[Guideline Summary] Clinical recommendation - Treatment of psychiatric disorders with nutraceuticals and phytoceuticals

An international taskforce involving leading academics and clinicians from 15 countries convened by the World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Disorders (CANMAT) provided update on guidelines regarding nutraceutical and phytoceutical therapies for use in psychiatric disorders.

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It is concluded that several nutraceuticals and phytoceuticals were given either a supportive recommendation or a provisional recommendation across various psychiatric disorders.

Treatment of unipolar depression

Across nutraceuticals with Grade A evidence, positive directionality and various levels of support (recommended, provisionally recommended or weakly recommended) was reported for:
- Adjunctive omega-3 fatty acids (+++)
- Vitamin D (+)
- Adjunctive probiotics (++)
- Adjunctive zinc (+)
- Methylfolate (+)
- Adjunctive s-adenosyl methionine (SAMe) (+)
Phytoceuticals with supporting Grade A evidence and positively directionality are:
- St John’s wort (+++)
- Saffron (++)
- Curcumin (++)
- Lavender (+)

Treatment of bipolar disorder

Weak support was noted for omega-3 fatty acids (+)
N-acetyl cysteine (NAC) was not recommended currently (+/-)

Treatment of OCD-related disorders

NAC was weakly recommended (+)

Treatment of anxiety-related disorder

No nutraceutical showed adequate evidence in any anxiety-related disorder
Ashwagandha (++), galphimia (+) and lavender (++) were supported in treating anxiety disorder

Treatment of schizophrenia

Vitamin D (+), NAC (++) and methylfolate (++) were recommended with various degrees in the treatment of negative symptoms in schizophrenia
Ginkgo was weakly supported in the adjunctive treatment of negative symptoms of schizophrenia (+)

Treatment of attention deficit hyperactivity disorder (ADHD)

Micronutrients (+) and vitamin D (+) were weakly recommended
Omega-3 fatty acids (+/-), omega-9 fatty acids (-), acetyl L carnitine (-) and zinc (+/-) were not supported

Remarks:
(+++) represents ‘Recommended’; (++) represents ‘Provisionally Recommended’; (+) represents ‘Weakly Recommended’; (+/-) represents ‘(Not Currently Recommended)’ and (-) represents ‘Not Recommended’

Link to the full article:
https://www.tandfonline.com/doi/full/10.1080/15622975.2021.2013041

Reference:

Sarris J et al. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce. World J Biol Psychiatry. 2022:1-32.