Therapeutic Potential of Saffron in Depression: A Critical Appraisal of Clinical Evidence

Öz

Saffron (Crocus sativus L.) has attracted increasing scientific interest because of its potential antidepressant effects. Randomized controlled trials suggest that saffron may be superior to placebo for mild-to-moderate depressive symptoms, while several short-term studies have reported outcomes broadly similar to fluoxetine, sertraline, citalopram, and imipramine. This review does not simply summarize efficacy data; it critically examines why positive efficacy signals have not yet translated into a well-defined clinical recommendation. Recent meta-analyses show an important discrepancy between significant improvements on self-reported measures such as the Beck Depression Inventory and less consistent findings on clinician-rated Hamilton Depression Rating Scale scores. Furthermore, most head-to-head comparisons with antidepressants were not designed as formal equivalence or non-inferiority trials. Heterogeneity in saffron preparations, active constituent concentrations, plant parts, doses, and standardization methods further limits generalizability. Current evidence supports saffron as a promising phytotherapeutic option, particularly for mild-to-moderate depressive symptoms and potentially as an adjunct to conventional treatment. However, its precise place in evidence-based depression care remains uncertain. Well-powered, multicenter, long-term randomized trials using chemically standardized preparations and clinically meaningful outcomes are required before saffron can be considered an established alternative to conventional antidepressants.

Anahtar Kelimeler

• Saffron
• Crocus sativus
• depression
• antidepressant
• crocin
• phytotherapy

Safranın Depresyondaki Terapötik Potansiyeli: Klinik Kanıtların Eleştirel Değerlendirilmesi

Öz

Safran (Crocus sativus L.), depresif belirtiler üzerindeki potansiyel etkileri nedeniyle son yıllarda giderek artan sayıda klinik araştırmaya konu olmuştur. Randomize kontrollü çalışmalar, safranın özellikle hafif ve orta şiddette depresyonda plaseboya üstün olabileceğini; bazı kısa süreli çalışmalarda ise fluoksetin, sertralin, sitalopram ve imipramin gibi antidepresanlarla benzer sonuçlar verebildiğini düşündürmektedir. Bu derlemenin amacı, safranın yalnızca etkinlik verilerini özetlemek değil, olumlu etkinlik sinyallerinin neden henüz güçlü ve standartlaştırılmış bir klinik öneriye dönüşmediğini eleştirel olarak değerlendirmektir. Güncel meta-analizlerde Beck Depresyon Ölçeği gibi öz-bildirim araçlarında anlamlı iyileşme bildirilmesine karşın, klinisyen tarafından değerlendirilen Hamilton Depresyon Ölçeği sonuçlarının aynı tutarlılığı göstermemesi önemli bir kanıt uyumsuzluğuna işaret etmektedir. Ayrıca antidepresanlarla yapılan karşılaştırmaların çoğu formal eşdeğerlik veya non-inferiority tasarımında değildir. Preparatların aktif bileşenleri, kullanılan bitki bölümü, dozları ve standardizasyon yöntemlerindeki farklılıklar da genellenebilirliği sınırlandırmaktadır. Mevcut kanıtlar safranın özellikle hafif-orta depresif belirtilerde ve tamamlayıcı tedavi yaklaşımında umut verici olabileceğini göstermektedir. Bununla birlikte standart antidepresanların kanıtlanmış bir alternatifi olarak kabul edilmeden önce daha güçlü, uzun süreli ve standardize çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Safran
• Crocus sativus
• depresyon
• antidepresan
• krosin
• fitoterapi

Kaynakça

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