Selective dietary supplementation in early postpartum is associated with high resilience against depressed mood

Abstract

Medical research is moving toward prevention strategies during prodromal states. Postpartum blues (PPB) is often a prodromal state for postpartum depression (PPD), with severe PPB strongly associated with an elevated risk for PPD. The most common complication of childbearing, PPD has a prevalence of 13%, but there are no widespread prevention strategies, and no nutraceutical interventions have been developed. To counter the effects of the 40% increase in monoamine oxidase A (MAO-A) levels that occurs during PPB, a dietary supplement kit consisting of monoamine precursor amino acids and dietary antioxidants was created. Key ingredients (tryptophan and tyrosine) were shown not to affect their total concentration in breast milk. The aim of this open-label study was to assess whether this dietary supplement reduces vulnerability to depressed mood at postpartum day 5, the typical peak of PPB. Forty-one healthy women completed all study procedures. One group (n = 21) received the dietary supplement, composed of 2 g of tryptophan, 10 g of tyrosine, and blueberry juice with blueberry extract. The control group (n = 20) did not receive any supplement. PPB severity was quantitated by the elevation in depressed mood on a visual analog scale following the sad mood induction procedure (MIP). Following the MIP, there was a robust induction of depressed mood in the control group, but no effect in the supplement group [43.85 ± 18.98 mm vs. 0.05 ± 9.57 mm shift; effect size: 2.9; F(1,39) = 88.33, P < 0.001]. This dietary supplement designed to counter functions of elevated MAO-A activity eliminates vulnerability to depressed mood during the peak of PPB.

Trial registration: ClinicalTrials.gov NCT02073175.

Keywords: monoamine; monoamine oxidase A; postpartum blues; prevention; prodrome.

Conflict of interest statement

Conflict of interest statement: Y.D. is developing natural health products to overcome a high MAO-A state in early postpartum. J.H.M. has received operating grant funding for other studies from Eli Lilly, GlaxoSmithKline, Bristol-Myers Squibb, Lundbeck, SK Life Science, and Johnson & Johnson/Janssen in the past 5 years. J.H.M. has served as a consultant for all of these companies except Johnson & Johnson, as well as for Sepracor, Trius Therapeutics, and Mylan Inc. None of these companies participated in the funding, design, or execution of this study or preparation of the manuscript. J.H.M. is developing natural health products to treat high-risk states for major depressive episode, and is listed as the inventor on a patent application for this dietary supplement. J.H.M. is applying for patents to implement measures using MAO to diagnose or treat mood disorders and to use peripheral measures as surrogate measures for brain inflammation. Z.V.S. receives royalties from Guilford Press for books related to mindfulness-based cognitive therapy and fees for training workshops. He also serves on the advisory board of MindfulNoggin, part of NogginLabs, a private company specializing in customized web-based learning. D.E.S. is a member of the scientific advisory board for the Cymbalta (duloxetine) Pregnancy Registry for Eli Lilly. She is a co-author of UpToDate chapters on antidepressant drugs during pregnancy and their effects on exposed infants. A.V.R. and M.S. do not have any conflicts of interest related to this work.

Figures

Fig. 1.

Timing of the VAS and POMS relative to the MIP.

Fig. 2.

Elimination of sad mood induction in postpartum women after taking the supplement. There was a highly significant elevation in depressed mood scores as measured by a VAS in day-5 postpartum women not taking any supplements compared with day-5 postpartum women taking the dietary supplement [F(1,39) = 88.33, P < 0.001, repeated-measures ANOVA].

Fig. 3.

No mood induction effect on POMS depression scores in postpartum women after taking the supplement. There was a significant elevation in depression scores as measured by the POMS in day-5 postpartum women not taking any supplements compared with day-5 postpartum women taking the dietary supplement [F(1,39) = 20.24, P < 0.001, repeated-measures ANOVA].