Efficacy of vitamin C as an adjunct to fluoxetine therapy in pediatric major depressive disorder: a randomized, double-blind, placebo-controlled pilot study

Abstract

BackgroundCurrent antidepressants used to treat pediatric patients have the disadvantage of limited efficacy and potentially serious side effects. The purpose of this study was to assess the efficacy of vitamin C as an adjuvant agent in the treatment of pediatric major depressive disorder in a six-month, double-blind, placebo-controlled pilot trial.MethodsThe study group (n=12) was given fluoxetine (10–20 mg/day) plus vitamin C (1000 mg/day) and control group (n=12) administered fluoxetine (10–20 mg/day) plus placebo. The data were analyzed by ANOVA and t-test for independent samples.ResultsBoth groups demonstrated significantly improved scores on the Children’s Depression Rating Scale (CDRS), the Children’s Depression Inventory (CDI), and the Clinical Global Impression (CGI). ANOVA was significantly different on all clinical measurements (group effect, time effect, and interaction), with the exception of group effect and interaction for CGI. Patients treated for six months with fluoxetine and vitamin C showed a significant decrease in depressive symptoms in comparison to the fluoxetine plus placebo group as measured by the CDRS (t=11.36, P<0.0001) and CDI (t=12.27, P<0.0001), but not CGI (t=0.13, P=0.90). No serious adverse effects were observed.ConclusionsThese preliminary results suggest that vitamin C may be an effective adjuvant agent in the treatment of MDD in pediatric patients.

Oxidative Stress and Major Depression

“…Even in the present scenario ascorbic acid has been found to be effective in the mouse model of depression [34]. In a study done in the paediatric age group also the ascorbic acid treatment as an adjunct to fluoxetine has been found to be effective [35]. In our present study we evaluated the levels of ascorbic acid in major depression as compared to healthy controls and found the levels of ascorbic acid to be decreased significantly (p < 0.0001).…”

Chronic stress impacts the cardiovascular system: animal models and clinical outcomes

“…Antidepressant properties have been described for other antioxidants as well (201,211,247,278,285). A randomized, double-blind, placebo-controlled pilot study in humans showed that the addition of vitamin C to antidepressant therapy significantly improved clinical outcomes (10). Addition of N-acetylcysteine to a tranylcypromine regimen also increased the response rate of patients with major depression who were resistant to conventional depression therapy (53).…”

A review of nutrient treatments for paediatric depression

“…Patients treated for six months with fluoxetine and vitamin C showed a highly significant (p <0.0001) decrease in depressive symptoms compared to the fluoxetine plus placebo group as measured by the CDRS and CDI, but not CGI. These preliminary results suggest that vitamin C may be an effective add-on agent in the treatment of depression in paediatric patients (Amr et al, 2013).…”

“…Only 4 studies were identified utilising this 'gold standard' research design. These include one study investigating the following nutrients; omega-3 PUFAs (Nemets et al, 2006), vitamin C (Amr et al, 2013), zinc (DiGirolamo et al, 2010, and iron (Lozoff et al, 2014). Unfortunately, these studies were compromised by small sample sizes and/or included participants with a lack of clearly defined major depression.…”