Would Magnesium Help Depression ?

Recent article suggests Magnesium might help depression but has more theoretical than actual data to prove it

Med Hypotheses. 2010 Apr;74(4):649-60.
Magnesium for treatment-resistant depression: a review and hypothesis.
Eby GA 3rd, Eby KL. abstract here

Their clinical studies:

• Weston PG. Magnesium as a sedative. Am J Psychiatry 1921–22;1:637–8.
  “Magnesium Sulfate (one or two cc of a 25% or 50% solution) given hypodermically to 50 patients having agitated depression in 1921 caused patients to relax and sleep from 4 to 6 h resulting in a 90% success rate for magnesium” – Sounds like the effect you would expect for Mag Sulphate given for pre-seizures in toxemia – not sure this represents antidepressant effects though
  
• Intern Med. 2004 May;43(5):410-4.
  Depressive state and paresthesia dramatically improved by intravenous MgSO4 in Gitelman’s syndrome.
  Enya M, Kanoh Y, Mune T, Ishizawa M, Sarui H, Yamamoto M, Takeda N, Yasuda K,
  Yasujima M, Tsutaya S, Takeda J. free full article
  patient with multiple electrolyte abnormalities felt better after IV magnesium – that could be described as depression better or more likely just better having low magnesium corrected
  
• Chouinard G, Beauclair L, Geiser R, Etienne P. A pilot study of magnesium
  aspartate hydrochloride (Magnesiocard) as a mood stabilizer for rapid cycling
  bipolar affective disorder patients. Prog Neuropsychopharmacol Biol
  Psychiatry 1990;14:171–80. abstract here
  
  • 9 bipolar cases
  • over period 4 weeks, was given 20 meq/day, increased to 40 meq Magnesium/day using Magnesiocarde (mono-Magnesium L-aspartate hydrochloride trihydrate, (C4H6ClNO4Mg.3H20)
  • “found to be equivalent to lithium in a small group of severe manic-depressive patients, and perhaps superior to lithium in about one third of these patients.”
  • Well, no one in their right mind would not be using atypical anti-psychotics to help prevent swinging nowadays BECAUSE LITHIUM DOES NOT PREVENT HYPOMANIA – so terrible comparison
• Kalinin VV, Zheleznova EV, Rogacheva TA, et al. A use of magnesium and vitamin B6 in the treatment of anxiety–depressive states in patients with epilepsy.
  Zh Nevrol Psikhiatr Im S S Korsakova 2004;104:51–5.
  they state “In tests of magnesium lactate and vitamin B6 (pyridoxine) in the treatment of 25 patients with anxiety–depression and epilepsy, the combination exerted positive non-specific influences on patient’s mental state, especially with regard to affective disorders. The positive effects of magnesium treatment emerged on the 14th day of treatment and achieved a statistically significant level by the 28th day. Treatment was well tolerated and did not cause any side effects
  Well, nonspecific effects don’t count
  
• Barragán-Rodríguez L, Rodríguez-Morán M, Guerrero-Romero F. Efficacy and safety of oral magnesium supplementation in the treatment of depression in the elderly with type 2 diabetes: a randomized, equivalent trial.
  Magnes Res 2008;21:218–23.
  • Took cases already sick with Hypomagnesium (low magnesium) levels
  • Fixed their low magnesium levels and when they felt better said that was relief of depression
  • Compared results to Imipramine 50 mg; – now an antidepressant dose is 150 – 300 mg so 50 mg is just enough to make them sick with side effects but not high enough to actually help them
  • Said magnesium worked better then imipramine – G’d; will someone shoot me…
    

Comment – There was lots of pure science stuff suggesting Magnesium should work. However, there are writings on how low iron individuals with restless legs should get better on Iron but the results have not been that good:

see:    Celiac Disease Could Mean Pain and What About Iron For Restless Legs?

None of above mentioned studies meant much. It could be said that low magnesium could make one feel depressed and fixing that helps.

For that scenario, they suggested

Magnesium Sulphate 20 mEq/day dissolved in 100 ml normal saline given over 2 h each day for 3 days)

comes in 5 gm/10 mls = 4 meq/ml;  so give  5 mls concentrate in: – I would give in at least 250 mls saline or D5W as can make the veins burn.

They suggest following up with oral magnesium.
“125–300 mg 4 t/d’ – some of the studies had real problems with tolerance as can cause diarrhea…

Well, I guess I will check more often for low magnesium especially in diabetics who seem more prone to it (alcoholics do to)

Any comments?