They cited the recommendations by Glickman-Simon and Pettit14 to improve the design of future RCTs that investigate whether there is a therapeutic role for vitamin D in treating depression. The authors also added several recommendations of their own.

RCTs should:

·         Enroll only depressed patients deficient in vitamin D


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·         Administer a standardized oral dosage

·         Measure post-treatment vitamin D levels to ensure that they are now within the normal range

·         Examine improvements, both in relation to formalized clinical depression disorders and depression severity

·         Evaluate vitamin D supplementation as monotherapy, rather than as augmentation in those already taking antidepressants

Conclusion

Despite their caveats and concerns, the authors nevertheless concluded from the cross-sectional and longitudinal studies that there is “increasing evidence of an increased risk for depression in those who are vitamin D deficient, and that vitamin D supplementation is of benefit for depressed individuals who are vitamin D deficient.”

References

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3.      Han B, Lyu Y, Sun H, et al. Low serum levels of vitamin D are associated with post-stroke depression.  Eur J Neurol. 2015 Sep;22(9):1269-74.

4.      Okereke OI, Singh A. The role of vitamin D in the prevention of late-life depression. J Affect Disord. 2016 Jul 1;198:1-14.

5.      Johansson P, Alehagen U, van der Wal MH, et al. Vitamin D levels and depressive symptoms in patients with chronic heart failure. Int J Cardiol. 2016 Mar 15;207:185-9.

6.      Vaziri F, Nasiri S, Tavana Z, et al. A randomized controlled trial of vitamin D supplementation on perinatal depression: in Iranian pregnant mothers. BMC Pregnancy Childbirth. 2016 Aug 20;16:239.

7.      Parker GB, Brotchie H, Graham RK. Vitamin D and depression. J Affect Disord. In Press.

8.      Lee DM, Tajar A, O’Neill TW, et al.  Lower vitamin D levels are associated with depression among community-dwelling European men. J Psychopharmacol. 2011 Oct;25(10):1320-8.

9.      Zhao G, Ford ES, Li C, Balluz LS. No associations between serum concentrations of 25-hydroxyvitamin D and parathyroid hormone and depression among US adults. Br J Nutr. 2010 Dec;104(11):1696-702.

10.   Black LJ, Jacoby P, Allen KL, et al. Low vitamin D levels are associated with symptoms of depression in young adult males. Aust N Z J Psychiatry. 2014 May;48(5):464-71.

11.  Milaneschi Y, Shardell M, Corsi AM, et al. Serum 25-hydroxyvitamin D and depressive symptoms in older women and men. J Clin Endocrinol Metab. 2010 Jul;95(7):3225-33.

12.  Milaneschi Y, Hoogendijk W, Lips P, et al. The association between low vitamin D and depressive disorders. Mol Psychiatry. 2014 Apr;19(4):444-51.

13.  Almeida OP, Hankey GJ, Yeap BB, et al. Vitamin D concentration and its association with past, current and future depression in older men: The Health In Men Study. Maturitas. 2015 May;81(1):36-41.

14.  Glickman-Simon P, Pettit J. There is currently insufficient evidence to determine the effectiveness of vitamin D supplementation for depression. Explore. 2013;11(3):223.