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Information on the latest vitamin D news and research.

Find out more information on deficiency, supplementation, sun exposure, and how vitamin D relates to your health.

RCT: Vitamin D and Prozac

Many readers have either taken a selective serotonin reuptake inhibiter (SSRI) like Prozac, Zoloft, Celexa, Lexapro, Luvox, or Paxil for one of the following:

  • depression
  • anxiety
  • obsessive-compulsive disorder
  • or for other indications

While the potential side effects of these SSRIs are considerable, most people tolerate the drugs just fine. However, the drugs frequently either don’t work or only help a little.

Iranian researchers, led by Dr Nayereh Khoraminya, recently tested vitamin D in a randomized controlled trial to see if it helped Prozac work better. Vitamin D was added to standard treatment to see if Prozac and vitamin D worked better than Prozac alone. They studied 42 patients with major depression, giving half of them 20 mg/day of Prozac and the other half 20 mg/day of Prozac plus 1,500 IU/day of vitamin D.

Khoraminya N, Tehrani-Doost M, Jazayeri S, Hosseini A, Djazayery A. Therapeutic effects of vitamin D as adjunctive therapy to fluoxetine in patients with major depressive disorder. Aust N Z J Psychiatry. 2012 Oct 23

The researchers tested depression severity at the beginning of the study then every two weeks for eight weeks. The first thing they found was that 95% of their patients had levels less than 30 ng/ml. They also found the lower the level at the beginning of the study, the worse the depression, a correlation that has been reported many times before.

What had not been reported before was that vitamin D made Prozac work better. Prozac often takes 8 weeks to begin working, but here, after only four weeks, they saw that the Prozac and vitamin D group had improved more than the Prozac only group (p<.001). That improvement continued throughout the study.

Depression is a serious disease, it often makes life not worth living. I recommend standard treatment by a physician together with 10,000 IU/day of vitamin D. That dose, 10,000 IU/day, is safe according to the Food and Nutrition Board (FNB) as that is the NOAEL or “no observed adverse effects level.” That is, the FNB says that there are no credible reports of adults taking 10,000 IU/day and suffering any ill effects.

If you want to try 10,000 IU/day before seeing the doctor, I understand, but unless you notice a response within the first few weeks, please see a doctor as major depression is a life threatening disorder.

Remember also that sunlight and sunbeds help depressive symptoms via a number of non-vitamin D mechanisms including bright light, endorphins, melatonin, and probably other mechanisms. I have treated some people with depression where the only thing that cured their depression was daily sunlight or sunbed exposure.

  About: John Cannell, MD

Dr. John Cannell is founder of the Vitamin D Council. He has written many peer-reviewed papers on vitamin D and speaks frequently across the United States on the subject. Dr. Cannell holds an M.D. and has served the medical field as a general practitioner, emergency physician, and psychiatrist.

2 Responses to RCT: Vitamin D and Prozac

  1. JBG says:

    “Iranian researchers. . .studied 42 patients with major depression, giving half of them 20 mg/day of Prozac and the other half 20 mg/day of Prozac plus 1,500 IU/day of vitamin D.”

    My immediate thought on reading that was, Why didn’t they have a third group that got 1,500 IU/day of vitamin D, period? Couldn’t it be that vitamin D by itself was doing most of the heavy lifting in the Prozac+D group?

    I agree that sunlight would likely be even better.

  2. logan_n@q.com says:

    There are probably other or analogous examples of this effect. Sometimes a phase III trial does not produce results expected from phase II, and one could check to see if latitude or season had an effect in some cases. Probably detailed data would only be available to a CRO or a pharma company — or is that wrong? I don’t know what the FDA does with data after an approval determination is made, or if data is now submitted in machine readable form.

    The council could contact such sources and propose some statistical work. Such information would be worth a lot to pharmas spending large sums to test new drugs.