Bioactive Components for Depression: Naringin, Caffeine, Probiotics, Saffron and Lavender May Exert Antidepressant Effects Through Inflammation Modulation

Depression is one of the most prevalent psychiatric illnesses, leading to increased functional disability and mortality. Current pharmacotherapy is moderately effective, with response rates and remission rates reported at 50% and 15-40% following the first trial with conventional drugs, respectively, and electroconvulsive therapy is beneficial for only half of the refractory patients. A more accurate understanding of pathophysiology and the use of complementary therapies to overcome resistance to treatment have been suggested (1). After serotonergic and then glutamatergic systems, new research in the pathophysiology of depression has turned to the inflammatory mechanism. In this mechanism, cytokines disrupt tryptophan, Brain-Derived Neurotrophic Factor (BDNF), cAMP Response Element-Binding protein (CREB), and tropomyosin receptor kinase B (TrkB) levels balance (2). This mechanism is briefly described in figure 1. Celecoxib, simvastatin, pioglitazone, and dexamethasone are the medications that have had both antidepressant and anti-inflammatory effects in clinical trials (2). Another novel drug is gemfibrozil, which possibly exerts its antidepressant effects on humans through enhancing the BDNF pathway and activating CREB (1).