Fact Check: Can Turmeric lemonade treat depression better than Prozac?

A post on Instagram claims that Turmeric lemonade may treat depression better than Prozac.

Claim: An Instagram post claims that Turmeric lemonade may treat depression better than Prozac. The post claims that consuming a mixture of four cups of distilled or filtered water, two tablespoons of turmeric (grated or powdered), juice from one and a half lemons, juice from one blood orange, and Stevia extract may treat depression. The link to the post is here.

Fact Check:

The claim is Mostly False.

What is Depression?

According to the American Psychiatric Association, “Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, think, act, and perceive the world.”(1)

Symptoms:

Symptoms of depression symptoms can vary from mild to severe and can appear differently in each person. These symptoms can include Depression; symptoms can manifest as persistent sadness, irritability, and feelings of emptiness or hopelessness. Affected individuals may lose interest in activities they once enjoyed and experience significant changes in appetite and weight, either eating much less or more than usual and may gain or lose weight. Sleep disturbances are also common, with individuals sleeping too little or too much. There is often a notable decrease in energy, leading to fatigue or increased tiredness, and physical activities may either increase purposelessly or slow down, including slowed speech that others can notice. Feelings of worthlessness or excessive guilt are frequent, alongside difficulties in concentration, forgetfulness, and trouble making decisions. In severe cases, there may be thoughts of death, including suicidal ideation or attempts.

Depression has multiple risk factors - biological (genetic, chronic diseases, terminal illness), psychological, social (familial, relationships, violence, disasters), cultural (religion, caste, beliefs, attitudes), economic, etc. Consumption of alcohol and drugs can further aggravate the condition. Depending on the number and severity of symptoms, it can be categorized as mild, moderate, or severe. Effective treatment options are available. (2)

Incidence of Depression:

Globally, the total number of people with depression was estimated to exceed 300 million in 2015, equivalent to 4.3% of the world’s population. (2) A population-based study in India indicates that the prevalence of depression is at 15.1%, positioning India as the residence of an estimated 57 million people, or 18% of the global total, who are affected by this mental health condition. (3)

Causes of Depression:

Speaking to the medical dialogues team, Dr Meenakshi Jain, Assistant Professor, Psychiatry, Amrita Hospital Faridabad, explained, " Depressive disorders include a range of illnesses like premenstrual dysphoric disorder, disruptive mood dysregulation disorder, major depressive disorder, etc. These disorders, in simple terms, are characterized by a group of symptoms like severe recurrent temper outbursts such as verbal rage, irritability, anger, low mood, limited or diminished interest in nearly all activities, weight loss, disturbed sleep, tiredness, reduced attention and concentration, feeling of worthlessness and in severe cases can also be associated with suicidal thoughts. A few cases of such illness can also show features like overeating or excess sleep.

Causes of depressive disorders

Research in the area of depressive disorders could not conclude a single definite cause for depression. Multiple risk factors are known to be associated with these disorders, like traumatic childhood experiences, stressful life events, genetic factors, negative affective temperament, etc. Hormonal changes such as during the menstrual cycle Or menopause in females or altered testosterone levels in males are also found to be related to depressive symptoms. Many illnesses like hypothyroidism, Parkinson disease, cancer, insomnia etc, have high comorbidity with depression. Finally, many substances, such as alcohol, cannabis, opioids, etc, are also known to factor in the development of depressive disorders."

What is Prozac?

Fluoxetine sold under the brand name Prozac, an FDA-approved medication , is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It has demonstrated efficacy in treating a spectrum of psychological conditions. These indications include major depressive disorder, obsessive-compulsive disorder, panic disorder, bulimia, binge eating disorder, premenstrual dysphoric disorder, and bipolar depression, including cases of treatment-resistant depression when combined with olanzapine.(4)

Can Turmeric lemonade treat depression better than Prozac?

Some studies showed that curcumin in turmeric has antidepressant properties. HAving said that, the claim that turmeric lemonade treats depression better than Prozac is not supported by definitive scientific evidence.

 A study by Lopresti et al. reported while greater antidepressant effects of curcumin compared to placebo were observed from weeks 4 to 8 when evaluating the whole treatment period (i.e., baseline to week 8), curcumin was not found to be significantly more effective than placebo in reducing depressive and anxiety symptoms.

However, they also mentioned that the study's findings on the antidepressant effects of curcumin are limited by its small sample size, which included only about 50 participants and even fewer for those with atypical depression. This limitation affects the reliability and statistical power of the results, suggesting a need for further research with larger sample sizes to confirm these findings. (5)

The study by Sanmukhani J et al. tracked 60 adults diagnosed with Major Depressive Disorder (MDD) who scored above seven on the Hamilton Depression Rating Scale (HAMD-17). Participants were assigned to three groups: one received 1000 mg of curcumin, another 20 mg of fluoxetine and the third a combination of both curcumin (BCM-95) and fluoxetine. After eight weeks, the combined treatment group showed the highest improvement rate at 77.8%, while the fluoxetine-only and curcumin-only groups had response rates of 64.7% and 62.5%, respectively, which were not statistically significant. (6)

However, Goel et al. mentioned, “To achieve therapeutic benefits for serious health conditions, it is recommended to use a concentrated extract of turmeric known as curcumin. Regular turmeric powder, which typically contains only 2-5% curcumin, may not be potent enough for medicinal purposes.” (7)

The studies showed that concentrated curcumin extract affects depressive disorders, not raw turmeric powder.

Responding to the claim, Dr Krithishree S S, Consultant Psychiatrist KMC Hospital, said, " Curcumin, the active compound in turmeric, only makes up about 0.3% to 8.6% of turmeric's composition and has low bioavailability when ingested. Its absorption in the intestines is poor, it has a rapid metabolism and a short half-life, and it's lipophilic, which means it doesn't easily stay in body fluids. Due to its low molecular weight, curcumin struggles to cross the blood-brain barrier effectively. Consequently, conventional doses of curcumin might not provide the necessary levels in the brain to have a significant neuromodulation effect.

Curcumin, the active component in turmeric, is still a long way from becoming an approved antidepressant treatment due to challenges like low bioavailability and difficulty in crossing the blood-brain barrier. Despite its potential as a nootropic, which may enhance mental alertness and energy levels, it is not suitable as a primary treatment for major depressive disorders. Recent advances in pharmacology have led to the development of newer antidepressants that are more effective, faster-acting, better tolerated, and have fewer side effects, making them preferable over curcumin for treating depression."

Medical Dialogues Final Take:

In the field of medical research there has been no head on comparison between turmeric lemonade and Prozac. Turmeric lemonade is not proven to treat depression better than Prozac or any other clinically approved antidepressant medication like fluoxetine (the generic name for Prozac). Most studies on curcumin's effects on depression involve high doses of concentrated curcumin extracts, not turmeric in its natural form, and certainly not in lemonade, which would contain far lower levels of curcumin. Hence, the claim that Turmeric lemonade may treat depression better than Prozac is Mostly false.

References:

1. https://www.psychiatry.org/patients-families/depression.
2. https://www.who.int/india/health-topics/depression.
3. Gandhi, P. Aravind1, Kishore, Jugal2. Prevalence of Depression and the Associated Factors among the Software Professionals in Delhi: A Cross-Sectional Study. Indian Journal of Public Health 64(4):p 413-416, Oct–Dec 2020. | DOI: 10.4103/ijph.IJPH_568_19.

4. Sohel, A. J., Shutter, M. C., Patel, P., & Molla, M. (2024). Fluoxetine. *Last updated February 28, 2024.
5. Lopresti, A. L., Maes, M., Maker, G., & Hood, S. D. (2014). Curcumin for the treatment of major depression: A randomised, double-blind, placebo controlled study. *Journal of Affective Disorders, 167*(1). https://doi.org/10.1016/j.jad.2014.06.001.
6. Sanmukhani J, Satodia V, Trivedi J, Patel T, Tiwari D, Panchal B, Goel A, Tripathi CB. Efficacy and safety of curcumin in major depressive disorder: a randomized controlled trial. Phytother Res. 2013;28(4):579-85.
7. Goel, A. Curcumin: The All in One Solution for Health.