Role of vitamin D supplementation as adjunctive therapy to escitalopram in patients of major depressive disorder: a 8 week prospective, randomized, interventional, clinical study


  • Shivangna Singh Department of Pharmacology, FHMC, Agra, Uttar Pradesh, India
  • Priyamvada Sharma Department of Pharmacology, FHMC, Agra, Uttar Pradesh, India
  • Vivek Gautam Department of General Medicine, SNMC, Agra, Uttar Pradesh, India



Major depressive disorder, Selective serotonin reuptake inhibitor, Vitamin D3


Background: Depression is a major public health problem and occurs in persons of all ages, and is associated with increased morbidity, soaring costs for treatment and reduced productivity and quality of life. Vitamin D is involved in numerous brain processes including neuroimmunomodulation, neuroprotection, neuroplasticity, regulation of neurotrophic factors, and making it biologically plausible to be associated with depression. Aim of the present study is to compare the therapeutic effects of vitamin D given along with escitalopram versus escitalopram given alone in patients with major depressive disorder.  

Methods: In this prospective, randomized, interventional clinical study, 60 patients with a diagnosis of major depressive disorder based on ICD-10 criteria were randomly assigned into two groups, one group received 60000IU vitamin D3 weekly plus 10 mg escitalopram OD daily while the other group received escitalopram10 mg OD daily alone for 8 weeks. Depression severity was assessed at 2-week intervals using the 24-item Hamilton Depression Rating Scale (HDRS). Serum 25(OH) vitamin D levels were measured in all the patients at baseline and after intervention.

Result: Fifty nine patients completed the trial. Depression severity based on HDRS decreased significantly after intervention, with a significant difference between the two groups. The vitamin D3+escitalopram combination was significantly better than escitalopram alone from the fourth week of treatment. Conclusion: Role of vitamin D in mood disorder and its dietary supplementation is effective as an adjuvant treatment along with SSRIs in depressive disorders, especially in vitamin D deficient patients.


Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006Nov28;3(11):442.

Eyles DW, Smith S, Kinobe R, Hewison M, McGrath JJ. Distribution of the vitamin D receptor and1alpha-hydroxylase in human brain. J Chem Neuro Anat. 2005;29(1):21-30.

Patrick RP, Ames BN. Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism. FASEB J. 2014Jun;28(6):2398-413.

Capuron L, Miller AH. Cytokines and psychopathology: lessons from interferon-alpha. Biol Psychiatry. 2004;56(11):819-24.

De Abreu DF, Eyles D, Feron F. Vitamin D, a neuroimmunomodulator: implications for neurodegenerative and autoimmunediseases. Psychoneuroendocrinology. 2009;34(Suppl 1):265-77.

Eyles DW, Feron F, Cui X. Developmental vitamin D deficiency causes abnormal brain development. Psychoneuroendocrinol. 2009;34:247-57.

Nayereh K, Mehdi TH . Therapeutic effects of vitamin D as adjunctive therapy to fluoxetine in patients with major depressive disorder. Australian NZ J Psychiatry. 2012;47(3):271-5.

Rebecca ES, Anglin, Zainab S. Vitamin D deficiency and depression in adults: systematic review and meta-analysis. The British J Psychiatry. 2013;202:100-7.

Zanetidou S, Murri MB, Buffa A. Vitamin D supplements in geriatric major depression. Int J Geriatric Psych. 2011;26:1209-10.

Sanders KM, Stuart AL, Williamson EJ. Annual high-dose vitamin D3 and mental well-being: Randomised controlled trial. British J Psychiatry. 2011;198(5):357-64.

Robinson M, Whitehouse AJ, Newnham JP. Low maternal serum vitamin D during pregnancy and the risk for postpartum depression symptoms. Arch Womens Ment Health. 2014;17(3):213-9.

Williams JA, Romero VC, Clinton CM. Vitamin D levels and perinatal depressive symptoms in women at risk: a secondary analysis of the mothers, omega-3, and mental health study. BMC Pregnancy Childbirth. 2016;16(1):203.

Murphy PK, Wagner CL. Vitamin D and mooddisorders among women: An integrative review. J. Midwifery. Womens Health. 2008;53(5):440-6.

Vaziri F, Nasiri S, Tavana Z. A randomized controlled trial of vitamin D supplementation on perinatal depression: in Iranian pregnant mothers. BMC Pregnancy Childbirth. 2016;16:23-9.

McCann JC, Ames BN. Is there convincing biological or behavioral evidence linking vitamin D deficiency to brain dysfunction? FASEB. J. 2008;22(4):982-1001.

Garcion E, Wion-Barbot N, Montero-Menei CN. New clues about vitamin D functions in the nervous system. Trends. Endocrinol. Metab. 2002;13(3):100-5.

Eyles D, Cui X, Pelekanos M. Developmental Vitamin D Deficiency and Brain Dopamine Ontogeny. Schizophr. Res. 2010;117(2-3):169.

Sanchez B, Relova JL, Gallego R. 1, 25-Dihydroxyvitamin D3 administration to 6-hydroxydopamine-lesioned rats increases glial cell line-derived neurotrophic factor and partially restores tyrosine hydroxylase expression in substantia nigra and striatum. J. Neurosci. Res. 2009;87(3):723-32.

Jain SK, Micinski D. Vitamin D upregulates glutamate cysteine ligase and glutathione reductase and GSH formation and decreases ROS and MCP-1 and IL-8 secretion in high-glucose exposed U937 monocytes. Biochem. Biophys. Res. Commun. 2013;437(1):7-11.




How to Cite

Singh, S., Sharma, P., & Gautam, V. (2019). Role of vitamin D supplementation as adjunctive therapy to escitalopram in patients of major depressive disorder: a 8 week prospective, randomized, interventional, clinical study. International Journal of Basic & Clinical Pharmacology, 8(8), 1713–1716.



Original Research Articles