17-item HAM-D and MADRS | Blood pathology: plasma cytokines IL-1β, TNF-α, and BDNF | Significant reduction in depressive symptoms in the curcumin group for both the HAM-D and MADRS (P ≤ 0.05). Significant reduction in cytokines IL-1β, TNF-α, and BDNF for the curcumin group (P ≤ 0.001). Curcumin group HAM-D mean scores: baseline = 14.06, change from baseline at conclusion = 4.52. Placebo: baseline = 14.28, change from baseline at conclusion = 3.30. Curcumin group MADRS mean scores: baseline = 18.22, change from baseline at conclusion = 6.26. Placebo: baseline = 18.68, change from baseline at conclusion = 4.52. |
| Ibero-Baraibar et al. (31) | 2016 | Spain | Double-blinded, randomized, placebo-controlled trial. Duration: 4 wk. | 1: 15% energy-restriction diet plus 1.4 g cocoa extract twice daily (645 mg total polyphenols). 2: 15% energy-restriction diet only. | 50 subjects (n = 27 women; n = 23 men). Condition: overweight or obese adults. | Spanish translation of the BDI | 3-d food recall questionnaire | Depressive symptoms were reduced significantly in both experimental groups (P ≤ 0.05). However, no differences were observed in depression scores between the 2 groups. Cocoa group BDI mean scores: baseline = 9.4, conclusion = 5.7. Placebo: baseline = 11.8, conclusion = 6.1. |
| Pribis (32) | 2016 | United States | Double-blinded, randomized, placebo-controlled, crossover design. Duration: 8-wk intervention followed by 6-wk washout period followed by 8-wk crossover intervention. | 1: Banana bread with 60 g ground walnuts. 2: Banana bread without walnuts. | 49 subjects (n = 29 women; n = 20 men). Condition: students aged between 18 and 25 y. | The Profile of Mood States | Lifestyle survey and FFQ | Men, but not women, had a significant medium-effect-size improvement in total mood disturbances. Both men and women had a nonstatistically significant improvement in depression (P = 0.103). |
| Hirose et al. (33) | 2016 | Japan | Randomized, double-blinded, placebo-controlled trial. Duration: 8 wk. | 1: 12.5 mg isoflavone aglycone/d. 2: 25 mg isoflavone aglycone/d. 3: Placebo. | 90 women aged 40–60 y. Condition: menopausal. | HADS | Menopausal symptom scale and Athens Insomnia Scale | Low-dose (25 mg/d) isoflavone aglycone significantly reduced symptoms of depression (P = 0.033). |
| Mirghafourvand et al. (34) | 2017 | Iran | RCT. Duration: 8 wk. | 1: Orange peel essential oil (10 drops 3 times/d). 2: Placebo. | 48 women. Condition: postpartum. | The Edinburgh Postnatal Depression Questionnaire | The Spielberger State-Trait Anxiety Inventory | No statistically significant difference between intervention and placebo (P = 0.956). Orange peel group depression mean scores: baseline = 8.0, conclusion = 6.7. Placebo: baseline = 8.1, conclusion = 6.7. |
| Kamalifard et al. (35) | 2017 | Iran | Triple-blind RCT. Duration: 8 wk. | 1: 500 mg bitter orange powder/d. 2: 500 mg lavender flower powder/d. 3: 500 mg placebo (starch)/d. | 156 women aged 45–60 y. Condition: menopausal. | BDI | Sociodemographic questionnaire | Both orange and lavender were effective at reducing symptoms of depression compared with placebo (P = 0.001). There was no significant difference between orange and lavender. Bitter orange group BDI mean scores: baseline = 21.38, conclusion = 14.48. Lavender: baseline = 20.82, conclusion = 14.07. Placebo: baseline = 20.01, conclusion = 16.78. |
| Davinelli et al. (36) | 2017 | Italy | Randomized, double-blinded, placebo-controlled trial. Duration: 12 wk. | 1: Capsule containing 200 mg fermented soy (80 mg isoflavone aglycones and 10 mg equol) and 25 mg resveratrol/d. 2: Placebo capsule. | 60 women aged 50–55 y. Condition: menopausal. | HAM-D | HRQL Menopause Rating Scale | Treatment group saw improvements in depression scores in comparison with the placebo group (P = 0.001). |
| Kazemian et al. (37) | 2017 | Iran | RCT. Duration: 1 mo. | 1: Capsule containing Zingiber officinale (ginger), Boswellia carterii (frankincense), and Achillea millefolium (yarrow) daily. 2: Placebo. | 42 subjects (n = 19 women; n = 23 men). Condition: IBS. | HADS | IBS-SSS | Symptoms of depression reduced significantly in the intervention group (P = 0.001) with no significant changes in the placebo group (P = 0.31). Herb group HADS mean scores: baseline = 17.4, conclusion = 12.5. Placebo: baseline = 18.0, conclusion = 17.22. |
| Chang and Chen (38) | 2018 | Taiwan | Single-blinded, placebo-controlled, randomized clinical trial. Duration: 2 wk. | 1: Chamomile tea (1 cup/d which included 2 g dried flowers and 300 mL hot water steeped for 10–15 min). 2: Regular care with no chamomile tea. | 80 women. Condition: 6 wk postpartum. | Edinburgh Postnatal Depression Scale | Postpartum Fatigue Scale | The chamomile tea group significantly lowered depressive symptoms compared with the control group (T = −2.372, P = 0.020). Chamomile group depression mean scores: baseline = 7.86, conclusion = 7.26. Placebo: baseline = 9.71, conclusion = 9.51. |
1
BDI, Beck Depression Inventory; BDNF, brain-derived neurotrophic factor; HADS, Hospital Anxiety and Depression Scale; HAM-D, Hamilton Rating Scale for Depression; HRQL, health-related quality of life; IBS, irritable bowel syndrome; IBS-SSS, irritable bowel syndrome-severity scoring system; IDS-SR, Inventory of Depressive Symptomatology self-rated scale; MADRS, Montgomery-Asberg Depression Rating Scale; RCT, randomized controlled trial; ZSDS, Zung Self-Rating Depression Scale.