Food and Behaviour Research

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Vitamin D as potential antidepressant in outpatients with musculoskeletal pain

Abdul-Razzak KK, Mayyas FA, Al-Farras MI (2018) Int J Clin Pharmacol Ther.  2018 Sep;56(9): 400-410. doi: 10.5414/CP203252. 

Web URL: Read this and related abstracts on PubMed here



To determine the incidence of vitamin D deficiency, anxiety, and depression disorders in an outpatient population with musculoskeletal pain (MSP), and to evaluate the effects of correcting a vitamin D deficiency on MSP and psychological symptoms.


A total of 261 outpatients with MSP and 100 controls were involved. The Hospital Anxiety and Depression Scale (HADS) was used to assess psychological symptoms. Serum vitamin D was measured. Outpatients with vitamin D insufficiency and deficiency received oral vitamin D supplementation. Pain severity and psychological symptoms were evaluated before and after vitamin D supplementation plus dairy products.


Vitamin D deficiency was found in 88.7% of participants in the MSP group and 69% of controls.

Clinical anxiety was reported by 38.3% of participants in the MSP group and 9% of controls, while clinical depression was reported by 31.8% of participants in the MSP group and 2% of controls.

Multisite pain was significantly and positively associated with anxiety, depression, and pain severity, and was inversely associated with daily calcium intake. Anxiety was inversely associated with vitamin D level, daily calcium intake, and age. A similar pattern was observed for depression.  MSP was the most significant independent predictor of anxiety (OR = 7.84) and depression (OR = 5.89).

Relative to baseline, all measured outcome parameters significantly improved after vitamin D supplementation plus increased intake of dairy products.


Low serum vitamin D is associated with Musculo-Skeletal Pain, along with low calcium intake, depression, and anxiety. Supplementation with vitamin D improved MSP and associated disorders.


In adults with musculo-skeletal pain, high levels of Vitamin D deficiency and low dietary calcium intakes were found in this study of outpatients, along with high rates of both anxiety and depression.

Strong links were found between pain and mental health symptoms, which were each also associated with low Vitamin D levels.

Both the patients' pain and their anxious and depressive symptoms improved following dietary supplementation with Vitamin D and advice to increase intakes of milk and dairy products (as a good source of calcium).

This was only an open study, with no placebo control group, so no definitive conclusions can be drawn about causal effects of the intervention. However, these findings clearly merit further investigation in properly controlled clinical trials.

Musculo-skeletal pain, depression and anxiety are all extremely common conditions seen in general practice - and even the best current treatments are ineffective in many cases, and/or have undesirable side-effects.

For more information on Vitamin D and Depression, please see the following lists, which are regularly updated: