Effects of Ellagic Acid Supplementation on Antioxidant Status and Symptom Improvement in Patients with Major Depressive Disorder: A Double-blind Randomized Clinical Trial

Abstract

Background: Depression is one of the most common mood disorders and a major public health concern. Ellagic acid (EA), a type of polyphenol, acts as a strong hydrogen bond network as an electron receptor, enabling it to participate in various reactions. Objectives: Major depression is a critical medical condition that has emerged as a public health issue due to its high incidence, mortality, and suicide rates. One significant factor in the pathogenesis of depression is oxidative stress. This study aimed to evaluate the effects of ellagic acid supplementation on antioxidant status and symptom improvement in patients with major depressive disorder, considering the antioxidant capabilities of ellagic acid. Methods: A total of 40 patients diagnosed with major depressive disorder based on DSM-V criteria were assessed using the Beck Depression and Hamilton Depression Questionnaires. The dietary and caloric intake of the patients were monitored. Additionally, height and weight were measured, and patients with similar age, gender, and weight were matched. The individuals were randomly assigned to either the intervention group or the placebo group using a randomization table. The intervention group received a daily dose of 200 mg of ellagic acid in capsule form. The placebo group received a daily dose of one capsule containing 200 mg of wheat flour, identical in appearance to the intervention substance. The study period lasted for 8 weeks. Venous blood samples were collected before and after the study from all 40 individuals, and after serum separation, oxidative stress markers (malondialdehyde and total antioxidant capacity). were measured using a specific kit and ELISA method. Results: The study results showed a significant reduction in depression scores in the ellagic acid group during the study (P: 0.001)., with these alterations being significant when compared to the placebo group. In the ellagic acid group, a significant increase in total antioxidant capacity (P: 0.027). and a significant decrease in malondialdehyde levels (P: 0.014). were observed at the end of the study, and these changes were significant compared to the placebo group. In contrast, significant changes in total antioxidant capacity and malondialdehyde levels were not observed in the placebo group. Conclusions: The current study indicates that ellagic acid intervention may have a favorable effect on depression in patients with major depressive disorder. This is achieved by reducing BDI scores and serum levels of MDA, as well as increasing serum levels of TAC in these patients compared to the placebo group. However, further investigation is necessary to explore the mechanisms underlying the different alterations of ellagic acid in depression.