Vitamin E, Alpha-Tocopherol, and Its Effects on Depression and Anxiety: A Systematic Review and Meta-Analysis

Systematic review and meta-analysis of 12 adult studies examining depression or anxiety outcomes in people with symptoms or risk of mood disorders. Included populations were diverse, including older adults, women with antenatal/postnatal or menopausal symptoms, and patients with chronic medical or psychiatric conditions.

Oral vitamin E supplementation, reported as alpha-tocopherol or tocopherol, was evaluated across multiple regimens ranging from 80 mg/day to 2000 IU/day for 6 weeks to 3 years. Several trials tested vitamin E alone, while others used it in combination with omega-3 fatty acids, selenium, curcumin, pravastatin, silybin, or DHA.

Vitamin E supplementation showed potential for reducing depressive symptoms, but the anxiety findings were inconclusive. Several small trials reported benefit, including Rees 2008 for depression (HDRS SMD -1.08, 95% CI -1.92, -0.25), Jamilian 2018 (BDI SMD -1.16, 95% CI -1.84, -0.49), and Malaguarnera 2016 (BDI SMD -2.69, 95% CI -3.38, -1.99). Other studies were null or borderline, such as Lu 2009 (SMD -0.24, 95% CI -0.58, 0.10) and Carlsson 2002 (SMD -0.64, 95% CI -1.33, 0.04), and anxiety results ranged from positive to no clear benefit. Overall, the authors concluded that vitamin E may help depressive symptoms, but larger high-quality trials of vitamin E alone are needed.

The evidence base was small and heterogeneous, with varied populations, outcome scales, doses, and treatment durations. Several trials used vitamin E in combination with other active ingredients, making it difficult to isolate the effect of vitamin E alone. Anxiety outcomes were sparse and inconsistent, and some studies did not report quantitative data suitable for pooling.