The most popular prescriptions for depression are SSRIs or TCAs (tricyclic antidepressants), while the most common prescriptions for anxiety are benzodiazepines.

All of these medications have a plethora of side effects that are undesirable. The goal for this article is to introduce a natural and safe alternative for anxiety and depression with minimal or no side effects.

My purpose is not to say that the aforementioned pharmaceutical treatments are unnecessary or always ineffective. On the other hand, I do not see why one would not try something like niacinamide for anxiety or depression as a first option before moving onto drugs with a much greater side effect profile.

There are currently millions of people with anxiety that are on benzodiazepines like xanax (alprazolam), clonazepam (Klonopin), clorazepate (Tranxene), chlordiazepoxide (Librium), or diazepam (Valium).

The main issue with taking a benzodiazepine is the rapid tolerance and dependence that can develop from taking it on a daily basis. Anyone who has tried to get off of a benzo has felt the pronounced anxiety and suffering that accompanies the withdrawal. For many, a benzo withdrawal is the worst form of withdrawal that they have ever experienced.

The dependence issue is unfortunate, because this means that the people with anxiety will feel even more anxiety than usual if they miss a dose that they have become accustomed to. Other side effects of prolonged benzodiazepine use can be cognitive dysfunction or memory issues and sleep problems if not taken for sleep.

While the main issue with benzos is dependence, there are a whole host of common side effects that can occur from SSRIs or TCAs. I won’t go over every one in detail here, but here is a brief list:(1, 2)

  • Drowsiness
  • Nausea
  • Dry mouth
  • Insomnia
  • Diarrhea
  • Nervousness, agitation or restlessness
  • Dizziness
  • Sexual problems, such as reduced sexual desire or difficulty reaching orgasm or inability to maintain an erection (erectile dysfunction)
  • Headache
  • Blurred vision
  • Increased appetite leading to weight gain
  • Weight loss
  • Excessive sweating
  • Tremor

Some may need to take these drugs in spite of their side effects, yet many be able to find relief through safer means.

NOTE: Please talk with your healthcare provider before starting any new supplements. Never stop prescribed medication without talking to your doctor first! This article is for information purposes only and is not medical advice for you.

How Does Niacinamide Decrease Anxiety?

All the way back in 1979 we knew that niacinamide was able to relax animals and had “Benzodiazepine-like actions” (benzodiazepines are drugs such as Xanax and Valium commonly used to treat anxiety).(3) In fact, it was later shown that niacinamide actually binds to an atypical part of the benzodiazepine receptor.(4) Niacinamide was shown to have anxiolytic (anti-anxiety) properties in a variety of animal studies.(5, 6, 7) The animals were always calmer, were less prone to get angry, and were somewhat protected from stressful situations.

There have been a ton of anecdotal reports over the years raving about the effect of niacin or niacinamide to help with their depression or anxiety. You can read a bunch here, and you can read about a doctor’s experience with using niacinamide for decades here.

Orthomolecular physicians (doctors who utilize vitamins and minerals, sometimes in very large doses, to help with diseases and pathology) have found success with niacinamide to treat anxiety (see here(10), here(11), here(12), and here(13))

Unfortunately, there haven’t been any recent studies to further delve into the connection between niacinamide and anxiety. At this point, it is worth trying as a conservative treatment option before moving onto harsher drugs in my opinion.

How does niacin work for depression?

(Psssst…! Check out my recommended brands for niacin and niacinamide so you don’t get confused and get the wrong kind!)

Back in 1953, it was reported that niacin was effective at relieving depression in 14 out of 15 patients.(8) However, this study didn’t have a control group and was performed a long time ago, so it would be nice to have some recent data. Unfortunately, no one seems interested in funding any research on the connection between niacin and depression. Theoretically, it makes sense that niacin can help alleviate depression based on the broad anti-inflammatory effects of niacin on the brain.(9)

Anecdotally, there are many reports of niacin working quite well for depression. Read here.

While there isn’t as much research done with niacin and depression, an improvement in mood is a common feature with niacin supplementation, and the side effects from trying niacin would be small to negligible.

Based on the available data, both niacin and niacinamide can work for anxiety, although in my opinion, niacinamide would likely work a bit better than niacin. However, niacin is likely the only type to work for depression.

You can try both and see which one fits you better. Remember than regular niacin has a flushing effect, so you will get very red and itchy when you first start taking niacin. However, if you continue with niacin everyday and you split the dose into three servings, then the flush will lessen and almost or completely disappear in a week or so. Niacinamide does not make you flush.

Please be aware that while niacin/niacinamide have helped many people with depression and especially anxiety on their own, most of the time a complete program utilizing a whole-food diet, other vitamins like vitamin C and B6, minerals such as magnesium and zinc, and sometimes herbs like ashwagandha, lemon balm, black cumin seed oil etc. is more effective and sometimes necessary to completely resolve the underlying issue. Most patients are able to reduce the supplements to the basics (like vitamin C and niacinamide and possibly magnesium) along with a good diet once their symptoms get under control. It is always best to work with an experienced health care practitioner for these issues; this will result in faster resolution and safer treatments.

Please comment below if you have any questions or if you have experience taking niacin or niacinamide for any type of mood disorders. I would love to hear from you!

References

  1. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825
  2. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046983
  3. Möhler H, Polc P, Cumin R, Pieri L, Kettler R. Nicotinamide is a brain
    constituent with benzodiazepine-like actions. Nature. 1979 Apr 5;278(5704):563-5.
    PubMed PMID: 155222.
  4. Lapin IP. Dissimilar effects of nicotinamide and inosine, putative endogenous
    ligands of the benzodiazepine receptors, on pentylenetetrazol seizures in four
    strains of mice. Pharmacol Biochem Behav. 1980 Sep;13(3):337-41. PubMed PMID:
    6252561.
  5. Akhundov RA, Voronina TA. [Nootropic and anxiolytic properties of endogenous
    ligands of benzodiazepine receptors and their structural analogs]. Biull Eksp
    Biol Med. 1984 Feb;97(2):174-7. Russian. PubMed PMID: 6141825.
  6. Akhundov RA, Sultanov AA, Gadzhily RA, Sadykhov RV. [Psychoregulating role of
    nicotinamide]. Biull Eksp Biol Med. 1993 May;115(5):487-91. Russian. PubMed PMID:
    7913840.
  7. Akhundov RA, Zagorevskiĭ VA, Voronina TA. [Nootropic activity of nicotinamide
    and its structural analogs]. Biull Eksp Biol Med. 1990 Oct;110(10):384-6.
    Russian. PubMed PMID: 2149078.
  8. TONGE WL. Nicotinic acid in the treatment of depression. Ann Intern Med. 1953
    Mar;38(3):551-3. PubMed PMID: 13031399.
  9. Hoane MR, Akstulewicz SL, Toppen J. Treatment with vitamin B3 improves
    functional recovery and reduces GFAP expression following traumatic brain injury
    in rats. J Neurotrauma. 2003 Nov;20(11):1189-99. PubMed PMID: 14651806.
  10. Supplemental Niacinamide Mitigates Anxiety Symptoms: Three Case Reports. Jonathan E. Prousky, N.D., FRSH1
  11. Niacinamide’s Potent role in Alleviating Anxiety with its Benzodiazepine-like
    Properties: A Case Report. Jonathan E. Prousky, N.D., FRSH1
  12. Treatment of Chronic Anxiety and Associated Physical Complaints with Niacinamide and Essential Fatty Acids: Two Cases. Jonathan Wright, M.D.1
  13. Clinical Experiences with a Vitamin B3 Dependent Family. Jonathan E. Prousky, N.D., FRSH1

2 Comments

Chaela Marie · April 24, 2020 at 9:27 pm

Thank you for this article … I am long time Clonopin user .. . prescribed for intermittent panic disorder and essential tremor. Finding a physician to assist me in safely withdrawing has been impossible … few doctors understand pharmacology. Hit upon nicotinamide for sleep
assistance four months ago & within a few days reduced clonopin (my only rx) by 1/3. Am self experimenting to reduce by another third within 4 months.
This info needs to reach the many people needing sound health care advice — it’s not available in US outside of a few major medical research centers.

    Dr. Sean Golden · July 28, 2020 at 12:17 am

    I’m so glad to hear the niacinamide seems to be helping you! Niacinamide can be taken in large doses long term as long as you supplement with trimethylglycine to replenish the methyl groups.

    I with there was more support for these types of treatments as well. Unfortunately, orthomolecular medicine (using vitamins in high doses for various conditions) will never become widespread as it doesn’t stand to make much money compared to pharmaceuticals that can be patented.

    Don’t hesitate to ask any questions here or leave any updates!

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