Depression correlates positively with elevated levels of oxidative stress and chronic systemic inflammation. It is not clear whether the oxidative stress and inflammation contribute to the development of depression or the depression is a contributing cause to higher levels of oxidative stress and inflammation.
Patients with depression have lower levels of Coenzyme Q10. Supplementation may help.
In either case, two things are known [Maes 2009 p. 462]:
- Plasma CoQ10 concentrations are significantly lower in depressed patients than in normal controls. CoQ10 levels are notably lower in patients with treatment-resistant depression and in patients with chronic fatigue syndrome. The lower CoQ10 concentrations may play a role in the pathophysiology of depression.
- Coenzyme Q10 is a strong antioxidant that our bodies produce naturally. It has anti-inflammatory effects. Depressed patients may benefit from Coenzyme Q10 supplementation
The levels of Coenzyme Q10 in our bodies decrease as we get older and whenever we take certain medications such as statin drugs and bisphosphonates. Supplementation may be necessary to make up for the decrease.
Clinical research results indicate that CoQ10 supplementation may be beneficial for individuals with heart conditions and low-energy syndromes, with migraine headaches, and with demanding exercise programs [Mayo Clinic 2024; Maes 2009, p. 462; Maes 2009, p. 470].
To date, there have been relatively few clinical studies of the effect of CoQ10 supplementation on patients with depression. Let’s take a look at what has been done.
Coenzyme Q10 and Moderate and Severe Depression
Majmasanaye 2024
In 2024, Majmasanaye et al reported on a randomized controlled trial that enrolled 69 patients with moderate and severe depression. The researchers administered a daily dose of Coenzyme Q10 200 mg or placebo for eight weeks to the patients who were also receiving conventional treatments for depression. At four and eight weeks, they used scores on the Montgomery-Asberg Depression Rating Scale to evaluate the patients’ depression [Majmasanaye 2024].
- After eight weeks of CoQ10 adjuvant treatment, there was a statistically significant reduction in depression symptoms. There was no significant depression symptom reduction in the patients in the placebo group.
- The researchers concluded that 200 mg/day of Coenzyme Q10 as an adjuvant treatment can reduce depression and fatigue and can improve the quality of life of patients with depression.
Coenzyme Q10 and Bipolar Disorder
Mehrpooya 2018
In a 2018 RCT, Mehrpooya et al administered adjuvant Coenzyme Q10 (200 mg/day) or placebo to patients with bipolar disorder who were presenting with depression at the time of the study. The patients were being treated with antidepressants and mood stabilizers.
Mehrpooya et al randomly assigned the patients to a CoQ10 adjuvant treatment group or to a placebo adjuvant treatment group. They administered the Coenzyme Q10 or the placebo to the patients for two months. To evaluate a possible effect of the adjuvant treatment, they used the patients’ scores on the Montgomery-Asberg Depression Rating Scale at baseline, in the fourth week, and in the eighth week of the study.
Over the eight-week period, the symptoms of depression decreased in both groups. However, the adjuvant CoQ10 treatment group showed improved symptoms of depression after eight weeks of treatment that were statistically significant compared to the level of depression at the start of the study. The same was not true of the placebo adjuvant treatment.
The adjuvant CoQ10 treatment was well-tolerated. It had minimal adverse effects. Over a period of eight weeks, Coenzyme Q10 improved the symptoms of depression. The improvement may have been an outcome of Coenzyme Q10’s antioxidant and anti-inflammatory properties [Mehrpooya 2018; Jahangard 2019].
Forester 2015
In 2015, Forester et al administered 800 mg/day Coenzyme Q10 to 80 bipolar depression patients, aged 55 years or older, for four weeks in an open label study, i.e., no placebo group. The patients were receiving conventionally prescribed medication.
The researchers assessed the effect of the CoQ10 supplementation on the patients’ depressive symptoms using the Montgomery-Asberg Depression Rating Scale. They controlled for such possibly confounding variables as age, sex, and statin use. They reported that the CoQ10 supplementation was associated with a significant reduction in the patients’ depressive symptoms scores from baseline through week 4 of the study. They observed no serious or unexpected adverse events [Forester 2015].
Coenzyme Q10 and Depression in Fibromyalgia Patients
Alcocer-Gomez 2014
A 40-day randomized controlled trial enrolling fibromyalgia patients has shown that CoQ10 supplementation can have a therapeutic effect. CoQ10 supplementation, compared to placebo, significantly reduced the severity of fatigue, pain, and morning tiredness [Cordero 2013].
In 2014, Alcocer-Gomez and Cordero reported further on the administration of Coenzyme Q10 (300 mg/day in three daily doses of 100 mg) or placebo to 20 women diagnosed with fibromyalgia for 40 days. At the beginning of the study, when compared to healthy controls, the fibromyalgia patients had significantly reduced levels of Coenzyme Q10 and serotonin in blood platelets.
Alcocer-Gomez and Cordero reported that the CoQ10 treatment restored Coenzyme Q10 and serotonin levels in the platelets of the fibromyalgia patients. They observed a significant improvement in the fibromyalgia patients’ depressive symptoms in the Coenzyme Q10-treated group but not in the placebo group [Alcocer-Gomez 2014].
The study results indicate that CoQ10 deficiency may affect serotonin content, transmission, and function. Sufficient CoQ10 status may contribute to the normal regulation of the bioenergetics status in platelets as well as in other cells such as the neurons of the central nervous system [Alcocer-Gomez 2014].
Coenzyme Q10 and Chronic Fatigue Syndrome
Maes 2009
Compared with healthy subjects, patients with chronic fatigue syndrome have lower plasma levels of Coenzyme Q10 (Maes 2009, p. 470; Maes 2009, p. 462). There is an inverse relationship between plasma CoQ10 levels and fatigue severity (Maes 2009, p. 470).
Castro-Marrero 2015, 2021
In randomized controlled trials, CoQ10 supplementation has reduced fatigue in patients with chronic fatigue syndrome [Castro-Marrero 2015; Castro-Marrero 2021].
Conclusion: CoQ10 Deficiency and Depression
Plasma concentrations of Coenzyme Q10 tend to be significantly lower in depressed patients than in normal controls.
In patients with treatment-resistant depression and patients with chronic fatigue syndrome, plasma CoQ10 concentrations are significantly lower.
Depressed patients may benefit from CoQ10 supplementation.
It is important to find a CoQ10 supplement with scientifically documented absorption and bioavailability.
Not all CoQ10 supplements are equally well absorbed.
Buying a cheap but poorly formulated CoQ10 can be a waste of money.
Sources
Alcocer-Gómez E, Sánchez-Alcázar JA, Cordero MD. Coenzyme Q10 regulates serotonin levels and depressive symptoms in fibromyalgia patients: results of a small clinical trial. J Clin Psychopharmacol. 2014 Apr;34(2):277-8.
Castro-Marrero J, Segundo MJ, Lacasa M, Martinez-Martinez A, Sentañes RS, Alegre-Martin J. Effect of dietary Coenzyme Q10 plus NADH supplementation on fatigue perception and health-related quality of life in individuals with myalgic encephalomyelitis/chronic fatigue syndrome: a prospective, randomized, double-blind, placebo-controlled trial. Nutrients. 2021 Jul 30;13(8):2658.
Castro-Marrero J, Cordero MD, Segundo MJ, Sáez-Francàs N, Calvo N, Román-Malo L, Aliste L, Fernández de Sevilla T, Alegre J. Does oral coenzyme Q10 plus NADH supplementation improve fatigue and biochemical parameters in chronic fatigue syndrome? Antioxid Redox Signal. 2015 Mar 10;22(8):679-85.
Cordero MD, Alcocer-Gómez E, de Miguel M, Culic O, Carrión AM, Alvarez-Suarez JM, Bullón P, Battino M, Fernández-Rodríguez A, Sánchez-Alcazar JA. Can coenzyme q10 improve clinical and molecular parameters in fibromyalgia? Antioxid Redox Signal. 2013 Oct 20;19(12):1356-61.
Forester BP, Harper DG, Georgakas J, Ravichandran C, Madurai N, Cohen BM. Antidepressant effects of open label treatment with Coenzyme Q10 in geriatric bipolar depression. J Clin Psychopharmacol. 2015 Jun;35(3):338-40.
Jahangard L, Yasrebifar F, Haghighi M, Ranjbar A, Mehrpooya M. Influence of adjuvant Coenzyme Q10 on inflammatory and oxidative stress biomarkers in patients with bipolar disorders during the depressive episode. Mol Biol Rep. 2019 Oct;46(5):5333-5343.
Maes M, Mihaylova I, Kubera M, Uytterhoeven M, Vrydags N, Bosmans E. Lower plasma Coenzyme Q10 in depression: a marker for treatment resistance and chronic fatigue in depression and a risk factor to cardiovascular disorder in that illness. Neuro Endocrinol Lett. 2009;30(4):462-9.
Maes M, Mihaylova I, Kubera M, Uytterhoeven M, Vrydags N, Bosmans E. Coenzyme Q10 deficiency in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is related to fatigue, autonomic and neurocognitive symptoms and is another risk factor explaining the early mortality in ME/CFS due to cardiovascular disorder. Neuro Endocrinol Lett. 2009;30(4):470-6.
Majmasanaye M, Mehrpooya M, Amiri H, Eshraghi A. Discovering the potential value of Coenzyme Q10 as an adjuvant treatment in patients with depression. J Clin Psychopharmacol. 2024 May-Jun 01;44(3):232-239.
Mayo Clinic. Coenzyme Q10. Mayo Foundation for Medical Education and Research. 2024. Retrieved from https://www.mayoclinic.org/drugs-supplements-coenzyme-q10/art-20362602
Mehrpooya M, Yasrebifar F, Haghighi M, Mohammadi Y, Jahangard L. Evaluating the effect of Coenzyme Q10 augmentation on treatment of bipolar depression: a double-blind controlled clinical trial. J Clin Psychopharmacol. 2018 Oct;38(5):460-466.
The information presented in this review article is not intended as medical advice. It should not be used as such.
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