Micronutrient supplementation as treatment for psychiatric symptoms

Although the role of micronutrient supplementation has been highlighted over the last years, the evidence for the effect of broad-spectrum micronutrients to treat psychiatric symptoms in adults and children is still limited today. More research in larger clinical studies is needed [1].

There is no clear definition of broad-spectrum micronutrients. “Typically, it contains a combination of different vitamins and minerals, combined with botanicals, amino acids, and fatty acids,” explained Dr Alexander Häge (ZI Mannheim, Germany) [1].

The rationale for using broad-spectrum micronutrients in psychiatry is that they serve as co-enzymes for the synthesis, uptake, and breakdown of neurotransmitters, and they are required as co-factors in the energy metabolism of neurons. Adding micronutrients could either restore an inborn metabolic dysfunction or correct the effects of malabsorption due to gastrointestinal inflammation, microbiome composition, or mitochondria dysfunction, which can lead to reduced energy metabolism of neurons and glial cells [2,3].

“There is a hype concerning the consumption of vitamins and minerals,” Dr Häge said. Although some studies investigating micronutrients for the treatment of psychiatric disorders, such as impulsivity, inattention, and hyperactivity, and other mental health issues, such as mood and stress, have reported positive effects, the evidence is still limited. Studies in children and adolescents have mainly been open-label retrospective database analyses, case reports, and patient preference studies. Furthermore, a large variability in ingredients and doses was used across studies. Double-blind, placebo-controlled studies with micronutrients in both adults and children showed some improvements but no group differences in attention-deficit/hyperactivity disorder (ADHD) symptomatology. It is quite difficult to draw any conclusions from these studies [4,5].

Dr Häge briefly discussed the VANTASTIC study, a randomised double-blind trial in 180 children and adolescents with high levels of impulsivity and irritability. The primary outcome measure is the response rate at the end of the placebo-controlled phase, and completion is scheduled for September 2022.

1. Häge A. Broad spectrum micronutrients to treat psychiatric symptoms in children and adolescents – hype or hope? S.03.01. ECNP Congress 2020.
2. Rucklidge JJ & Kaplan BJ. Expert Rev Neurother. 2013 Jan;13(1):49-73.
3. Rucklidge JJ & Kaplan BJ. CNS Drugs. 2014 Sep;28(9):775-85.
4. Rucklidge JJ, et al. J Child Psychol Psychiatry. 2018 Mar;59(3):232-246.
5. Rucklidge JJ, et al. Br J Psychiatry. 2014;204:306-31.

Posted on 2 November 20204 November 2020