In vitro, animal and seven human studies have demonstrated that curcumin has multifactorial physiological effects on the body, which may account for its antidepressant and anxiolytic effects.
Positive anxiolytic effects from curcumin administration were also identified in some trials.
Disturbances in neurotransmitter activity involving serotonin, dopamine, noradrenaline and glutamate have been regularly observed in depression. Findings from animal trials have demonstrated curcumin can alter the concentrations and activity of many of these neurotransmitters.
Curcumin may increase serotonin and dopamine levels, and inhibit monoamine oxidase enzymes, which could enhance antidepressant effect. Coadministration may provide an additive or synergistic effect when combined with antidepressant pharmaceutical medication.
Curcumin has been shown in vivo to inhibit the immobility period in the forced swimming test (a model for antidepressant effect), to increase serotonin (5-HT) and dopamine levels and inhibit monoamine oxidase enzymes (MAO-A and MAO-B). Curcumin was also shown to enhance the anti-immobility effect of the antidepressant drugs fluoxetine, venlafaxine, or bupropion, but not the tricyclics imipramine and desipramine (Kulkarni, Bhutani, and Bishnoi 2008).
In a study of major depression participants were given fluoxetine, curcumin or a combination. Curcumin was well tolerated by all the patients. The proportion of responders as measured by the HAM-D17 scale was higher in the combination group than in the fluoxetine and the curcumin groups; however, these data were not statistically significant.
Three randomised, controlled clinical trials have examined the effects of curcumin in depression. One of the trials also examined curcumin in combination with saffron. The combination may have greater effect.
Treatments lasted 5–12 weeks, with daily dosages ranging from 500 to 1500 mg. Varying curcumin extracts have been utilised in these trials, including non-patented and patented extracts such as BCM-95® and C3 Complex®.
However, a meta-analysis of the trials concluded that the quality of evidence is low, suggesting considerable uncertainty regarding the efficacy and acceptability of curcumin for treating depression or depressive symptoms.
Clinical trials and Reviews
A study aimed to compare the efficacy and safety of curcumin, an active ingredient of Curcuma longa, with fluoxetine in patients with major depressive disorder (MDD).
A total of 60 patients diagnosed with MDD were randomized to receive either fluoxetine (20 mg), curcumin (1000 mg), or their combination for six weeks. The primary efficacy variable was response rates according to the Hamilton Depression Rating Scale (HAM-D17).
The results showed that curcumin was well tolerated by all patients. The proportion of responders, as measured by the HAM-D17 scale, was higher in the combination group (77.8%) than in the fluoxetine (64.7%) and curcumin (62.5%) groups. However, these data were not statistically significant (P = 0.58).
Interestingly, the mean change in HAM-D17 score at the end of six weeks was comparable in all three groups (P = 0.77). This study provides the first clinical evidence that curcumin may be used as an effective and safe treatment for patients with MDD without concurrent suicidal ideation or other psychotic disorders (Sanmukhani et al. 2014).
In this randomized, double-blind, placebo-controlled study, 56 participants with major depressive disorder were treated with either curcumin (500 mg twice daily) or a placebo for 8 weeks.
The primary measure used was the Inventory of Depressive Symptomatology self-rated version (IDS-SR30), while secondary outcomes included IDS-SR30 factor scores and the Spielberger State-Trait Anxiety Inventory (STAI).
The results showed that both curcumin and placebo groups experienced improvements in IDS-SR30 total scores and most secondary outcome measures from baseline to week 4.
However, from weeks 4 to 8, curcumin was found to be significantly more effective than the placebo in improving several mood-related symptoms. This was demonstrated by a significant group x time interaction for IDS-SR30 total score and IDS-SR30 mood score, and a non-significant trend for STAI trait score. The study also identified greater efficacy from curcumin treatment in a subgroup of individuals with atypical depression.
In conclusion, the study provides partial support for the antidepressant effects of curcumin in people with major depressive disorder, with benefits observed 4 to 8 weeks after treatment. However, the authors suggest that further research with larger sample sizes, extended treatment periods, and varying curcumin dosages is needed to confirm these findings (Lopresti et al. 2014).
Previous research has indicated that curcumin (found in turmeric) and saffron may have antidepressant effects for individuals with major depressive disorder. However, these studies had limitations such as poor design, small sample sizes, short treatment durations, and similar intervention dosages.
In this randomized, double-blind, placebo-controlled study, 123 participants with major depressive disorder were assigned to one of four treatment groups: placebo, low-dose curcumin extract (250mg twice daily), high-dose curcumin extract (500mg twice daily), or a combination of low-dose curcumin extract and saffron (15mg twice daily) for 12 weeks. Outcome measures included the Inventory of Depressive Symptomatology self-rated version (IDS-SR(30)) and the Spielberger State-Trait Anxiety Inventory (STAI).
The combined active drug treatments showed significantly greater improvements in depressive symptoms compared to the placebo group (p=.031), as well as better improvements in STAI-state (p<.001) and STAI-trait scores (p=.001).
The active drug treatments were more effective for individuals with atypical depression compared to other patients (response rates of 65% versus 35% respectively, p=.012). No significant differences were observed between the various curcumin dosages or the curcumin/saffron combination.
Limitations: Further research with larger sample sizes is needed to investigate the efficacy of different curcumin and saffron/curcumin combination dosages. The effects on individuals with atypical depression should also be examined in larger studies.
Conclusions: Active drug treatments, including different curcumin dosages and the curcumin/saffron combination, were effective in reducing depressive and anxiolytic symptoms in individuals with major depressive disorder (Lopresti and Drummond 2017).
Curcumin, a plant polyphenol with strong anti-inflammatory, antioxidant, and neuroprotective properties, has been gaining attention as a potential antidepressant. However, clinical trials have produced inconsistent results regarding its effectiveness in treating depression.
This meta-analysis aims to summarize the current evidence and generate hypotheses for future research. The authors conducted a preliminary search using specific keywords related to curcumin and depression on various databases, resulting in 2081 articles published between January 1, 1960, and August 1, 2016.
After reviewing these articles, six clinical trials involving 377 patients were selected for the meta-analysis, comparing curcumin to a placebo.
The results showed that curcumin significantly improved depressive symptoms, as evidenced by the pooled standardized mean difference from baseline Hamilton Rating Scale for Depression scores (pooled standardized mean difference -0.344, 95% confidence interval -0.558 to -0.129; P = .002).
Additionally, three of the trials reported significant anti-anxiety effects. Importantly, no adverse events were reported in any of the trials. Most trials had a low risk of bias, except for one open trial and one single-blinded study.
However, there were some limitations to this meta-analysis. Due to the small number of studies available, a funnel plot or sensitivity analysis could not be conducted. Furthermore, evidence on the long-term efficacy and safety of curcumin is limited, as the duration of all available studies ranged from 4 to 8 weeks. In conclusion, curcumin appears to be safe, well-tolerated, and effective in treating depression among patients. Future research should include more robust randomized controlled trials with larger sample sizes and longer follow-up periods to confirm its benefits (Ng et al. 2017).
The authors conducted a systematic review and meta-analysis to assess its efficacy and acceptability. Methods: The researchers searched databases such as PubMed, EMBASE, PsycInfo, Web of Science, Cochrane Library, and ClinicalTrials.gov from their inception until March 4, 2020.
They analysed outcomes including depressive symptoms, response rates, drop-out rates, and adverse effects. The meta-analysis included 594 patients from ten trials. Three trials had a high risk of bias, four had an unclear risk of bias, and three had a low risk of bias. Most of the risk of bias domains were at low or unclear risks, with three domains at high risks.
The pooled results indicated a significant difference in depression or depressive symptoms (SMD = -0.32, 95% CI: -0.50 to -0.13, I(2) = 15%, n = 594) and response rates (OR = 3.20, 95% CI: 1.28-7.99, I(2) = 35%, n = 271). However, no differences were found in drop-out rates (OR = 1.06, 95% CI: 0.58-1.93, I(2) = 0%, n = 594), digestive symptoms (OR = 1.27, 95% CI: 0.69-2.32, I(2) = 0%, n = 284), and neurological symptoms (OR = 1.08, 95% CI: 0.49-2.36, I(2) = 0%, n = 284). Subgroup analysis revealed that depression was associated with a reduction (SMD = -0.35, 95% CI: -0.56 to -0.15, I(2) = 7%, n = 432), but depressive symptoms were not (SMD = -0.17, 95% CI: -0.61 to 0.26, I(2) = 40%, n = 162).
Conclusions: The quality of evidence is low, suggesting considerable uncertainty regarding the efficacy and acceptability of curcumin for treating depression or depressive symptoms (Wang et al. 2021).
Curcumin is the major biologically active polyphenolic constituent of Curcuma longa that has been shown to have antioxidant, anti-inflammatory, neuroprotective, anticancer, antimicrobial, and cardioprotective effects. Interest in curcumin as a treatment for mental health conditions has increased and there is an expanding body of preclinical and clinical research examining its antidepressant and anxiolytic effects.
In this narrative review, human trials investigating the effects of curcumin for the treatment of depression or depressive symptoms are summarised.
In vitro, animal and human studies have demonstrated that curcumin has multifactorial physiological effects on the body, which may account for its antidepressant and anxiolytic effects. Positive anxiolytic effects from curcumin administration were also identified in the trials. Disturbances in neurotransmitter activity involving serotonin, dopamine, noradrenaline and glutamate have been regularly observed in depression.
Findings from animal trials have demonstrated curcumin can alter the concentrations and activity of many of these neurotransmitters (Lopresti 2022).
References
Kulkarni, S. K., M. K. Bhutani, and M. Bishnoi. 2008. 'Antidepressant activity of curcumin: involvement of serotonin and dopamine system', Psychopharmacology (Berl), 201: 435-42.
Lopresti, A. L. 2022. 'Potential Role of Curcumin for the Treatment of Major Depressive Disorder', CNS Drugs, 36: 123-41.
Lopresti, A. L., and P. D. Drummond. 2017. 'Efficacy of curcumin, and a saffron/curcumin combination for the treatment of major depression: A randomised, double-blind, placebo-controlled study', J Affect Disord, 207: 188-96.
Lopresti, A. L., M. Maes, G. L. Maker, S. D. Hood, and P. D. Drummond. 2014. 'Curcumin for the treatment of major depression: a randomised, double-blind, placebo controlled study', J Affect Disord, 167: 368-75.
Ng, Q. X., S. S. H. Koh, H. W. Chan, and C. Y. X. Ho. 2017. 'Clinical Use of Curcumin in Depression: A Meta-Analysis', J Am Med Dir Assoc, 18: 503-08.
Sanmukhani, J., V. Satodia, J. Trivedi, T. Patel, D. Tiwari, B. Panchal, A. Goel, and C. B. Tripathi. 2014. 'Efficacy and safety of curcumin in major depressive disorder: a randomized controlled trial', Phytother Res, 28: 579-85.
Wang, Z., Q. Zhang, H. Huang, and Z. Liu. 2021. 'The efficacy and acceptability of curcumin for the treatment of depression or depressive symptoms: A systematic review and meta-analysis', J Affect Disord, 282: 242-51.