A global review of 64 over-the-counter and natural remedies for depression finds only a few with solid evidence of benefit. Published in 2025, the study urges caution against aggressive marketing of supplements and provides guidance for Thai consumers and healthcare professionals seeking safe, accessible options.
Depression affects people worldwide, including Thailand, where symptoms surged after the COVID-19 era and amid ongoing economic pressures. In Thai communities, mental health stigma still leads many to try herbs or traditional medicines instead of seeking professional care. Data from international research underscore the need for reliable information on effective treatments.
A large international team screened nearly 24,000 records and analyzed 209 randomized trials across 64 OTC products used for at least one week. This rigorous approach helps separate hype from real evidence and how these products compare with placebo.
The results show a gap between popular use and proven benefit. Only five remedies demonstrated substantial evidence across at least 10 trials: omega-3 fatty acids, St John’s Wort, saffron, probiotics, and vitamin D. Saffron, which holds cultural resonance across Asia, stands out as a consistently supported option.
St John’s Wort and saffron emerged as the most promising natural options, with effects sometimes comparable to prescription antidepressants. Omega-3s produced mixed results, while probiotics and vitamin D showed potential to reduce depressive symptoms relative to placebo. Other widely used supplements—such as melatonin, magnesium, and curcumin—generated inconsistent or weak results, offering limited reassurance for mood improvement.
Beyond the top remedies, several lesser-known natural agents showed promise in at least two trials. Folic acid, lavender, zinc, tryptophan, rhodiola, lemon balm, bitter orange, Persian lavender, and chamomile tea appeared to help in some studies. In contrast, prebiotics and SAMe did not outperform placebo in available research.
Among all products assessed, only a minority can be confidently recommended. Nearly two-thirds had only a single trial or low-quality evidence. Researchers call for more high-quality studies, especially for widely used but under-researched items such as ginseng, gingko, lime flower, orange blossom, and peppermint.
Safety concerns recur throughout the review. Many trials did not thoroughly report side effects, and clinicians and consumers should consider possible interactions with other medicines or health conditions. In Thailand, where self-medication remains common from rural herbal shops to urban pharmacies, careful guidance from healthcare professionals is particularly important.
Experts warn that “natural” does not automatically mean harmless or effective. Thai regulators and health authorities are urged to strengthen labeling and regulation of supplements to protect consumers from misleading claims. This aligns with global best practices and supports safer choices for managing mild to moderate depression.
Thai culture blends traditional plant knowledge with modern medicine. Many families rely on local herbs and mindfulness practices as first-line strategies before seeking medical help. The new findings reinforce evidence-based decision-making while respecting cultural practices, and they open opportunities to integrate effective supplements with counseling and Buddhist mental training in culturally appropriate ways.
Looking ahead, researchers identified gaps, including the lack of trials pairing natural products with psychotherapy or counseling. Given Thailand’s screening and access challenges for mental health services, integrated approaches could be particularly relevant and culturally sensitive.
The report also calls for improved safety reporting in OTC trials. A higher standard of adverse-event monitoring is essential to protect vulnerable groups, including the elderly and those with complex health needs. Strengthened collaboration among healthcare providers, traditional healers, and regulators will be crucial for Thailand’s safe supplement use.
Practical guidance for Thai readers considering natural approaches to depression includes consulting a healthcare professional before starting any supplement, prioritizing products with robust evidence (notably St John’s Wort, saffron, probiotics, and vitamin D), and maintaining healthy skepticism toward online testimonials. Families can support safe decisions by engaging in open conversations and seeking professional guidance alongside trusted traditional practices.
Actionable steps:
- Check with a local pharmacist or healthcare provider about evidence-based products.
- Seek help from hospital mental health services or hotlines when needed.
- Stay informed through reputable Thai medical bodies and public health agencies.
In summary, while some natural remedies offer real relief, effective depression treatment still hinges on evidence-based medicine, professional guidance, and thoughtful integration with traditional practices. The findings encourage readers and policymakers to scrutinize health claims and prioritize safety and transparency in the pursuit of better mental health for all Thais.