[SAT-377] Vitamin D Deficiency (VDD) and Major Depressive Disorder (MDD): A Causal or Casual Association?
Sonal Pathak, Mohammad Asim Nisar, David S Rosenthal. Bayhealth Endocrinology, Dover, DE; St Lukes Roosevelt Hospital, New York, NY; Nassau University Medical Center, East Meadow, NY.
Background: Vit D is associated with several metabolic, musculoskeletal and immunologic effects. Its psychosomatic effects have been speculated, but less studied. We present 3 cases of VDD in patients with MDD, with significant improvement in mood after repletion. We'll discuss controversies regarding effects of Vit D on mood and cognitive disorders and a potential role of Vit D replacement as an adjunct in management of MDD in Vit D deficient patients.
Cases: Patient #1 was a 42 y/o F treated for hypothyroidism with obesity and depression for 5 years. She was euthyroid on a stable dose of L-T4 with TSH 1.24µIU/ml (0.45-4.50). In spite of optimization of antidepressant therapy, her depression had exacerbated over the preceding 6 months (*BDI 32). Patients #2 and #3 were females aged 58 and 66 years, being treated for DM2 and also suffered from depression (*BDI 26 and 21 respectively). VDD was suspected based on risk factors/symptoms. Presenting 25(OH)VitD levels were low (normal 30-85 ng/ml) at 12, 8.9 and 14.5ng/ml respectively. After Vit D repletion, 25(OH)Vit D levels became sufficient at 32, 34.6, and 38ng/ml respectively. Other medications and environmental factors were unchanged. Depressive symptoms were reported to be significantly improved by all patients (*BDI 12, 8 and 16 respectively).
Discussion: Vit D receptors and α-hydroxylases have been mapped throughout the brain, including the amygdala/limbic system, where behavior/emotions are regulated. Vit D is also involved in release of neurotransmitters like serotonin/dopamine in brain. Association of VDD with dementia & schizophrenia has been well studied. However, data from epidemiological studies and a few randomized controlled trials on relationship between Vit D status and depression has been equivocal, although suggestive of a possible causal association. Effects of Vit D replacement in deficient patients with MDD has been less studied, with a few reports suggesting a significant positive effect, but limited by confounding variables.
Conclusion: Detection and treatment of VDD in patients with depression may be an easy and cost-effective adjunct to mainstream therapies; however, more research is needed to definitively confirm these findings.
*Beck Depression Inventory score (BDI): 0–9 minimal depression; 10–18 mild depression; 19–29 moderate depression; 30–63 severe depression.
1. Milaneschi et al, JCEM 95(7), July 2010. 2. Ganji et al, Int Archives of Medicine, 2010, 3:29. 3. Bertone-Johnson, Nutr Rev. August 2009; 67(8).
Nothing to Disclose: SP, MAN, DSR
Date: Saturday, June 23, 2012
Session Info: POSTER SESSION: Metabolic Bone Diseases (1:30 PM-3:30 PM)
Presentation Time: 1:30 pm
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