Malcolm N. McLeod

Effectiveness of chromium in atypical depression: a placebo-controlled trial

BACKGROUND Chromium picolinate (CP) has been reported to benefit patients with symptoms of atypical depression. METHODS A placebo-controlled, double-blind, pilot study of CP was conducted in 15 patients with DSM-IV major depressive disorder, atypical type. Patients received 600 micro g of CP or matching placebo (PBO) for 8 weeks. RESULTS Seven (70%) CP and zero (0%) PBO patients met responder criteria (p =.02). Other outcomes were consistent with greater effect of CP. Three patients on CP failed to show any improvement. Chromium picolinate was well tolerated. CONCLUSIONS Chromium picolinate shows promising antidepressant effects in atypical depression. Its mechanism of action may relate to 5HT2A downregulation, increased insulin sensitivity, or to other effects.

Chromium treatment of depression.

Eight patients with refractory mood disorders received chromium supplements and described dramatic improvements in their symptoms and functioning. In several instances, single-blind trials confirmed specificity of response to chromium. Side-effects were rare and mild, and most commonly included enhanced dreaming and mild psychomotor activation. To our knowledge, this is the first case series describing the response to chromium monotherapy. The putative antidepressant effects of chromium could be accounted for by enhancement of insulin utilization and related increases in tryptophan availability in the central nervous system, and/or by chromiums effects on norepinephrine release.

Chromium Supplementation for Menstrual Cycle-Related Mood Symptoms

ABSTRACT Background: Premenstrual dysphoric disorder (PMDD) afflicts ∼7% of reproductive-age women resulting in impaired relationships, diminished overall quality of life, and disability-adjusted life years lost on par with other major psychiatric disorders. Response to pharmacological treatment is inadequate in ∼50% of women with PMDD. Objective: The goal of the present study is to evaluate the effects of a novel approach—short-term chromium supplementation—on menstrual cycle-related mood and physical symptoms. Methods: Five women were studied under single-blind conditions in a private clinical setting (2 of them were referred specifically for treatment-resistant menstrual-related symptoms); 6 women completed a double-blind crossover study of chromium plus placebo versus chromium plus sertraline in a university clinical research setting. Treatments were administered from mid-cycle to onset of menses in 1-month intervals. Symptom ratings were obtained by self-report, using daily symptom checklists, and by clinical assessment, using the Hamilton Psychiatric Rating Scale for Depression (HAM-D) and the Clinical Global Impressions (CGI) scale. Results: Overall, chromium treatment was associated with reduced mood symptoms and improved overall health satisfaction in most participants. In some cases, chromium alone was associated with marked clinical improvement; in others, chromium plus an antidepressant resulted in greater improvement than either chromium alone or an antidepressant alone. Conclusion: These preliminary observations suggest that chromium may be a useful monotherapy or adjunctive therapy for women suffering from significant menstrual cycle-related symptoms. Larger, controlled studies are needed to evaluate the efficacy of chromium treatment in this patient population.

A comparison of phenelzine and imipramine in depressed inpatients

Phenelzine and imipramine were compared double-blind, in 43 depressed inpatients. A placebo week preceded drug treatment; this allowed early identification of placebo responders who did not therefore enter the study. After three weeks treatment, the two drugs were equally effective on Hamilton, Beck and SCL-90 measures of depression and anxiety. On the the SCL-90 scales of hostility and paranoia imipramine was more effective; in some patients phenelzine was associated with increased hostility. Measurement of MAO inhibition and plasma tricyclic levels indicated that adequate doses were generally used - (mean 81 mg/day phenelzine and 144 mg/day imipramine).