Evaluation of Serum Magnesium Levels in Patients With the Diagnosis of Depressive Disorder Applied to a Psychiatry Clinic: A Retrospective Study

Year 2024, , 33 - 39, 20.03.2024

Sinan Altunöz , Hayriye Baykan , Özgür Baykan

https://doi.org/10.53424/balikesirsbd.1276423

Abstract

ABSTRACT
Objective: The role of magnesium in the pathophysiology of depression has increased the interest in magnesium. Therefore, in this study, we aimed to evaluate serum magnesium levels in patients diagnosed with depressive disorder who applied to the psychiatry outpatient clinic. Materials and Methods: The data of 1013 patients who were diagnosed with depressive disorder and whose serum magnesium levels were measured were included in the study by retrospectively scanning the data of the patients who had applied to the Psychiatry outpatient clinic of Balıkesir University Faculty of Medicine between July 2020 and July 2022. Since the serum glucose, GGT and creatinine values were above their reference ranges in 183 of 1013 patients included in the study, the data of these patients were excluded from the analysis. Results: Serum magnesium values of 12.9% of female and 9.1% of male patients were below the reference values (1.9-2.7 mg/dl). The mean (±SD) magnesium values of all patients, female and male patient groups were statistically significantly different from the population mean. (2.02±0.15 mg/dl, 2.01±0.16 mg/dl and 2.04±0.15 mg/dl ; P<0.001, P<0.001, and P<0.001, respectively). No statistically significant relationship was observed between magnesium levels and age of the patients. Conclusion: In our study, hypomagnesemia was observed in 11.9% of patients with a diagnosis of depressive disorder. For this reason, we thought that if hypomagnesemia is detected in patients followed up with depressive disorder, its replacement may be important as it may be effective in reducing depressive symptoms.
Keywords: Magnesium, Depression, Adjunctive therapy, Antidepressants.

Keywords

Magnesium, Depression, Adjunctive therapy, Antidepressants

References

• Abumaria, N., Yin, B., Zhang, L., Li, X. Y., Chen, T., Descalzi, G., et al. (2011). Effects of elevation of brain magnesium on fear conditioning, fear extinction, and synaptic plasticity in the infralimbic prefrontal cortex and lateral amygdala. The Journal of neuroscience : the official journal of the Society for Neuroscience, 31(42), 14871–14881. https://doi.org/10.1523/JNEUROSCI.3782-11.2011
• Afsharfar, M., Shahraki, M., Shakiba, M., Asbaghi, O., & Dashipour, A. (2021). The effects of magnesium supplementation on serum level of brain derived neurotrophic factor (BDNF) and depression status in patients with depression. Clinical nutrition ESPEN, 42, 381–386. https://doi.org/10.1016/j.clnesp.2020.12.022
• Andrade C. (2017). Ketamine for Depression, 1: Clinical Summary of Issues Related to Efficacy, Adverse Effects, and Mechanism of Action. The Journal of clinical psychiatry, 78(4), e415–e419. https://doi.org/10.4088/JCP.17f11567
• Berman, R. M., Cappiello, A., Anand, A., Oren, D. A., Heninger, G. R., Charney, D. S., et al. (2000). Antidepressant effects of ketamine in depressed patients. Biological psychiatry, 47(4), 351–354. https://doi.org/10.1016/s0006-3223(99)00230-9
• Chrzastek, Z., Guligowska, A., Sobczuk, P., & Kostka, T. (2023). Dietary factors, risk of developing depression, and severity of its symptoms in older adults-A narrative review of current knowledge. Nutrition (Burbank, Los Angeles County, Calif.), 106, 111892. https://doi.org/10.1016/j.nut.2022.111892
• Cipriani, A., Furukawa, T. A., Salanti, G., Chaimani, A., Atkinson, L. Z., Ogawa, Y., et al. (2018). Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet (London, England), 391(10128), 1357–1366. https://doi.org/10.1016/S0140-6736(17)32802-7
• Cubała, W. J., Landowski, J., Szyszko, M., & Czarnowski, W. (2013). Magnesium in drug-naïve patients with a short-duration, first episode of major depressive disorder: impact on psychopathological features. Magnesium research, 26(4), 192–198. https://doi.org/10.1684/mrh.2014.0355
• Duncan, W. C., Sarasso, S., Ferrarelli, F., Selter, J., Riedner, B. A., Hejazi, N. S., et al. (2013). Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder. The international journal of neuropsychopharmacology, 16(2), 301–311. https://doi.org/10.1017/S1461145712000545
• Eby, G. A., & Eby, K. L. (2006). Rapid recovery from major depression using magnesium treatment. Medical hypotheses, 67(2), 362–370. https://doi.org/10.1016/j.mehy.2006.01.047
• Górska N., Sáupski J., Szaáach ŁP., Wáodarczyk A., Szarmach J., Jakuszkowiak-Wojten K., et al. (2019). Magnesium and ketamine in the treatment of depression. Psychiatr. danubina 31(Suppl. 3) 549–553.
• Gragossian, A., Bashir, K., Bhutta, B. S., & Friede, R. (2022). Hypomagnesemia. In StatPearls. StatPearls Publishing.
• Gröber, U., Schmidt, J., & Kisters, K. (2015). Magnesium in Prevention and Therapy. Nutrients, 7(9), 8199–8226. https://doi.org/10.3390/nu7095388
• Gröber U. (2006). Interaktionen zwischen Arzneimitteln und Mikronährstoffen [Interactions between drugs and micronutrients]. Medizinische monatsschrift fur pharmazeuten, 29(1), 26–35.
• Ismail, Y., Ismail, A. A., & Ismail, A. A. (2010). The underestimated problem of using serum magnesium measurements to exclude magnesium deficiency in adults; a health warning is needed for "normal" results. Clinical chemistry and laboratory medicine, 48(3), 323–327. https://doi.org/10.1515/CCLM.2010.077
• Jorm AF, Patten SB, Brugha TS, Mojtabai R. (2017). Has increased provision of treatment reduced the prevalence of common mental disorders? Review of the evidence from four countries. World Psychiatry, 16:90–99.
• Kim YK, Na KS, Myint AM. (2016). The role of pro-inflammatory cytokines in neuroinflammation, neurogenesis and the neuroendocrine system in major depression. Progress in neuro-psychopharmacology & biological psychiatry, 64:277–284.
• Lang, U. E., Beglinger, C., Schweinfurth, N., Walter, M., & Borgwardt, S. (2015). Nutritional aspects of depression. Cellular physiology and biochemistry: international journal of experimental cellular physiology, biochemistry, and pharmacology, 37(3), 1029–1043. https://doi.org/10.1159/000430229
• Mederle, O. A., Balas, M., Ioanoviciu, S. D., Gurban, C. V., Tudor, A., & Borza, C. (2018). Correlations between bone turnover markers, serum magnesium and bone mass density in postmenopausal osteoporosis. Clinical interventions in aging, 13, 1383–1389. https://doi.org/10.2147/CIA.S170111
• Misztak P, Opoka W, Topór-Mądry R. (2015). The serum concentration of magnesium as a potential state marker in patients with diagnosis of bipolar disorder. Psychiatria polska, 49: 1277- 87.
• Morrissette, D. A., & Stahl, S. M. (2014). Modulating the serotonin system in the treatment of major depressive disorder. CNS spectrums, 19 Suppl 1, 57–68. https://doi.org/10.1017/S1092852914000613
• Poleszak, E., Wlaź, P., Kedzierska, E., Nieoczym, D., Wróbel, A., Fidecka, S., et al. (2007). NMDA/glutamate mechanism of antidepressant-like action of magnesium in forced swim test in mice. Pharmacology, biochemistry, and behavior, 88(2), 158–164. https://doi.org/10.1016/j.pbb.2007.07.018
• Rajizadeh, A., Mozaffari-Khosravi, H., Yassini-Ardakani, M., & Dehghani, A. (2017). Effect of magnesium supplementation on depression status in depressed patients with magnesium deficiency: A randomized, double-blind, placebo-controlled trial. Nutrition (Burbank, Los Angeles County, Calif.), 35, 56–60. https://doi.org/10.1016/j.nut.2016.10.014
• Singewald N., Sinner C., Hetzenauer A., Sartori S. B., Murck H. (2004). Magnesium-deficient diet alters depression- and anxiety-related behavior in mice – influence of desipramine and Hypericum perforatum extract. Neuropharmacology 47 1189–1197. 10.1016/j.neuropharm.2004.08.010.
• Song, Y., Ridker, P. M., Manson, J. E., Cook, N. R., Buring, J. E., & Liu, S. (2005). Magnesium intake, C-reactive protein, and the prevalence of metabolic syndrome in middle-aged and older U.S. women. Diabetes care, 28(6), 1438–1444. https://doi.org/10.2337/diacare.28.6.1438
• Tarleton, E. K., Littenberg, B., MacLean, C. D., Kennedy, A. G., & Daley, C. (2017). Role of magnesium supplementation in the treatment of depression: A randomized clinical trial. PloS one, 12(6), e0180067. https://doi.org/10.1371/journal.pone.0180067
• Vos T., Abajobir A. A., Abbafati C., Abbas K. M., Abate K. H., Abd-Allah F., et al. (2017). Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 390 1211–1259.
• Wang J., Um P., Dickerman B. A., Liu J. (2018). Zinc, magnesium, selenium and depression: a review of the evidence, potential mechanisms and implications. Nutrients 10:584. 10.3390/nu10050584
• Widmer, J., Bovier, P., Karege, F., Raffin, Y., Hilleret, H., Gaillard, J. M., et al. (1992). Evolution of blood magnesium, sodium and potassium in depressed patients followed for three months. Neuropsychobiology, 26(4), 173–179. https://doi.org/10.1159/000118914
• Widmer J, Henrotte JG, Raffin Y, Bovier P, Hilleret H, Gaillard JM. (1995). Relationship between erythrocyte magnesium, plasma electrolytes and cortisol, and intensity of symptoms in major depressed patients. J Affectiv Disorder 34(3), 201–209. https://doi.org/10.1016/0165-0327(95)00018-i