Table 3.
Characteristics of included studies.
| Source | Study design | Participants | Population | Intervention | Comparison (If Any) | Measures of Effect | Duration of Follow-Up | Findings * |
|---|---|---|---|---|---|---|---|---|
| Rees et al. (2008) [29] | RCT | 26 |
Tx: 31.2 ± 4.4 years old Pb: 34.5 ± 3.8 years old Women in the antenatal and postnatal period |
6 g containing 27.3% DHA, 6.9% EPA, 3.3% omega-6 fatty acids, 80 mg vitamin E Once per day in divided doses for 6 weeks |
Sunola Oil | Edinburgh Postnatal Depression Scale, HDRS, MADRS | 6 weeks Data at 6 weeks used for meta-analysis. |
Significant improvement in depression with Vitamin E HDRS improved from 19.7 ± 4.8 to 7.9 ± 5.1 in the intervention group versus improvement from 9.0 ± 3.5 to 0.7 ± 5.1 in the placebo group (SMD: –1.08, 95%CI: –1.92, –0.25)† |
| Radzinskii et al. (2016) [30] | RCT | 125 |
Tx: 52.4 ± 5.02 Pb: 51.97 ± 4.25 42–60-year-old women with vasomotor and psycho-somatic menopausal symptoms |
2 pills (200 mg each) of Amberen daily Amberen contains tocopheryl acetate (vitamin E), ammonium succinate, calcium disuccinate, monosodium l-glutamate, glycine, magnesium disuccinate, zinc difumarate and |
Placebo (High purity corn starch) | Greene climacteric test and Spielberger–Hanin test | Data collection every 30 days, followed up for 90 days Data at 3 months used for meta-analysis. |
Amberen showed a statistically significant improvement in anxiety, stress resistance and adaptability Spielberger-Hanin test for situational anxiety showed improvement in the Amberen group from 0.52 ± 9.72 to –10.02 ± 7.78 at 90 days versus deprovement from –4.16 ± 10.08 to –0.14 ± 10.05 in the placebo group (SMD: –2.37, 95%CI: –2.83, –1.91)‡ |
| Jamilian et al. (2018) [31] | RCT | 40 |
Tx: 22.3 ± 4.7 Px: 24.4 ± 4.7 |
1000 mg omega-3 fatty acids, 400 IU Vit E per day for 12 weeks | Placebo | BDI, general health questionnaire scores, DASS | 12 weeks Data at 12 weeks used for meta-analysis. |
Co-administration of omega-3 and vitamin E had favourable effects on parameters of mental health After 12 weeks, greater reduction in BDI was noted with Vitamin E –2.2 ± 2.0 versus –0.2 ± 1.3 with placebo (SMD: –1.16, 95%CI: –1.84, –0.49)† |
| Ataei-Almanghadim et al. (2020) [32] |
RCT | 93 | 51.6 ± 5.4 Women with normal menopause |
500 mg oral capsule of curcumin Twice a day for 8 weeks |
Oral tablets of vitamin E (200 IU/day) Placebo |
Hot flashes and anxiety (primary objectives), sexual function, menopausal symptoms and adverse effects (secondary objectives) | 4 weeks and 8 weeks after the intervention Data at 8 weeks used for meta-analysis. |
Vitamin E had no significant effect on anxiety, sexual function and menopausal symptoms versus placebo After 8 weeks, state anxiety improved from 44.4 ± 13.2 to 39.1 ± 9.9 in the Vitamin E, and 44.9 ± 10.2 to 38.4 ± 9.1 in the placebo group (SMD: 0.17, 95%CI: –0.33, 0.67)‡ |
| Tolonen et al. (1985) [33] | RCT | 30 |
Tx: 76.8 (58–90) years old; 26.7% male Pb: 76.2 (50–92) years old; 20.0% male Geriatric patients Medications that participants were on were not specified |
8 mg of sodium selenate, one 45 μg capsule of ‘Vita-hiven’ (Se yeast in birch ash) and 400 mg of d-alpha-tocopherol (Ido-E) Twice a day for 1 year |
Placebo | Sandoz Clinical Assessment Geriatric-scale | Data collection every 2 months Intervention over 1 year |
Statistically significant improvements observed in the therapy group compared with the placebo group in both depression (p < 0.001) and anxiety (p < 0.01) Quantitative results were not available for meta-analysis |
| Carlsson et al. (2002) [34] | RCT | 41 |
Tx: 76.2 ± 4.4 Px: 76.4 ± 4.3 |
400 IU tocopherol every night for 6 months | 20 mg pravastatin each night for 6 months | Global Health Perception Question, GDS, Assessment of Living Skills and Resources questionnaire< Wechsler Adult Intelligence Scale-R, Sleep Dysfunction Scale | 12 months Data at 6 months used for meta-analysis. |
No significant changes in health perception, depression, physical function, cognition or sleep dysfunction occurred After 6 months, GDS showed improvement from 2.00 ± 2.27 to 1.17 ± 1.20 in the tocopherol group versus deprovement from 1.20 ± 2.31 to 1.35 ± 2.37 in placebo (SMD: –0.64, 95%CI: –1.33, 0.04)† |
| Lohr et al. (1988) [35] | RCT | 15 | Mean age of 44 ± 18 (range 19–71) Participants have chronic schizophrenia (n = 9) or schizoaffective disorder (n = 6) and persistent tardive dyskinesia for at least 1 year Participants were kept on constant doses of neuroleptic and anticholinergic medications throughout the study |
Alpha-tocopherol 400 IU 1st week: once in the morning 2nd week: twice a day 3rd and 4th week: thrice a day |
Placebo | BPRS, a modified version of the Abnormal In- voluntary Movement Scale (AIMS) with a score range of 0 to 36, a modified version of the Simpson-Angus Scale for Extra- pyramidal Side Effects (SAS) with a score range of 0 to 24 |
10 weeks Data at 4 weeks used for meta-analysis. |
Improvement in depression and anxiety with alpha-tocopherol versus placebo, both of which were not statistically significant After 4 weeks, BRPS depression subscale showed better results in the alpha-tocopherol group of 1.4 ± 2.4 versus 3.1 ± 3.2 in placebo (SMD: –0.58, 95%CI: –1.32, 0.15)† Anxiety subscale similarly showed better scores of 1.1 ± 1.9 in the alpha-tocopherol group versus 2.4 ± 2.5 in placebo (SMD: –0.57, 95%CI: –1.30, 0.16)‡ |
| Mazloom et al. (2013) [36] | RCT | 41 |
Vitamin C: 47 ± 8.93 Vitamin E: 48 ± 6.28 Placebo: 46.61 ± 7.58 Type 2 diabetic patients receiving standard oral hypoglycemic agents |
Vitamin E capsule, 400 IU One capsule per day for 6 weeks |
Vitamin C capsule, 1000 mg Placebo capsule (acetate cellulose), 1000 mg |
DASS | 6 weeks Data at 6 weeks used for meta-analysis. |
No significant difference in depression or anxiety with Vitamin E versus placebo After 6 weeks, depression deproved from 21.92 ± 6.54 to 23.78 ± 6.11 in Vitamin E group versus 20.23 ± 5.65 to 21.15 ± 8.09 with placebo (SMD: 0.20, 95%CI: –0.55, 0.96)† Anxiety worsened from 31.07 ± 6.24 to 34.28 ± 7.54 with Vitamin E versus improvement from 28.69 ± 9.40 to 27.92 ± 8.73 with placebo (SMD: 0.75, 95%CI: –0.04, 1.53)‡ |
| Malaguarnera et al. (2016) [37] | RCT | 62 |
Tx: 47.2 ± 3.7 yo Pb: 45.8 ± 3.9 yo 58% male Patients with chronic Hepatitis C, who are treated with Peg-IFN-alpha and RBV |
94 mg silybin, 30 mg vitamin E, 194 mg phospholipids Three times a day for 12 months |
Placebo | BDI, BPRS, Work Ability Index | 12 months Data at 6 months used for meta-analysis. |
Significant reduction in depression and anxiety were observed in the intervention group versus placebo group After 6 months, BDI deproved from 30.7 ± 7.1 to 34.6 ± 7.1 with vitamin E versus 30.8 ± 6.9 versus 46.7 ± 6.8 with placebo (SMD: –2.69, 95%CI: –3.38, –1.99)† STAI improved from 50.8 ± 7.9 to 50.4 ± 7.2 with Vitamin E but deproved from 50.1 ± 7.6 to 60.4 ± 7.7 with placebo (SMD: –2.19, 95%CI: –2.82, –1.55)‡ |
| Lu et al. (2009) [38] | RCT | 756 | 55–91 54.3% male patients with Amnestic Mild Cognitive Impairment (aMCI) |
Donepezil, 10 mg Duration of intervention: 3 years |
Vitamin E, 2000 IU Placebo |
BDI and time to diagnosis of possible or probable AD according to NINCDS-ADRDA criteria | Every 6 months, up to 36 months Data at 6 months used for meta-analysis. |
No significant improvement of depression with Vitamin E versus placebo After 6 months, BDI improved from 14.1 ± 4.3 to 11.3 ± 6.0 with Vitamin E versus 13.4 ± 3.8 to 11.4 ± 5.2 with placebo (SMD: –0.24, 95%CI: –0.58, 0.10)† |
| Adler et al. (1999) [39] | RCT | 107 | Patients with tardive dyskinesia | 1600 IU per day of d-vitamin E | Placebo | BPRS | 2 years Data at 12 months used for meta-analysis. |
No significant effects on BPRS (SMD: 0.32, 95%CI: –0.06, 0.71) BPRS subscale scores for depression and axiety not reported No significant adverse events noted |
| Meyer et al. (2013) [40] | RCT | 95 | 18–75 years Major Depression |
Eight 1 g capsules yielding 250 mg DHA, 70 mg EPA, 10 mg vitamin E per day for 16 weeks | Placebo | HDRS, BDI | 16 weeks | Trial did not show beneficial effects of DHA Quantitative results were not available for meta-analysis |
Abbreviations: RCT, randomised-controlled trial; DHA, docosahexaenoic acid; EPA, eicosapentaenoic acid; IU, international units; BDI, Beck’s Depression Inventory; HDRS, Hamilton Depression Rating Scale; MADRS, Montgomery-Asberg Depression Rating Scale; BPRS, Brief Psychiatric Rating Scale; GDS, Geriatric Depression Scale; STAI, State-trait Anxiety Inventory; DASS, Depression Anxiety and Stress Scale; SMD, standardised mean difference; 95% CI, 95% confidence interval. * Mean (standard deviation) reported unless otherwise stated. † This outcome was used in meta-analysis of depression. ‡This outcome was used in meta-analysis of anxiety. Depression.