Alternative Therapies for Depression

Therapy	Best Evidence *	Probably Useful †	Least Evidence ‡
Herbals		Ginkgo biloba (80 mg t.i.d.) in elderly; Saint John's Wort (300 mg t.i.d., 0.3% hypericin).	Saint John's Wort and 5-HTP in combination; damiana; yohimbe; aromatherapy
Diet and Nutrition/Lifestyle	Exercise; relaxation, stress reduction; thiamine (1–10 mg/d); niacin (500–1000 mg b.i.d.); pyridoxine (50–100 mg/d); folic acid (800 µg/d); vitamin B 12 (800 µg/d); vitamin C (500-1000 mg t.i.d.).	S-adenosyl-l-methionine (SAMe) (200mg b.i.d.–400 mg q.i.d.). Avoid in bipolar disorder. 5-HT (hydroxytryptophan) (100–200 mg t.i.d.); flaxseed oil (1T/day); iron replacement; vitamin E (200–400 IU/day).	Inositol; phenylalanine; phosphatidylserine; tyrosine; detect and treat food allergy; restrict caffeine and sugar.
Mind-Body Interventions	Cognitive-behavioral therapy; spiritual approaches, prayer.	Tai chi; qi gong; hypnosis; meditation; biofeedback.
Pharmacological and Biological Treatments			DHEA; neural therapy.
Bioelectromagnetic Therapies	Light therapy (for seasonal affective disorder).	Magnetic brain stimulation; energy healing.
Alternative Systems of Care	Acupuncture.	Ayurveda.	Homeopathy (not commonly used except for postpartum depression): Each t.i.d. for 2 weeks: sepia 30C; ignatia 30C; pulsatilla 30C; natrum muriatricum 30C.
Hands-On Healing Techniques	Massage.

^*Therapies with the highest degree of scientific support for efficacy and safety.
^†Therapies that are often helpful but that do not have the highest degree of supporting evidence for efficacy and safety.
^‡Therapies that may be useful but that have limited scientific evidence for efficacy and safety.
NOTE: C denotes the number of times that a substance is diluted at a ratio of 1:100.
SOURCE: Sierpina, VS: Integrative Health Care: Complementary and Alternative Therapies for the Whole Person, F.A. Davis, Philadelphia, 2000.