CAM (antioxidant, antiinflammatory, modulates serotonin, dopamine, opioid-but non-addictive)

  • Major Depression1
  • Unlike most antidepressants, has evidence in mild and in youth depression.
  • Insomnia (safe in elderly)2
  • ADHD3
  • Cognition (age related3 and dementia3)
  • OCD3
  • Opioid Use (withdrawal and cravings)3
  • SE-weight loss3
  • Sexual dysfunction Female2
  • Sexual dysfunction Male2

Dosing

30 mg/d of product with 2% safranal (the Affron branded extract has most research).

INTERACTIONS: Saffron may raise levels of drugs that are metabolized by CYP3A4. Among psychiatric medications, that includes some antipsychotics (cariprazine, lumateperone, lurasidone, quetiapine, ziprasidone, pimavanserin), citalopram, buspirone, guanfacine, a few benzos, and z-hypnotics (zolpidem, eszopiclone, zaleplon).

Management

Well-studied as monotherapy and augmentation in mild-moderate depression (and subclinical low mood). Lowers side effects of antidepressants when added to them. $12-30/month

Treats depression in 25 RCTs, including specific populations: Youth (12-16), elderly, overweight, postpartum, postmenopausal, post-methamphetamine use, and HIV+. Works in 1-2 months.

Medical Benefits: Diabetes, weight loss, acute stroke, fatty liver disease, macular degeneration, premenstrual syndrome. May prevent cancer, dementia.

TOLERABILITY: fatigue, nausea.

RISKS: Anticoagulation effects.

EMR Text

Depression

Saffron use based on multiple large randomized controlled trials in major depressive disorder, including studies in youth and elderly, as augmentation and monotherapy (Dai L et al, J Nerv Ment Dis. 2020;208(4):269-276).

Saffron side effects, and lab-tested products, reviewed with patient.

Insomnia

Saffron use based on multiple randomized controlled trials in insomnia, where it improved sleep duration and quality, including large trials (Sadat Rafiei SK et al, Nutr Metab Insights. 2023;16).

Saffron side effects, and lab-tested products, reviewed with patient.

OCD

Saffron use based on small, randomized controlled trials in OCD, where it equaled the benefits of fluoxetine and fluvoxamine (Abbaszadeh-Mashkani S et al, Phytother Res. 2021;35(3):1486-1494).

Saffron side effects, and lab-tested products, reviewed with patient.

ADHD

Saffron use based on small, randomized controlled trials in ADHD, where it worked as monotherapy and as augmentation to stimulants (Seyedi-Sahebari S, et al, J Atten Disord. 2024;28(1):14-24).

Saffron side effects, and lab-tested products, reviewed with patient.

Cognition and Dementia

Saffron use based on multiple randomized controlled trials where it improved cognition, including trials in dementia and age-related cognitive decline (Ayati Z et al, BMC Complement Med Ther. 2020;20(1):333).

Saffron side effects, and lab-tested products, reviewed with patient.

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