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Dr. Bob is Robert Hsiung, MD,
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Posted by Lao Tzu on May 20, 2008, at 16:08:22
Just wanted to comment more thoroughly on taking B vitamins for depression as an adjunct to taking antidepressants and mood stabilizers. I realize that a lot of people, especially healthy people without mental illness, will benefit from taking just a B complex vitamin, either a B-50 or B-100. I'm just proposing the idea that people with mental illness may benefit from taking specific combos of B vitamins at very specific dosages. In my personal experience, a depression with a lot of anxiety may benefit from taking B12, B6, and B3 along with Zinc and Magnesium, and perhaps folic acid added to this regimen as long as you respond well to it. Some depressives actually get worse on folic acid, but some get better too. I'd just like to say about this regimen that when one first starts taking B12 supplements, they may experience a lot of energy initially. Not to be too concerned. It's probably best to start off with a very low dosage of B12 in the beginning, say 250mcg, and then slowly increase the daily dosage over the weeks until you come to a dosage that is comfortable. For me, that is at least 500mcg, but with another person it could be as much as 750mcg or even 1000mcg. B12 tablets you buy in the drug store usually come in 1000mcg sizes, so you can buy a pill cutter at the drug store and divide the tablet into 4 250mcg pieces. This is just a suggestion because when I first started B12 I couldn't take 1000mcg or even 500mcg to start because it was TOO energizing. I had to start low and work up to 500 or 750mcg. As the weeks pass, you may notice that the low dosage becomes ineffective for your depression. Not to worry. You will have to increase it, and eventually the dose will plateau and most likely you will probably get a predictable response every day from a specific dose that feels good to you. At least, in my case, that's how it worked for me. I also found that B12 is good to take with zinc. For me, they seemed to balance each other out, but be careful with zinc. If I took too much I would feel overly sedated. However, some people require more zinc than others, esp. those who have pyroluria condition. I would try anywhere from 15mg to 30mg to start and see how that feels. I would also tell someone that is very lethargic not to take too much zinc and to definitely try taking the B12 with the zinc. I have discovered from trial and error that B12, B6, and B3 work well together. The right dosage of each is imperative. Too much B3 could cause a flushing sensation, but too little might not be very affective for the depression/anxiety. I would always recommend taking the minimum dosage as indicated on the pill bottle, usually 250mg and then increase it until arriving at a comfortable dose. Again, these are just suggestions. When I experimented with the B vitamins I started by taking them individually to see how they made me feel. Over time, I learned that no one B vitamin by itself could address all issues of the depression and that minerals needed to be added for a better effect.
The B vitamins may be more effective if taken in specific combinations at specific dosages. If you are fatigued, a combination of B1, B5, and vitamin C may help. Adding a little fish oil to this may improve mood, but there again, with fish oil I would start off low, say 1 or 2 capsules a day with the b vitamins and gradually increase that over weeks to see what is comfortable to you. Also a note about when you first start taking B1. Many websites proclaim that B1 supplementation is good for anxiety. In my experience, when I first started taking B1 it actually increased my anxiety a little, so if you have a lot of anxiety I wouldn't recommend taking B1, but instead you might try a combination of B12, B6, zinc, magnesium, and B3. With B1 or thiamine, I find that at least 200-300mg a day is beneficial for me, whereas only 100mg is kind of weak. But to start, if may be good to try 50mg and gradually increase it. And I, of course, don't believe that B1 taken alone is going to solve your fatigue problems. In my experience, it seems best to take B1 with B5 or pantothenic acid(50-100mg) and vitamin C as well. COq10 could be added to enhance energy levels, but in my experience, a low dosage of COq10 is sufficient, say 30mg, whereas higher dosages may be counterproductive. I would also recommend Provigil for depressives that have low energy problems. In my experience, this drug made a world of difference to me. I hope this post is insightful for some of you. Though it seems rather simple, it took me a long time to figure out what really worked for me. I would also remind you that these supplements work for me because I am already taking an anti-depressant, anti-psychotic, and a mood stabilizer, so the medication you are taking is probably a factor in how well supplements will work for your depression.
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