Written by Joyce Smith, BS. A 6-week supplementation with 248 mg of MgCl2 significantly reduced symptoms of anxiety and depression in the 126 participants with diagnosed depression.
Depression affects 350 million people worldwide and by 2030 is predicted to be the leading cause of disease burden 1. Limited current treatment options are available due to cost, side effects and patient acceptability. This, coupled with a 50% remission rate and with 20% of patients symptomatic even after 2 years of additional treatment, underscores the need for better treatment options 2. Even Cognitive Behavioral Therapy, lifestyle interventions, and other alternative, drug-free approaches require highly trained therapists and several weeks to months to achieve effectiveness 3.
Studies exploring magnesium as a treatment option have shown inconsistent results, thus prompting researchers to consider a 12-week open label randomized cross-over controlled trial 4. This trial was carried out in outpatient primary clinics on 126 mild-to moderately depressed adults (mean age 52) who met the inclusion criteria for depression based on Health Questionnaire-9 (PHQ-9) scores 5-19. Sixty-two (49%) participants randomized to immediate treatment and 64 (51%) to delayed treatment received 6 weeks of 248 mg of elemental magnesium (MgCl2) per day compared to 6 weeks of control (no treatment). MgCl2 was used in lieu of other magnesium salts because of its high bioavailability and tolerability 5.
The primary outcome was the net difference in the change in depression symptoms from baseline to the end of each treatment period. Secondary outcomes included changes in anxiety symptoms as well as adherence to the supplement regimen, appearance of adverse effects, and intention to use magnesium supplements in the future. Between June 2015 and May 2016, 112 study participants provided analyzable data for the following results.
- Six weeks of magnesium chloride supplementation resulted in a clinically significant net improvement in PHQ-9 scores of -6.0 points (CI -7.9, -4.2; P<0.001) as well as a net improvement in Generalized Anxiety Disorders-7 scores of -4.5 points (CI -6.6, -2.4; P<0.001).
Participant adherence of 83% was validated by a pill count. Overall, magnesium was well tolerated and 61% of participants reported they would use magnesium in the future. The effects of magnesium supplementation were observed within two weeks of supplementation and were similar for all participants regardless of age, gender, baseline level of magnesium and depression severity, or the use of antidepressant treatments. These results lead researchers to conclude that magnesium works quickly, and is well tolerated, therefore, making it effective for mild-to-moderate depression in adults. Furthermore, magnesium is safe and inexpensive.
This is the first clinical trial done on magnesium in the US. Enrolling patients over a full year minimized the effects of seasonal changes on depression. However this crossover trial had no placebo arm and no blinded randomization for either the study team or the volunteer: both are necessary for understanding the mechanism of action of an intervention. Whether magnesium induced a physiological change in its study participants or only a placebo effect or perhaps a combination of both, the participants did report significantly improved anxiety and depression when supplementing with magnesium than prior to taking it. Researchers state that these study results should be replicated in larger clinical trials.
Source: Tarleton EK, Littenberg B, MacLean CD, Kennedy AG, Daley C (2017) Role of magnesium supplementation in the treatment of depression: A randomized clinical trial. PLoS ONE 12(6): e0180067.
© 2017 Tarleton et al. Open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Posted December 7, 2017.
Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.
References:
- Organization WH. Depression Fact Sheet. 2017; Fact Sheet on Depression. Available at: http://www.who.int/mediacentre/factsheets/fs369/en/. Accessed November 3, 2017, 2017.
- Trevino K, McClintock SM, Fischer NM, Vora A, Husain MM. Defining treatment-resistant depression: a comprehensive review of the literature. Annals of Clinical Psychiatry. 2014;26(3):222-232.
- Høifødt RS, Strøm C, Kolstrup N, Eisemann M, Waterloo K. Effectiveness of cognitive behavioural therapy in primary health care: a review. Family practice. 2011;28(5):489-504.
- Tarleton EK, Littenberg B, MacLean CD, Kennedy AG, Daley C. Role of magnesium supplementation in the treatment of depression: A randomized clinical trial. PloS one. 2017;12(6):e0180067.
- Durlach J, Guiet-Bara A, Pages N, Bac P, Bara M. Magnesium chloride or magnesium sulfate: a genuine question. Magnes Res. 2005;18(3):187-192.
