How Do I Choose an Over-the-Counter Pill for Depression?

Although severe depression needs the intervention of a doctor's care with prescription medication, those with milder forms of the mental state can often find relief from pills available over the counter.

​Know what each one does, what the correct dosage is and any side effects before taking them.​

Deciding whether to try something over the counter before heading off to the doctor isn't a good idea as the side effects from over-the-counter supplements can be serious. Discuss with your health practitioner whether nutritional deficiencies might contribute to symptoms you're experiencing such as feelings of emptiness, fatigue, changes in appetite and trouble sleeping.

​Depressive brain disorders affect everyone differently​: Some run in families; others are brought on by hormonal changes and are more common in women. Men tend to experience more physical symptoms, such as fatigue and loss of sleep, and are prone to a higher death rate from stress-related disease and suicide.

​Read more:​ 10 Habits Keeping You Depressed

Consulting your doctor is an essential first step to rule out any physical causes for your symptoms, such as a thyroid disorder or other disease. If you're physically OK and don't want to turn to prescribed medication just yet, let your doctor know. ​Many physicians can provide recommendations for OTC supplements​ that might be able to help.

​Don't rely on supplements​ if you have major depression. A 2018 study by the NICM Health Research Institute showed that using a supplement containing popular OTC interventions for depression — including S-adenosyl methionine, folinic acid, omega-3 fatty acids, 5-HTP and zinc picolinate — weren't any more effective than a placebo.

With so many over-the-counter medications offered as potential help for mild depression, you could waste a significant amount of money by using a scattered approach and trying one after another at random. Instead, Mayo Clinic advises considering some pertinent questions when determining with your doctor's help which kind of antidepressant is best suited to your situation.

• ​What are your symptoms?​ Are you having trouble getting to sleep because of a racing mind? You'd want an OTC medication with more sedative properties than if you're having trouble getting off the couch due to fatigue or lack of motivation.
  
• ​What are the side effects?​ Some supplements can decrease libido or cause weight gain, which can make things worse with your partner if you're already feeling undesirable or withdrawn. Other symptoms can include sleeplessness, nervousness or dry mouth.
• ​How does it interact with other substances?​ Check out possible interactions with your other medications, supplements, vitamins or even some foods, such as grapefruit.
• ​Could it affect other health issues?​ Increased blood pressure, dizziness and similar side effects could exacerbate other health issues and leave you feeling worse.
• ​Could it affect your baby?​ If you're pregnant or breastfeeding, many OTC antidepressants could have a potentially harmful effect on your child.
• ​Has anyone in your family used it?​ Sometimes picking an OTC is as easy as trying what worked for a close family member, such as a parent or sibling. It can also help you stay away from those that may have caused your family member unpleasant side effects.

St. John's wort (​Hypericum perforatum​) increases your brain's serotonin levels. It's widely prescribed in Europe and is readily available as a dietary supplement in the U.S. The yellow flower is the medicinal part of the plant, which grows wild in Europe. Although it's considered an exotic flower in the U.S., it can sometimes be found blooming from June through September in moist climates like the Pacific Northwest, the Northeastern U.S. and even northern Arizona.

​Read more:​ 8 Warning Signs of Depression You Shouldn't Ignore

Ancient Greeks used the yellow flowers to make a tea, but the herb is most commonly used in pill form in the U.S. According to the National Center for Complementary and Integrative Health, studies since 2000 have shown the pills are equally as effective as placebos in double-blind studies.

It's essential to ​tell your doctor​ if you're using St. John's wort. It interacts with many medications, including antidepressants, birth control pills, heart medications, cancer medications and more. In the worst instances, a life-threatening increase in serotonin can bring on symptoms such as an increase in body temperature, heart palpitations, diarrhea, high blood pressure and agitation. It can also worsen psychotic symptoms in schizophrenic or bipolar patients.

What it does: The chemical known as ​5-hydroxytryptophan​ — or 5-HTP — can positively affect serotonin levels in the brain. Although it's naturally made as a byproduct in the body from the amino acid ​L-tryptophan​, it's available commercially in pill form sourced from the seed of an African shrub, ​Griffonia simplicifolia​.

Like most substances used to treat depression, 5-HTP is ​only useful for some​. A 2016 study by Duke University showed that the OTC pills significantly helped roughly one-third of participants. It's most effective in the form of a time-release capsule, thanks to extended bioavailability in the body.

5-HTP is generally safe in doses up to 400 milligrams per day, with the most common treatments being 100 to 300 milligrams. In larger doses, stomach and muscle problems can develop. Similar issues can also arise if you take the substance at 400 milligrams for more than a year.

Stop this supplement completely two weeks before surgery — side effects, such as anxiety, shivering and heart problems, can arise when there's too much serotonin in the brain.

Because 5-HTP is so useful and safe, it might be tempting to ingest its parent amino acid, L-tryptophan. ​Don't do it.​ It's linked to 37 deaths and more than 1,500 cases of eosinophilia-myalgia syndrome (EMS). People with EMS develop organ and nerve problems, severe muscle or nerve pain, baldness, skin conditions and swelling.

Even in the short term, the substance can cause diarrhea, belching, abdominal pain, gas and other unpleasant effects. It can aggravate liver and kidney disease as well as some blood disorders, according to WebMD.

Commonly called Arctic root, ​Rhodiola rosea​ grows in the far northern parts of the world, including arctic regions of Alaska, Europe, Sweden and Iceland. The natural supplement shows promise for helping the body deal with stress related to mood, chemicals and the environment. It's also possibly helpful for anxiety, fatigue due to stress and athletic performance, according to WebMD.

A 2016 review of studies on humans and animals by the University of Pennsylvania School of Medicine and the Swedish Herbal Institute showed that ​Rhodiola​ is generally safe and appears to have a beneficial effect on mood.

The seeming miracle supplement isn't without its downsides, however. Some people experience dry mouth, excess salivation or dizziness. Because it boosts the immune system, those with autoimmune disorders shouldn't take it — it can worsen their condition. The herb also lowers blood pressure and blood sugar, so ​seek a doctor's advice​ before taking it if you already take medication for either of these conditions.