Magnesium in major depression

Abstract

There are contradictory data regarding the levels of magnesium in patients with major depression (MD) and how antidepressants influence their concentration. Our results show erythrocyte magnesium in patients with MD (44.39 ± 2.7 mg/L vs 59.1 ± 3.2 mg/L in control group, p < 0.05) and only in patients with severe MD (Hamilton score > 23) was a moderate decrease in plasmatic magnesium observed (17.7 ± 1.5 mg/L vs 22.9 ± 3.3 mg/L in control group). Therapy with antidepressants from different groups and with different mechanisms of action, such as amytriptiline (25 mg x 3/day per os, 4 weeks) and sertraline (50 mg x 3/day per os, 4 weeks) leads to a significant increase of magnesium concentration in erythrocytes (57.6 ± 4.5 mg/L after amytriptiline, respectively 56.9 ± 3.2 mg/L after sertraline, p < 0.05 vs before therapy). At the same time, in patients with MD, plasmatic levels of zinc were significantly decreased before therapy and increased after treatment with amytriptiline and sertraline (0.68 ± 0.09 mg/L before treatment vs 0.9 ± 0.07 after amytriptiline). There is a positive correlation between concentrations of magnesium in erythrocytes and the clinical evolution of patients with MD. We consider that increasing intracellular concentration is a component of the antidepressant mechanism of sertraline and amytriptiline and maybe of other antidepressants. Anhedonia and autolytic tendencies are important elements of MD symptomatology. We tested the influence of MgCl 2 0.2 mM/kg/day on a reward system using conditioned place preference (Panlab) in rats. Our data show a moderate stimulation of the reward system by magnesium (290.6 ± 27 s time spent in a conditioned compartment before magnesium treatment and 363.3 ± 16 s after magnesium treatment) that reflects a stimulation of the reward system (RS). We consider that a magnesiuminduced stimulation of the RS is an important issue for treating anhedonia in patients with MD. An increase of intracellular magnesium may be part of the mechanism of action of antidepressants.

The Importance of Magnesium in Clinical Healthcare

“…Both sertraline given at 150 mg/day for 4 weeks and amitriptyline given at 75 mg/day for 4 weeks have been shown to increase Mg concentration in erythrocytes. It has been suggested that this may be a possible biochemical mechanism for the effectiveness of these drugs in some patients [75]. …”

Plasma magnesium levels and treatment outcome in depressed patients

“…38 Moreover, treatment with antidepressants (specifically, amytriptiline and sertraline) leads to a significant increase of erythrocyte Mg concentrations. 18 A recent randomized clinical trial evaluating the efficacy of oral Mg supplementation (with MgCl 2 ) in treating 23 depressed elderly patients with type 2 diabetes and hypomagnesaemia also demonstrated that MgCl 2 is as effective as imipramine 50 mg daily. 20 Since our report does not include information concerning a better outcome following Mg supplementation, we cannot substantiate a possible role of impaired Mg homeostasis in the unfavourable therapeutic course of depression.…”

“…Plasma Mg levels in severely depressed patients have, in fact, been found to be moderately decreased. 18 An association between Mg and anhedonic features, which typically characterize major depression, has been suggested by a recent study in which Mg's (MgCl 2 0.2 mM/kg/day) influence on the reward system was tested using conditioned place preference in rats and Mg has been shown to moderately stimulate the reward system. 15 A relation between Mg and a therapeutic potential in affective disorders has been noted as early as 1921: hypodermically administered Mg sulphate caused 50 patients having agitated depression to relax and sleep from 4 to 6 hours.…”

A pilot phase II trial of magnesium supplements to reduce menopausal hot flashes in breast cancer patients

“…Magnesium has been used for years to treat hypertension [8], eclampsia [9], and other cardiovascular [10] or nerve disorders [11] and is safe in patients with normal renal function. This pilot study was designed to evaluate the effectiveness of magnesium oxide as a natural, inexpensive, non-prescription, readily available treatment for patients experiencing hot flashes.…”