1-year naturalistic follow-up of a Randomised Double-Blind, Placebo-Controlled Trial (“NoMAD”) Exploring the Effectiveness of Micronutrients in Improving Symptoms of Anxiety and Depression

• Acutely, micronutrients speed up recovery from anxiety and depression in adults compared with placebo. • Most participants had either no or mild depression (78 %) and anxiety (85 %) at 1-year regardless of staying on the micronutrients. • Staying on micronutrients did not generally affect long-term outcome. • Health anxiety improved more for those who stayed on micronutrients compared to those who stopped or switched to medications. A randomised controlled trial (NoMAD trial) showed micronutrients led to faster recovery from depression and anxiety compared with placebo. The RCT was followed by a 10 week open-label component and then a one year naturalistic review. This 1-year follow-up of NoMAD explored the association between dominant treatment at 1-year follow-up with psychiatric outcomes. Ninety-four (63 %) of the original 150 NoMAD participants completed 1-year follow-up. Primary outcomes included Generalised Anxiety Disorder-7 questionnaire (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Modified-Clinical Global Impression-Improvements (MCGI-I). Outcomes were explored based on dominant therapy at 1-year follow-up: Micronutrients ( n = 20), Psychiatric Medications ( n = 9), and No Treatment ( n = 56). Nine participants could not be grouped due to mixed treatments at follow-up. Regardless of dominant therapy, participants were functioning significantly better at 1-year compared to baseline. There was little change from end of 10 weeks of open-label micronutrient treatment, with the exception of depression scores, which were significantly lower ( d = 0.4; p <.001). Most participants had either no or mild depression (78 %) and anxiety (85 %) scores at 1-year follow-up. Those who stayed on micronutrients were those who experienced better response at end of open-label compared with those who stopped or switched to medications. They also showed a greater reduction in health anxiety from end of open-label to 1-year follow-up compared with others. The main reason cited for stopping micronutrients was the cost. Limitations include a third of original sample lost to follow-up and uneven group sizes limit generalisability of results. Participants, regardless of long-term supplementation, were functioning well at one year.