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Supplements for mood and depression

Saffron, EPA, SAMe, and curcumin — the four monotherapies that beat antidepressants in the 2025 NMA.

The 2025 Cheng network meta-analysis (192 trials, 17,437 patients) ranks four nutraceuticals as monotherapy superior to standard antidepressants: saffron (SMD 0.69), curcumin (0.62), omega-3 EPA+DHA (0.60), and SAMe (0.52). As ADJUNCTS to antidepressants, zinc adds the largest effect (SMD 1.59). Caution: every serotonergic supplement on this list (5-HTP, tryptophan, SAMe, St John's Wort, saffron, rhodiola) carries serotonin-syndrome risk if combined with SSRI/SNRI/MAOI without psychiatrist input.
83
Zinc
Immunity · Cold duration
Tier 1
79
Inositol (high-dose, psychiatric)
OCD · Panic disorder · Mood
Tier 2
79
Inositol myo-form (PCOS/metabolic)
PCOS · Insulin sensitivity · Ovulation
Tier 2
78
Folate (5-MTHF)
Pregnancy · Methylation · Mood
Tier 1
72
Saffron (Crocus sativus)
Depression · Anxiety · Cognition
Tier 1
72
Lactobacillus casei Shirota
Gut · Immunity · Mood
Tier 2
72
Lactobacillus helveticus/B. longum R0052/R0175
Gut-brain axis · Stress · Mood
Tier 2
70
Bifidobacterium longum
Gut · Immunity · Mood-gut axis
Tier 2
69
Saffron Affron (standardised extract)
Depression · PMS · Cognition
Tier 2
65
Algal EPA (standalone)
Cardiovascular · Anti-inflammatory · Vegan
Tier 2
65
Uridine monophosphate (UMP)
Cognition · Brain health · Mood
Tier 2
64
Vitex / Chasteberry (Vitex agnus-castus)
PMS · Cycle regulation · Prolactin
Tier 2
62
S-Adenosylmethionine (SAMe)
Depression · Joint · Liver
Tier 2
62
Chasteberry/Vitex standardised (BNO 1095)
PMS · Menstrual regulation · Women's health
Tier 2
60
St. John's Wort
Mild-moderate depression
Tier 2
59
Black cohosh (Cimicifuga racemosa)
Menopause · Hot flashes · Mood
Tier 3
56
Activated B complex (methylated)
Energy · Mood · Methylation
Tier 3
56
DLPA (DL-Phenylalanine)
Mood · Pain · Catecholamines
Tier 3
55
Lion's mane mushroom
Cognition · Neuroprotection
Tier 3
53
Tryptophan (L-tryptophan)
Sleep · Mood · Serotonin precursor
Tier 3
52
Hericium erinaceus mycelium (Amyloban 3399)
Neuroprotection · Mood · Cognitive decline
Tier 3
50
Cannabigerol (CBG)
Cannabinoid · Anti-inflammatory · Focus
Tier 3
48
Agmatine sulfate
Neuropathic pain · Mood · Athletic
Tier 3
46
5-HTP
Mood · Sleep · Appetite
Tier 3
46
Lithium orotate (low-dose)
Mood · Neuroprotection · Longevity
Tier 3
Educational reference, not medical advice. Discuss any supplement change with a qualified clinician before acting on this list.
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