Effects of ascorbic acid on anxiety state and affect in a non-clinical sample

• Autorzy: Moritz B. , Schwarzbold M.L. , Guarnieri R. , Diaz A.P. , Rodrigues A.L.S. , Dafre A.L.
• Języki publikacji: EN

Abstrakty

EN

Objective Given that the literature data indicates that ascorbic acid may have an anxiolytic effect, we hypothesized that a single oral administration of ascorbic acid could acutely affect emotional states. Methods The effects of acid ascorbic supplementation on anxiety and other emotional states were evaluated by the State‑Trait Anxiety Inventory (STAI), and Visual Analogue Mood Scale (VAMS). Immediately before, and 2 hours after receiving a single ascorbic acid dose (1000 mg) or placebo, 142 graduate students were evaluated by the STAI and VAMS in a randomized, double‑blind, placebo‑controlled trial. Results No changes from basal levels were observed in the STAI state‑anxiety or VAMS scores. However, the ingestion of ascorbic acid by the 25% more anxious healthy subjects (women; 14 control and 23 ascorbic acid), as defined by the STAI trait‑anxiety scale, produced a significant reduction from baseline anxiety scores in the STAI state‑anxiety scale and VAMS anxiety subscale. The study evaluated a small sample with narrow sociodemographic characteristics, composed mainly of healthy young females (> 94%) enrolled in post‑graduation courses, without controlling diet, physical activity, and formal psychiatric diagnosis. Conclusions: Despite the sample size limitation, this study provides the first evidence of an acute anxiolytic effect of ascorbic acid. Broader population studies are required to evaluate the clinical relevance of presented data.

• Wydawca: -
• Czasopismo: Acta Neurobiologiae Experimentalis
• Rocznik: 2017
• Tom: 77
• Numer: 4
• Opis fizyczny: p.p.362-372,fig.,ref.

Twórcy

autor

Moritz B.

• Department of Biochemistry, Federal University of Santa Catarina, 88040‑900, Florianopolis, SC, Brazil

autor

Schwarzbold M.L.

• Department of Internal Medicine, Federal University of Santa Catarina, 88040‑900, Florianopolis, SC, Brazil

autor

Guarnieri R.

• University Hospital, Federal University of Santa Catarina, 88040‑900, Florianopolis, SC, Brazil

autor

Diaz A.P.

• Department of Internal Medicine, Federal University of Santa Catarina, 88040‑900, Florianopolis, SC, Brazil
• 1University Hospital, Federal University of Santa Catarina, 88040‑900, Florianopolis, SC, Brazil

autor

Rodrigues A.L.S.

• Department of Biochemistry, Federal University of Santa Catarina, 88040‑900, Florianopolis, SC, Brazil

autor

Dafre A.L.

• Department of Biochemistry, Federal University of Santa Catarina, 88040‑900, Florianopolis, SC, Brazil

Bibliografia

• American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (5th ed.). Amr M, El‑Mogy A, Shams T, Vieira K, Lakhan SE (2013) Efficacy of vitamin C as an adjunct to fluoxetine therapy in pediatric major depressive disorder: a  randomized, double‑blind, placebo‑controlled pilot study. Nutr. J. 12: 31.
• Asher M, Asnaani A, Aderka IM (2017) Gender differences in social anxiety disorder: A review. Clin. Psychol. Rev. 56: 1–12.
• Baldwin DS, Anderson IM, Nutt DJ, Allgulander C, Bandelow B, den Boer JA, Christmas DM, et al. (2014) Evidence‑based pharmacological treat‑ ment of anxiety disorders, post‑traumatic stress disorder and obses‑ sive‑compulsive disorder: a  revision of the 2005 guidelines from the British Association for Psychopharmacology. J. Psychopharmacol 28(5): 403–439.
• Baldwin DS, den Boer JA, Lyndon G, Emir B, Schweizer E, Haswell H (2015) Efficacy and safety of pregabalin in generalised anxiety disorder: A critical review of the literature. J. Psychopharmacol. Oxf. Engl. 29(10): 1047–1060.
• Bandelow B, Reitt M, Röver C, Michaelis S, Görlich Y, Wedekind D (2015) Efficacy of treatments for anxiety disorders: a meta‑analysis. Int. Clin. Psychopharmacol. 30(4): 183–192.
• Baxter AJ, Vos T, Scott KM, Ferrari AJ, Whiteford HA (2014) The global burden of anxiety disorders in 2010. Psychol. Med. 44(11): 2363–2374.
• Biaggio AM, Natalício L, Spielberger CD (1977) Desenvolvimento da forma experimental em português do Inventário de Ansiedade Traço‑Estado (IDATE) de Spielberger. Arq Bras Psic Apl 29(30): 31–41.
• Binfaré RW, Rosa AO, Lobato KR, Santos ARS, Rodrigues ALS (2009) Ascorbic acid administration produces an antidepressant‑like effect: Evidence for the involvement of monoaminergic neurotransmission. Prog. Neuropsychopharmacol. Biol. Psychiatry 33(3): 530–540.
• Bishop SJ (2009) Trait anxiety and impoverished prefrontal control of attention. Nat. Neurosci. 12(1): 92–98.
• Blanchard J (1991) Effects of gender on vitamin C pharmacokinetics in man. J. Am. Coll. Nutr. 10(5): 453–459.
• Botega N, Pondé  M, Medeiros P, Lima  M, Guerreiro C (1998) Validação da escala hospitalar de ansiedade e depressão (HAD) em pacientes epilépticos ambulatoriais. J Bras Psiquiatr. 1998;47(6): 285–9. J Bras Psiquiatr 47(6): 285–289.
• Brody S (2002) High‑dose ascorbic acid increases intercourse frequency and improves mood: a  randomized controlled clinical trial. Biol. Psychiatry 52(4): 371–374.
• Bystritsky A (2006) Treatment‑resistant anxiety disorders. Mol. Psychiatry 11(9): 805–814.
• Carr AC, Bozonet SM, Vissers MCM (2013) A Randomised Cross‑Over Pharmacokinetic Bioavailability Study of Synthetic versus Kiwifruit‑Derived Vitamin C. Nutrients 5(11): 4451–4461.
• Carr AC, Vissers MCM (2012) Good nutrition matters: hypovitaminosis C associated with depressed mood and poor wound healing. N. Z. Med. J. 125(1362): 107–109.
• Cloos JM, Ferreira  V (2009) Current use of benzodiazepines in anxiety disorders. Curr. Opin. Psychiatry 22(1): 90–95.
• Culpepper  L (2009) Generalized anxiety disorder and medical illness. J. Clin. Psychiatry 70 Suppl 2: 20–24.
• Cuthbert BN, Insel TR (2013) Toward the future of psychiatric diagnosis: the seven pillars of RDoC. BMC Med. 11: 126.
• Dell’osso B, Lader M (2013) Do benzodiazepines still deserve a major role in the treatment of psychiatric disorders? A critical reappraisal. Eur. Psychiatry 28(1): 7–20.
• DeSantis J (1993) Scurvy and psychiatric symptoms. Perspect. Psychiatr. Care 29(1): 18–22.
• Ellulu MS, Rahmat A, Patimah I, Khaza’ai H, Abed Y (2015) Effect of vitamin C on inflammation and metabolic markers in hypertensive and/ or diabetic obese adults: a randomized controlled trial. Drug Des. Devel. Ther. 9: 3405–3412.
• Endler NS, Kocovski NL (2001) State and trait anxiety revisited. J. Anxiety Disord. 15(3): 231–245.
• Etkin A, Klemenhagen KC, Dudman JT, Rogan MT, Hen R, Kandel ER, Hirsch J (2004) Individual differences in trait anxiety predict the response of the basolateral amygdala to unconsciously processed fearful faces. Neuron 44(6): 1043–1055.
• Farach FJ, Pruitt LD, Jun JJ, Jerud AB, Zoellner LA, Roy‑Byrne PP (2012) Pharmacological treatment of anxiety disorders: current treatments and future directions. J. Anxiety Disord. 26(8): 833–843.
• Gautam M, Agrawal M, Gautam M, Sharma P, Gautam AS, Gautam S (2012) Role of antioxidants in generalised anxiety disorder and depression. Indian J. Psychiatry 54(3): 244–247.
• Goodwin GM (2015) The overlap between anxiety, depression, and obsessive‑compulsive disorder. Dialogues Clin. Neurosci. 17(3): 249–260.
• Gorenstein C, Andrade L (1996) Validation of a Portuguese version of the Beck Depression Inventory and the State‑Trait Anxiety Inventory in Brazilian subjects. Braz. J. Med. Biol. Res. 29(4): 453–457.
• Gravielle MC (2016) Activation‑induced regulation of GABAA receptors: Is there a  link with the molecular basis of benzodiazepine tolerance? Pharmacol. Res. 109: 92–100.
• Greenberg PE, Sisitsky T, Kessler RC, Finkelstein SN, Berndt ER, Davidson JR, Ballenger JC, Fyer AJ (1999) The economic burden of anxiety disorders in the 1990s. J. Clin. Psychiatry 60(7): 427–435.
• Hajebrahimi B, Kiamanesh A, Asgharnejad Farid AA, Asadikaram G (2016) Type 2 diabetes and mental disorders; a  plausible link with inflammation. Cell. Mol. Biol. 62(13): 71–77.
• Hughes RN, Lowther CL, van Nobelen M (2011) Prolonged treatment with vitamins C and E separately and together decreases anxiety‑related open‑field behavior and acoustic startle in hooded rats. Pharmacol. Biochem. Behav. 97(3): 494–499.
• Insel TR (2014) The NIMH Research Domain Criteria (RDoC) Project: precision medicine for psychiatry. Am. J. Psychiatry 171(4): 395–397.
• Jiang Q (2014) Natural forms of vitamin E: metabolism, antioxidant, and anti‑inflammatory activities and their role in disease prevention and therapy. Free Radic. Biol. Med. 72: 76–90.
• Katzman MA, Bleau P, Blier P, Chokka P, Kjernisted K, Van Ameringen M (2014) Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive‑compulsive disorders. BMC Psychiatry 14(1): 1–83.
• Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush  AJ, Walters EE, Wang PS, National Comorbidity Survey Replication (2003) The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS‑R). JAMA 289(23): 3095–3105.
• Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age‑of‑onset distributions of DSM‑IV disorders in the National Comorbidity Survey Replication. Arch. Gen. Psychiatry 62(6): 593–602.
• Khajehnasiri F, Mortazavi SB, Allameh A, Akhondzadeh S (2013) Effect of omega‑3 and ascorbic acid on inflammation markers in depressed shift workers in Shahid Tondgoyan Oil Refinery, Iran: a  randomized dou‑ ble‑blind placebo‑controlled study. J. Clin. Biochem. Nutr. 53(1): 36–40.
• Kinsman RA, Hood J (1971) Some behavioral effects of ascorbic acid deficiency. Am. J. Clin. Nutr. 24(4): 455–464.
• Lane DJR, Richardson DR (2014) The active role of vitamin C in mammalian iron metabolism: Much more than just enhanced iron absorption! Free Radic. Biol. Med. 75: 69–83.
• Li SH, Graham BM (2017) Why are women so vulnerable to anxiety, trauma‑related and stress‑related disorders? The potential role of sex hormones. Lancet Psychiatry 4(1): 73–82.
• Lopresti AL (2015) A review of nutrient treatments for paediatric depression. J. Affect. Disord. 181: 24–32.
• Majewska MD, Bell JA, London ED (1990) Regulation of the NMDA receptor by redox phenomena: inhibitory role of ascorbate. Brain Res. 537(1–2): 328–332.
• Martinotti G, Lupi M, Sarchione F, Santacroce R, Salone A, De Berardis D, Serroni N, et al. (2013) The potential of pregabalin in neurology, psychiatry and addiction: a  qualitative overview. Curr. Pharm. Des. 19(35): 6367–6374.
• Masand PS, Gupta S (2002) Long‑term side effects of newer‑generation antidepressants: SSRIS, venlafaxine, nefazodone, bupropion, and mirtazapine. Ann. Clin. Psychiatry 14(3): 175–182.
• Mason SA, Baptista R, Della Gatta PA, Yousif A, Russell AP, Wadley GD (2014) High‑dose vitamin C supplementation increases skeletal muscle vitamin C concentration and SVCT2 transporter expression but does not alter redox status in healthy males. Free Radic. Biol. Med. 77: 130–138.
• Mazloom Z, Ekramzadeh  M, Hejazi N (2013) Efficacy of supplementary vitamins C and E on anxiety, depression and stress in type 2 diabetic patients: a randomized, single‑blind, placebo‑controlled trial. Pak. J. Biol. Sci. 16(22): 1597–1600.
• McLean CP, Anderson ER (2009) Brave men and timid women? A review of the gender differences in fear and anxiety. Clin. Psychol. Rev. 29(6): 496–505.
• Moretti M, Budni J, Dos Santos DB, Antunes A, Daufenbach JF, Manosso LM, Farina  M, Rodrigues ALS (2013) Protective effects of ascorbic acid on behavior and oxidative status of restraint‑stressed mice. J. Mol. Neurosci. 49(1): 68–79.
• Moretti M, Budni J, Freitas AE, Neis VB, Ribeiro CM, de Oliveira Balen G, Rieger DK, Leal RB, Rodrigues ALS (2015) TNF‑α‑induced depressive‑like phenotype and p38(MAPK) activation are abolished by ascorbic acid treatment. Eur. Neuropsychopharmacol 25(6): 902–912.
• Moretti  M, Budni J, Freitas AE, Rosa PB, Rodrigues ALS (2014) Antidepressant‑like effect of ascorbic acid is associated with the modulation of mammalian target of rapamycin pathway. J. Psychiatr. Res. 48(1): 16–24.
• Moretti  M, Budni J, Ribeiro CM, Rodrigues ALS (2012a) Involvement of different types of potassium channels in the antidepressant‑like effect of ascorbic acid in the mouse tail suspension test. Eur. J. Pharmacol. 687(1–3): 21–27.
• Moretti  M, Colla A, de Oliveira Balen G, dos Santos DB, Budni J, de Freitas AE, Farina M, Rodrigues ALS (2012b) Ascorbic acid treatment, similarly to fluoxetine, reverses depressive‑like behavior and brain oxidative damage induced by chronic unpredictable stress. J. Psychiatr. Res. 46(3): 331–340.
• Nauser T, Koppenol WH, Schöneich C (2015) Protein thiyl radical reactions and product formation: a kinetic simulation. Free Radic. Biol. Med. 80: 158–163.
• Norris H (1971) The action of sedatives on brain stem oculomotor systems in man. Neuropharmacology 10(21): 181–191. Nutt D, Mandel F, Baldinetti F (2009) Early onset anxiolytic efficacy after a  single dose of pregabalin: double‑blind, placebo‑ and active‑comparator controlled evaluation using a dental anxiety model. J. Psychopharmacol 23(8): 867–873.
• de Oliveira IJL, de Souza VV, Motta V, Da‑Silva SL (2015) Effects of Oral Vitamin C Supplementation on Anxiety in Students: A Double‑Blind, Ran‑ domized, Placebo‑Controlled Trial. Pak. J. Biol. Sci. PJBS 18(1): 11–18.
• Oreopoulos DG, Lindeman RD, VanderJagt DJ, Tzamaloukas AH, Bhagavan HN, Garry PJ (1993) Renal excretion of ascorbic acid: effect of age and sex. J. Am. Coll. Nutr. 12(5): 537–542.
• Perusini JN, Fanselow MS (2015) Neurobehavioral perspectives on the distinction between fear and anxiety. Learn. Mem. 22(9): 417–425.
• Puty B, Maximino C, Brasil A, da Silva WLL, Gouveia A, Oliveira KRM, Batista  E de JO, Crespo‑Lopez ME, Rocha FAF, Herculano AM (2014) Ascorbic acid protects against anxiogenic‑like effect induced by methylmercury in zebrafish: action on the serotonergic system. Zebrafish 11(4): 365–370.
• Rebec GV, Pierce RC (1994) A vitamin as neuromodulator: ascorbate release into the extracellular fluid of the brain regulates dopaminergic and glutamatergic transmission. Prog. Neurobiol. 43(6): 537–565.
• Reiss S (1997) Trait anxiety: it’s not what you think it is. J. Anxiety Disord. 11(2): 201–214.
• Ryu JH, Lee PB, Kim JH, Do SH, Kim CS (2012) Effects of pregabalin on the activity of glutamate transporter type 3. Br. J. Anaesth. 109(2): 234–239.
• Schoenfeld JD, Sibenaller ZA, Mapuskar KA, Wagner BA, Cramer‑Morales KL, Furqan M, Sandhu S, et al. (2017) O2⋅− and H2O2‑Mediated Disruption of Fe Metabolism Causes the Differential Susceptibility of NSCLC and GBM Cancer Cells to Pharmacological Ascorbate. Cancer Cell 31(4): 487–500.e8.
• Sorice A, Guerriero E, Capone F, Colonna G, Castello G, Costantini S (2014) Ascorbic acid: its role in immune system and chronic inflammation diseases. Mini Rev. Med. Chem. 14(5): 444–452.
• Spielberger CD, Gorsuch RI, Lushene RE (1970) Manual for the State‑trait Anxiety Inventory (Consulting Psychologists Press, Palo Alto, CA). Starcevic V (2014) The reappraisal of benzodiazepines in the treatment of anxiety and related disorders. Expert Rev. Neurother. 14(11): 1275–1286.
• Tovote P, Fadok JP, Lüthi A (2015) Neuronal circuits for fear and anxiety. Nat. Rev. Neurosci. 16(6): 317–331.
• Traber MG (2007) Vitamin E regulatory mechanisms. Annu. Rev. Nutr. 27: 347–362.
• Uzun S, Kozumplik O, Jakovljević M, Sedić B (2010) Side effects of treatment with benzodiazepines. Psychiatr. Danub. 22(1): 90–93.
• Verhamme C, de Haan RJ, Vermeulen M, Baas F, de Visser M, van Schaik IN (2009) Oral high dose ascorbic acid treatment for one year in young CMT1A patients: a randomised, double‑blind, placebo‑controlled phase II trial. BMC Med. 7: 70.
• Veskoukis AS, Goutianos G, Paschalis V, Margaritelis NV, Tzioura A, Dipla K, Zafeiridis A, Vrabas IS, Kyparos A, Nikolaidis MG (2016) The rat closely mimics oxidative stress and inflammation in humans after exercise but not after exercise combined with vitamin C administration. Eur. J. Appl. Physiol. 116(4): 791–804.
• Viana MC, Andrade LH (2012) Lifetime Prevalence, age and gender distribution and age‑of‑onset of psychiatric disorders in the São Paulo Metropolitan Area, Brazil: results from the São Paulo Megacity Mental Health Survey. Rev. Bras. Psiquiatr. 34(3): 249–260.
• Xu P, Gu R, Broster LS, Wu R, Van Dam NT, Jiang Y, Fan J, Luo Y jia (2013) Neural basis of emotional decision making in trait anxiety. J. Neurosci. 33(47): 18641–18653.
• Yusa T (2001) Increased extracellular ascorbate release reflects glutamate re‑uptake during the early stage of reperfusion after forebrain ischemia in rats. Brain Res. 897(1–2): 104–113.
• Zhang M, Robitaille L, Eintracht S, Hoffer LJ (2011) Vitamin C provision improves mood in acutely hospitalized patients. Nutrition 27(5): 530–533.
• Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr. Scand. 67(6): 361–370.
• Zomkowski ADE, Engel D, Cunha MP, Gabilan NH, Rodrigues ALS (2012) The role of the NMDA receptors and l‑arginine‑nitric oxide‑cyclic guanosine monophosphate pathway in the antidepressant‑like effect of duloxetine in the forced swimming test. Pharmacol. Biochem. Behav. 103(2): 408–417.
• Zuardi A, Karniol IG (1981) Estudo transcultural de uma escala de auto‑avaliação para estados subjetivos. J Bras Psiquiatr 30(5): 403–406.
• Zuardi AW, Cosme RA, Graeff FG, Guimarães FS (1993) Effects of ipsapirone and cannabidiol on human experimental anxiety. J. Psychopharmacol 7(1 Suppl): 82–88.