Effects of Zinc Supplementation in Patients with Major Depression: A Randomized Clinical Trial

By Ranjbar, Elham; Kasaei, Masoumeh Sabet et al. | Iranian Journal of Psychiatry, June 2013 | Go to article overview

Effects of Zinc Supplementation in Patients with Major Depression: A Randomized Clinical Trial


Ranjbar, Elham, Kasaei, Masoumeh Sabet, Mohammad-Shirazi, Minoo, Nasrollahzadeh, Javad, Rashidkhani, Bahram, Shams, Jamal, Mostafavi, Seyed-Ali, Mohammadi, Mohammad Reza, Iranian Journal of Psychiatry


Objective: Major depression is a mood disorder that causes changes in physical activity, appetite, sleep and weight. Regarding the role of zinc in the pathology of depression, the present study was aimed to investigate the effects of zinc supplementation in the treatment of this disease.

Methods: This study was a double-blind randomized clinical trial. Forty four patients with major depression were randomly assigned to groups receiving zinc supplementation and placebo. Patients in Zinc group received daily supplementation with 25 mg zinc adjunct to antidepressant; Selective Serotonin Reuptake Inhibitors (SSRIs), while the patients in placebo group received placebo with antidepressants (SSRIs) for twelve weeks. Severity of depression was measured using the Beck Depression Inventory at baseline and was repeated at the sixth and twelfth weeks. ANOVA with repeated measure was used to compare and track the changes during the study .

Results: The mean score of Beck test decreased significantly in the zinc supplement group at the end of week 6 (P<0.01) and 12 (P<0.001) compared to the baseline. The mean score of Beck Depression Inventory reduced significantly compared to the placebo group at the end of 12th week (P<0.05)

Conclusion: The results of the present study indicate that zinc supplementation together with SSRIs antidepressant drug improves major depressive disorders more effectively in patients with placebo plus antidepressants (SSRIs).

Key words: Major depressive disorder; Zinc supplement; placebo and Selective Serotonin Reuptake Inhibitors (SSRIs)

Iran J Psychiatry 2013; 8:2: 73-79

-According to the criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), major depressive disorder (MDD) is a psychiatric disorder with genetic, biological, and environmental risk factors. This disorder is one of the most common diseases in the world, with high levels of associated mortality. It affects people of every region in every ethnic group (1, 2) to the extent that one out of every 5 people referred to a physician is affected by depression (3).

About 19-34 % of patients with depression do not respond to antidepressants, and 15-50 % of them have a recurrence; therefore, other medications or supplementation with micronutrients are increasingly adjunct to antidepressant drugs to improve their therapeutic effects (4).

Zinc is one of the micronutrients involved in behavior, learning and mental functions. The first clinical studies in the field of serum zinc level in depressed patients have been published by Hansen and colleagues (5). The first report on the relationship between zinc status and brain function in humans has been published in 1998 by Sand stead and colleagues (6). Various studies have identified the effects of zinc in the pathophysiology of depression and antidepressant drugs mechanisms of action. Also, other clinical studies have shown low serum zinc concentrations in patients with depression (7).Furthennore, Long-term treatments with zinc in laboratory animals have had the same mechanisms and effects as the antidepressant drugs (8).

In previous studies, the dietary micronutrients as confounding factors have not been studied. However, the present study was designed to examine the effects of zinc supplementation in patients with major depression, while assessing and controlling dietary intake. The present study was the first randomized clinical trial in Iran designed to examine the effects of zinc supplementation in patients with major depression.

Material and Methods

Participants and Procedure

This study was a double blind randomized clinical trial that was performed on 44 patients with major depression. Study population was among people with depression who were referred to the psychiatric clinic of Imam Hussein, Tehran. Sampling started after obtaining approval from the ethics committee of Nutrition Research Institute, Shahid Beheshti University of Medical Sciences (No. …

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