The Effectiveness of Adjunctive Thiamine (vitamin B1) with Standard Treatment in Patients with Major Depressive Disorder
Article Sidebar
Main Article Content
Abstract
Objectives: To evaluate the effectiveness of adjunctive Thiamine (vitamin B1) with standard treatment in patients with Major Depressive Disorder (MDD) by comparing with standard treatment.
Methods: Randomized control trial in patients with MDD aged 18 – 60 years old, treated at both inpatient and outpatient wards of Nakhonsawan Rajanakarindra Psychiatric Hospital during September 2018 to June 2019. Fifty patients were randomly divided into Thiamine group and control group by draw lots. The Thiamine group received 300 mg/day of Thiamine with standard treatment and the control group received only standard treatment. Outcomes were evaluated by using Hamilton Rating Scale for Depression (HRSD), Montreal Cognitive Assessment (MoCA) and Reaction Time from Continuous Performance Test (CPT). Frequency, mean, percentage and standard deviation were used to examine personal data. Independent T-Test and Pearson Chi Square were used to compare the proportion of personal data. Independent T-Test was used to compare the changes of dependent variable between groups. Paired T-Test was used to compare the changes of dependent variable within a group.
Results: From the 4th week to the end of the study, the depressive severity score from HRSD in the Thiamine group was significantly decreased more than in the control group (p=0.004, 0.031 and 0.035). At 12th week the cognitive score from MoCA in the Thiamine group was significantly increased more than in the control group(p=0.007). From 8th week to the end of study, the reaction time from CPT in the Thiamine group was significantly decreased more than in the control group. (p=0.047 and 0.003).The only adverse event found was nausea and not severe.
Conclusion: Using adjunctive Thiamine with standard treatment was more effective than standard treatment alone in patients with Major Depressive Disorder without any serious adverse event.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความหลังผ่านการปรับแก้จากกองบรรณาธิการแล้ว เป็นลิขสิทธ์ของวารสารจิตเวชวิทยาสาร โรงพยาบาลสวนปรุง กรมสุขภาพจิต กระทรวงสาธารณสุข ห้ามเผยแพร่เพื่อประโยชน์ทางการค้าโดยไม่ได้รับอนุญาต แต่อนุญาตให้เผยแพร่บทความดังกล่าวเพื่อประโยชน์ทางการศึกษาแก่ประชาชนทั่วไป ทั้งนี้กองบรรณาธิการไม่จำเป็นต้องเห็นด้วยกับบทความหรือข้อคิดเห็นใดๆ ที่ปรากฏในวารสารสวนปรุง
References
American Psychiatric Association. Diagnostic and statistical manual of mental disorder: DSM-IV.4th ed. Washington, DC: APA;1994.
Bell IR, Edman JS, Morrow FD, Marby DW, Perrone G, Kayne HL, et al. Brief communication. Vitamin B1, B2, and B6 augmentation of tricyclic antidepressant treatment in geriatric depression with cognitive dysfunction. J Am Coll Nutr 1992,11:159-63. PMID: 1578091.
Benton D, Donohoe R. The effects of nutrients on mood. Public Health Nutr 1999;2:403-9. PMID: 10610080.
Benton D, Griffiths R, Haller J. Thiamine supplementation mood and cognitive functioning. Psychopharmacology (Berl) 1997;129:66-71. PMID: 9122365.
Benton D, Fordy J, Haller J. The impact of long-term vitamin supplementation on cognitive functioning. Psychopharmacology (Berl) 1995;117:298-305. PMID: 7770605.
Benton D, Haller J, Fordy J. Vitamin supplementation for 1 year improves mood. Neuropsychobiology 1995;32:98-105. PMID: 7477807.
Gibson GE, Hirsch JA, Fonzetti P, Jordan BD, Cirio RT, Elder J. Vitamin B1 (thiamine) and dementia. Ann N Y Acad Sci 2016;1367:21–30. PMID: 26971083.
Gibson GE, Zhang H. Interactions of oxidative stress with thiamine homeostasis promote neurodegeneration. Neurochem Int 2002;40:493-504. PMID: 11850106.
Ghaleiha A, Davari H, Jahangard L, Haghighi M, Ahmadpanah M, Seifrabie MA, et al. Adjuvant thiamine improved standard treatment in patients with major depressive disorder: results from a randomized, double-blind, and placebo-controlled clinical trial. Eur Arch Psychiatry Clin Neurosci 2016;266:695-702. PMID: 26984349.
Combs GF, McClung JP. The vitamins: fundamental aspects in nutrition and health. 3rd ed. London: Elsevier Academic Press; 2008.
Heseker H, Kubler W, Westenhofer J, Pudel V. Psycische Veranderungen als Fruhzeichen einer suboptimalen Vitaminversorgung. Ernahrungs Umschau 1990;37:38.
Kaner G, Soylu M, Yüksel N, Inanç N, Ongan D, Başmısırlı E. Evaluation of nutritional status of patients with depression. Biomed Res Int 2015;2015:521481. PMID: 26413529.
LaChance LR, Ramsey D. Antidepressant foods: an evidence-based nutrient profiling system for depression. World J Psychiatry 2018;8:97-104. PMID: 30254980.
Lam RW, Kennedy SH, Mclntyre RS, Khullar A. Cognitive dysfunction in major depressive disorder: effects on psychosocial functioning and implications for treatment. Can J Psychiatry 2014;59:649-54. PMID: 25702365.
Lotrakul M, Sukanich P. Ramathibodi essential psychiatry. 4th ed. Bangkok: Faculty of Medicine Ramathibodi Hospital, Mahidol University; 2015. (in Thai)
Lotrakul M, Sukanich P, Sukying C. The reliability and validity of Thai version of hamilton rating scale for depression. J Psychiatr Assoc Thailand 1996;41:235-46. (in Thai)
Markova N, Bazhenova N, Anthony DC, Vignisse J, Svistunov A, Lesch KP, et al. Thiamine and benfotiamine improve cognition and ameliorate GSK-3β-associated stress-induced behaviours in mice. Prog Neuropsychopharmacol Biol Psychiatry 2017;75:148-56. PMID: 27825907.
Mikkelsen K, Stojanovska L, Apostolopoulos V. The effects of vitamin B in depression. Curr Med Chem 2016;23:4317-37. PMID: 27655070.
Nasreddine ZS, Chertkow H, Phillips N, Whitehead V, Collin I, Cummings JL. The Montreal Cognitive Assessment (MoCA): a brief cognitive screening tool for detection of mild cognitive impairment . Neurology 2004;62:A132.
Paykel ES. Partial remission, residual symptoms, and relapse in depression. Dialogues Clin Neurosci 2008;10:431-7. PMID: 19170400.
Pehrson AL, Leiser SC, Gulinello M, Dale E, Li Y, Waller JA, et al. Treatment of cognitive dysfunction in major depressive disorder--a review of the preclinical evidence for efficacy of selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors and the multimodal-acting antidepressant vortioxetine. Eur J Pharmacol 2015;753:19-31. PMID: 25107284.
Plaitakis A, Hwang EC, Woert MH, Szilagyi PE, Berl S. Effect of thiamine deficiency on brain neurotransmitter systems. Ann N Y Acad Sci 1982;378:367-81. PMID: 6177269.
Riccio CA, Waldrop JJ, Reynolds CR, Lowe P. Effect of stimulants on the continuous performance test (CPT): implications for CPT use and interpretation. J Neuropsychiatry Clin Neurosci 2001;13:326-35. PMID: 11514638.
Riccio CA, Reynolds CR, Lowe PA. Clinical application of continuous performance test: measuring attention and implusive responding in children and adults. New York: John Wiley & Sons; 2001.
Sadock BJ, Sadock VA. Kaplan & Sadock's synopsis of psychiatry: behavioral sciences/ clinical psychiatry. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2007.
Talwar D, Davidson H, Cooney J, St JO’Reilly D. Vitamin B(1) status assessed by direct measurement of thiamin pyrophosphate in erythrocytes or whole blood by HPLC: comparison with erythrocyte transketolase activation assay. Clin Chem 2000;46:704-10. PMID: 10794754.
Tangwongchai S, Phanasathit M, Charernboon T, Akkayagorn L, Hemrungrojn S, Phanthumchinda K, et al. The Validity of Thai version of the montreal cognitive assessment (MoCA-T). Dement Neuropsychol [Internet]. 2009 [cited 2019 Sep 15];3:172. Available from: https://www.researchgate.net/publication/311715441_The_validity_of_thai_version_of_the_montreal_cognitive_assessment_MoCA-T
Tuttle WW, Wilson M, Daum K, Rhodes H. Influence of various levels of thiamine intake on physiologic response; reaction time. J Am Diet Assoc 1949;25:21-7. PMID: 18121575.
Vitamin B1 [Internet]. 2019 [cited 2019 Oct 10]. Available from: www.nutrition.anamai. moph.go.th/images/file/วิตามินบี%201.pdf
Zajecka J, Kornstein SG, Blier P. Residual symptoms in major depressive disorder: prevalence, effects, and management. J Clin Psychiatry 2013;74:407-14. PMID: 23656849.
Zempleni J, Rucker RB, McCormick DB, Suttie JW. Handbook of vitamins. 4th ed. Boca Raton: Taylor & Francis; 2007.
Zhang G, Ding H, Chen H, Ye X, Li H, Lin X, Ke Z. Thiamine nutritional status and depressive symptoms are inversely associated among older Chinese adults. J Nutr 2013;143:53-8. PMID: 23173173.