What is the evidence for magnesium in treating anxiety disorders?

From the Guidelines

Magnesium supplementation shows promising evidence for reducing anxiety symptoms, particularly in those with mild to moderate anxiety or those with low magnesium levels, with a recommended daily dose of 200-400mg. Research indicates that magnesium deficiency is associated with increased anxiety, and supplementation may help alleviate symptoms in some individuals 1. Clinical studies have found that magnesium supplements can reduce anxiety scores, particularly in those with mild to moderate anxiety or those with low magnesium levels. Common forms include magnesium glycinate, which is well-tolerated, or magnesium citrate, though the latter may cause loose stools. For anxiety management, a typical regimen involves taking magnesium daily for at least 6-8 weeks to evaluate effectiveness. Magnesium works by regulating neurotransmitters that affect stress response and may modulate GABA receptors, which have calming effects on the nervous system. It also helps regulate the hypothalamic-pituitary-adrenal (HPA) axis, which controls stress hormones. While generally safe, side effects can include digestive issues, and those with kidney problems should consult a healthcare provider before supplementing.

Some key points to consider when using magnesium for anxiety management include:

• Starting with a low dose and gradually increasing as needed and tolerated
• Choosing a well-tolerated form of magnesium, such as magnesium glycinate
• Being aware of potential side effects, such as digestive issues
• Consulting a healthcare provider before supplementing, especially for those with kidney problems
• Viewing magnesium as a complementary approach to anxiety management, rather than a standalone treatment for severe anxiety disorders.

It's also important to note that the evidence for magnesium in anxiety is based on studies that have investigated its effects in various contexts, including erythromelalgia, where magnesium has been used to treat symptoms 1. However, the most relevant and recent evidence for magnesium in anxiety is limited, and more research is needed to fully understand its effects. Nevertheless, based on the available evidence, magnesium supplementation appears to be a promising complementary approach to anxiety management, and its use can be considered in conjunction with other treatments, such as cognitive behavioral therapy, which is recommended for social anxiety disorder 1.

From the Research

Magnesium and Anxiety

• The relationship between magnesium and anxiety has been explored in several studies, with some indicating a potential benefit of magnesium supplementation in reducing anxiety symptoms 2, 3, 4, 5, 6.
• A systematic review of 18 studies found that magnesium supplementation had a beneficial effect on subjective anxiety in anxiety-vulnerable samples, although the quality of the evidence was poor 4.
• Another systematic review of 32 articles found that magnesium levels were lowered in several mental disorders, including depression and anxiety, and that magnesium supplementation could be beneficial in improving depressive symptoms and reducing anxiety 3.
• A randomized controlled trial found that magnesium supplementation, with or without vitamin B6, improved anxiety and depression scores, as well as quality of life, in stressed healthy adults 5.
• A systematic review of 15 studies found that the majority of included studies demonstrated improvement in at least one sleep- or anxiety-related parameter, with five out of seven studies measuring anxiety-related outcomes reporting improvements in self-reported anxiety 6.

Mechanisms and Dosage

• The exact mechanisms by which magnesium affects anxiety are not fully understood, but it is thought to play a role in mood regulation and neurotransmitter function 2, 3.
• The optimal dosage of magnesium for anxiety reduction is not established, with studies using a range of dosages and formulations 4, 5, 6.
• Some studies suggest that magnesium supplementation may be particularly beneficial in individuals with low magnesium status at baseline 6.

Limitations and Future Directions

• The evidence for the use of magnesium in anxiety is limited by the heterogeneity of the data and the small number of participants involved in most studies 4, 6.
• Further research is needed to confirm the efficacy of magnesium supplementation in reducing anxiety symptoms and to establish the most effective forms and dosages of magnesium for this purpose 3, 4, 6.