Is Saffron as good as fluoxetine? Human psycho pharm. 2014.Nov

17.11.2014

Saffron is the dried  stigmas and styles of the saffron flower (Crocus sativus L.). It is  the most expensive spice in the world. Saffron has been used as an anticonvulsive, analgesic, aphrodisiac and antispasmodic in traditional medicine. Pharmacological studies have shown that it may have anticancer, anti-inflammatory, antioxidant and anti platelet effects. A recent meta-analysis, was confirmed to be effective for the treatment of depression (Hausenblas et al., 2013).

What are the underlying mechanisms that make saffron an antidepressant?

Lopresti &  Drummond explores the evidence for saffrons antidepressant action and describes possible mechanisms in this article.

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1. Constituents of saffron like   crocin, crocetin and safranal, are potent antioxidants. Depression is associated with lowered antioxidant enzymes and elevated oxidative stress. The antioxidant action is high  when  the above three constituents are delivered collectively.

2. Crocin and crocetin  in saffron is shown to have strong anti-inflammatory activity. Depression is associated with inflammatory disorders. Inflammatory markers like C-reactive protein , interleukin-6 , and tumour necrosis factor-α are repeatedly shown to be higher in depression. Cytokine therapy is known to increase depression. Some anti-inflammatory agents have antidepressant action. Some antidepressants have anti-inflammatory action.

3. Evidence of saffron’s action on serotenerigic system is lacking

4.  Saffron might have a role in lowering the HPA response to stress, there is limited preliminary evidence to support this.

5. Saffron have some neuroprotective effect .It can increase BDNF.

4 published RCTs suggest that in mild moderate depression saffron is as effective as fluoxetine or imipramine. The effect size in 2013 metaanlysis was 1.62. The dosage used was 30mg/day. Daily dose up to 1.5 gm is considered safe.  Authors caution  use in individuals with coagulation disorders.Long term efficacy is not been studies beyond 8 weeks.

It appears that it is a promising option in mild to moderate depression. Studies on severe depression and for longer periods are lacking. Trials has not been conducted outside Iran.  Larger clinical trials with long-term follow-ups are needed before firm conclusions can be made regarding saffron‘s efficacy and safety for treating depressive symptoms.

 Author  (AL)has declared that he has shares in a neutraceutical company.

Summary of the article:

Saffron (Crocus sativus) for depression: a systematic review of clinical studies and examination of underlying antidepressantmechanisms of action.

Lopresti AL, Drummond PD.Hum Psychopharmacol. 2014 Nov;29(6):517-27

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